PART 1 Section 1.1 - Your Personal Information

Full Name *

Any Other Names Used?

Email *

Phone *

Date of birth *

Address *

Street Address

City

State

Country

Postal Code

Occupation

Marital Status/Place of Marriage - Is the Testator about to marry, separate or divorce *

Previous Marriage Name of Previous spouse Date & Place of Divorce/Death Separation Agreement (Provide Copy below)

Please provide a copy of above

Referring Source (if any)

Citizenship / Country of Birth

Section 1.2 - Financial Advisors

Accountant

Name
Phone
Email
Address

Investment Advisor

Name
Phone
Email
Address

Section 1.3 - Children (if applicable)

Child 1

Full Name
Address
Date of Birth
MAR/SIN

Child 2

Full Name
Address
Date of Birth
MAR/SIN

Child 3

Full Name
Address
t
MAR/SIN

Please share more details below if you have additional children.

1. Have you failed to mention any children above, either because they were born outside of your present marriage, or because you no longer are in contact with them. If so, please provide particulars.

2. Are any of the children adopted, disabled, or handicapped, such that they are presently receiving, or will receive in the future, benefits under the Family Benefits Act?

Section 1.4 - Dependents (Other than Spouse & Children)

Dependent 1

Full Name
Address
Relation
D.O.B Approx Age

Dependent 2

Full Name
Address
Relation
D.O.B Approx Age

Section 1.5 - Grandchildren (if applicable)

Please detail below your grandchildren (Full Name, Parent's Full Name, Address, D.O.B Approximate Age)

Section 1.6 - Other Beneficiaries

(Persons or Charities who might benefit from your Will)

Please detail below any beneficiaries (Full Name, Relation, Address, D.O.B Approximate Age)

PART 2 - Financial Statement

Household Goods & Property

Item - AUTOMOBILE, BOATS, REC. VEHICLES

Value
Ownership (Self, Spouse, Joint)

Item - FARM MACHINERY, TOOLS, LIVESTOCK

Value
Ownership (Self, Spouse, Joint)

Item - HEIRLOOMS, ARTWORK, PLATES, JEWELLERY (List only items $1,000 or greater)

Value
Ownership (Self, Spouse, Joint)

Assets

Real Estate (Residence, Cottage, Investment)

Property 1

Value
Ownership (Self, Spouse, Joint)

Property 1 - Original Cost ($)

Property 1 - Outstanding Mortgage ($)

Life Insured

Yes

No

Provide copy of the Deed/Transfer of Land (Property 1)

Property 2

Value
Ownership (Self, Spouse, Joint)

Property 2 - Original Cost ($)

Property 2 - Outstanding Mortgage ($)

Property 2 - Life Insured

Yes

No

Provide copy of the Deed/Transfer of Land (Property 2)

Property 3

Property 3 - Value
Ownership (Self, Spouse, Joint)

Property 3 - Original Cost ($)

Property 3 - Outstanding Mortgage ($)

Property 3 - Life Insured

Yes

No

Provide copy of the Deed/Transfer of Land (Property 3)

Rental Property

RSP / RIF / LIF / LIRA

RSP / RIF / LIF / LIRA #1

#1 Value
1 Ownership (Self, Spouse, Joint)
Locked in #1 (y/n)
Beneficiary #1

RSP / RIF / LIF / LIRA #2

#2 Value
2 Ownership (Self, Spouse, Joint)
Locked in #2 (y/n)
Beneficiary #2

RSP / RIF / LIF / LIRA #3

#3 Value
Locked In #3 (y/n)
3 Ownership (Self, Spouse, Joint)
Beneficiary #3

RSP / RIF / LIF / LIRA #4

#4 Value
Locked In #4 (y/n)
4 Ownership (Self, Spouse, Joint)
Beneficiary #4

Investments - (GICs, Tbills, Promissory notes, Mortgages, etc.)

Investment #1

RSP / RIF / LIF / LIRA 1 Value
Investment 1 Ownership (Self, Spouse, Joint)

Investment #2

Investment 2 Value
Investment 2 Ownership (Self, Spouse, Joint)

Investment #3

Investment 3 Value
Investment 3 Ownership (Self, Spouse, Joint)

Investment #4

Investment 4 Value
Investment 4 Ownership (Self, Spouse, Joint)

Bank Accounts

Bank Account 1

Bank 1 Branch Location
Bank 1 Average Balance
Bank 1 Ownership (Self, Spouse, Joint)
Bank 1 Location of Safety Deposit Box
Bank 1 Location of Key
Bank 1 Who has access to Safety Deposit Box
Safety Deposit Box 1 Address:

Bank Account 2

Bank 2 Branch Location
Bank 2 Average Balance
Bank 2 Ownership (Self, Spouse, Joint)
Bank 2 Location of Safety Deposit Box
Bank 2 Location of Key
Bank 2 Who has access to Safety Deposit Box
Safety Deposit Box 2 Address:

Bank Account 3

Bank 3 Branch Location
Bank 3 Average Balance
Bank 3 Location of Safety Deposit Box
Bank 3 Ownership (Self, Spouse, Joint)
Bank 3 Location of Key
Bank 3 Who has access to Safety Deposit Box
Safety Deposit Box 3 Address:

Life Insurance / Annuities (Bring Policy)

Policy 1

#1 Policy Number
#1 Value to Estate
#1 Term Whole Life (T/WL)
Policy #1 - Self
Policy #1 - Spouse
Policy #1 - Beneficiary

Policy 2

#2 Policy Number
#2 Value to Estate
#2 Term Whole Life (T/WL)
Policy #2 - Self
Policy #2 - Spouse
Policy #2 - Beneficiary

Policy 3

#3 Policy Number
#3 Value to Estate
#3 Term Whole Life (T/WL)
Policy #3 - Self
Policy #3 - Spouse
Policy #3 - Beneficiary

Business Activity

(Company Name) (Bring Shareholders or Partnership Agreement)

Business Activity #1

Company Name (Business Activity 1)
Shares / Bonds (Business Activity 1)
Self (Business Activity 1)
Spouse (Business Activity 1)
Original Cost / Market Value (Business Activity 1)

Business Activity #2

Company Name (Business Activity 2)
Shares / Bonds (Business Activity 2)
Self (Business Activity 2)
Spouse (Business Activity 2)
Original Cost / Market Value (Business Activity 2)

Business Activity #3

Company Name (Business Activity 3)
Shares / Bonds (Business Activity 3)
Self (Business Activity 3)
Spouse (Business Activity 3)
Original Cost / Market Value (Business Activity 3)

Are there any restrictions on transfer?

Are shares subject to buy-sell agreement?

If a buy-sell agreement is in force, is it funded? (Obtain all relevant documents)

Loans to Family / Friends

Loan #1

Loan 1 Amount ($)
Loan 1 - Documented (y/n)
Loan 1 - Self
Loan 1 - Spouse
Loan 1 - To be repaid or forgiven at death

Loan #2

Loan 2 Amount ($)
Loan 2 - Documented (y/n)
Loan 2 - Self
Loan 2 - Spouse
Loan 2 - To be repaid or forgiven at death

Loan #3

Loan 3 Amount ($)
Loan 3 - Documented (y/n)
Loan 3 - Self
Loan 3 - Spouse
Loan 3 - To be repaid or forgiven at death

Other Assets

Property in a foreign jurisdiction (List below, including as much details as possible)

Contingent or vested interest in an inter vivos or testamentary trust

Power of appointment

General or specific

Tax sheltered investments (murbs, oil and gasinvestments, movies, etc.)

Royalties

Brokerage account

Liabilities

(Bring in documentation)

Personal Loan / Guarantees

Type
Personal Loan / Guarantees Amount
Self
Spouse

Loans on Life Insurance

Personally Guarantees (Y/N)
Loans on Life Insurance Amount
Self
Spouse

Business Debts

Personally Guarantees (Y/N)
Business Debts Amount
Self
Spouse

Part 3 - GENERAL

Has the Testator, or the Testator’s spouse, previously made a Will, Trust, Continuing Power of Attorney for Property, or Power of Attorney forPersonal Care?

Yes

No

Documents Required:
Will, Trust, Power of Attorney for Property, Power of Attorney for Personal Care.

Does the Testator and the Testator’s common law spouse have a cohabitation agreement.

Yes

No

Documents Required:

Cohabitation Agreement

Do you and your spouse have a marriage contract?

Yes

No

Documents Required:

Marriage Contract

Have you, or your spouse, previously been married?

Yes

No

Documents Required:

Separation Agreement, Divorce Judgment

Is either Testator currently subject to any court orders respecting support obligations to a former spouse and/or children

Yes

No

Documents Required:

Court Order

If either you or your spouse have previously been married, were there any children of the marriage?

Yes

No

Documents Required:

None

NOTES, QUESTIONS, COMMENTS? (Please share in the section below)

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