Wills Questionnaire

1. Preliminary Matters

YesNo

2. Client Personal Information

Full Name*

Alias/Other Names you have been known by

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Citizenship*

Date of Birth*

Date

Place of Birth*

Civil Status*

3. Spouse / Partner Personal Information

Full Name

Address of Spouse/Partner (if different from the above). Please include the postal code.

Date of Birth

Date

Place of Birth

Citizenship

Date of Marriage

Date

4. Relationship Information

YesNo

If yes, Kindly provide us with a copy in order to determine your estate's obligations (if any) under the same.

YesNo

If yes, please provide the below information of your previous spouse/partner:

Full Name of Previous Spouse/ Partner

Address (please include the postal code)

Date of Death/Divorce/Termination of Relationship

Date

5. Employment Information

Name of Employer*

Address of Employer (please include the postal code)*

Executer(s)' Information

Full Name of Executor*

Address (please include the postal code)*

Relationship to you*

Occupation*

Full Name of Alternative Executor *

Address (please include the postal code)*

Relationship to you*

Occupation*

Disposition of Remains

Burial/Cremation/Funeral Arrangements, etc.*

YesNo

Assets and Finances

A. Real Estate

Property (1)

Address (please include postal code)

Property Description

Estimated Value

YesNo

Acquisition Date

Date

Property (2)

Address (please include postal code)

Property Description

Estimated Value

YesNo

Acquisition Date

Date

Property (3)

Address (please include postal code)

Property Description

Estimated Value

YesNo

Acquisition Date

Date

B. Business Interest

Business (1)

Business Name

Estimated Value

Acquisition Date

Date

Description

Business (2)

Business Name

Estimated Value

Acquisition Date

Date

Description

Business (3)

Business Name

Estimated Value

Acquisition Date

Date

Description

C. Personal Property

Bank Account(s) and Deposits

Bank Name

Account Name

Account Number

Bank Name

Account Name

Account Number

Securities/Bonds/Shares

Name of Institution

Value

Description

Life Insurance

Insurance Company Name

Policy Holder Name

Policy Number

Designated Beneficiary Name

Amount

RRSPs and RRIFs

Plan Issuer

Policy Holder Name

Account Number

Designated Beneficiary Name

Amount

Personal Effects

Named Owner

Description

Specific Requests

Name of Specific Item

To Whom

Address (please include postal code)

Name of Specific Item

To Whom

Address (please include postal code)

Name of Specific Item

To Whom

Address (please include postal code)

Residue

Full Name of Beneficiary*

Relationship*

Address (please include postal code)*

Full Name of Beneficiary

Relationship

Address (please include postal code)

Children

Full Name of First Child

Date of Birth

Date

YesNo

Full Name of Second Child

Date of Birth

Date

YesNo

Full Name of Third Child

Date of Birth

Date

YesNo

or (b) 1/2 at age: blanks and 1/2 at age: blank.

or (c) 1/3 at age: blanks , 1/3 at age: blank and 1/3 at age: .

Guardian(s)

Full Name

Relationship

Address (please include postal code)

Full Name

Relationship

Address (please include postal code)

Other Dependants*

*Refers to those who depend on you for financial support for whom you wish to provide, such as an elderly parent?

Full Name

Relationship

Address (please include postal code)

Full Name

Relationship

Address (please include postal code)

Full Name

Relationship

Address (please include postal code)

Trust Fund

YesNo

Amount to be put in Trust Fund (or share of residue of your estate)

Full Name of Dependant

Relationship

Other Dispositions to be made in the Will / Special Instructions

Text Field

Copies of the Will

We recommend not giving copies to friends or relatives, only to a corporate trustee or other professional advisor who is obliged to keep the contents confidential.

Yes (if Yes, fill in the information below)No

Full Name

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Full Name of Attorney

Relationship

Address (please include postal code)

Wills Questionnaire

ENDURING POWER OF ATTORNEY

PERSONAL DIRECTIVE

PERSONAL DIRECTIVE