PEA Seminar 2000: will-planning information sheet

(§1.32) WILL PLANNING INFORMATION SHEET

The information requested in this questionnaire is required in order to provide you with a will which reflects your requirements. The questionnaire is broken into three sections. Please complete all sections.

PART I - PERSONAL

Date of completion: __

Your name in full:

Occupation: _

Address: ____

Telephone no. at home: ______________________ at work: ____

Domicile (where usually resident): ___

Date and place of birth: _____

Name at birth, if different from above:

Present marital status:

SPOUSE

Name of spouse in full:

Your domicile at time of marriage: ___

Date and place of marriage: _

Did you have a marriage contract? ___

(Please attach a copy if one exists)

PREVIOUS MARRIAGES

Please give name(s) of previous spouse(s): ___

Date of separation: _________________________Date of divorce: ____

(Please attach copies of separation agreements and court orders)

YOUR CHILDREN

Please give full names and ages of all your children and any special circumstances relating to infirmity, adoption, legitimacy, custody, etc. must be noted or discussed. If your children do not reside with you, please note their current addresses:

FULL NAME DATE OF BIRTH

_________________________________________________ ________

PART II - ASSETS AND LIABILITIES

ASSETS

Real Estate

Street address of residence: _

Legal description: __

Market value (approx.) $__________

Mortgages on property $__________

(Please note whether mortgage is life insured)

Additional real estate held (please describe as above):

Street address:

Legal description: __

Market value (approx.): $__________

Mortgages on property: $__________

(Please note whether mortgage is life insured)

Household goods and furnishing (approx. value) $__________

Other personal property including jewellery, automobiles, boats, etc. (approximate value):

___________________________________________________________ $__________

Bank accounts and terms deposits including address of bank, number of account and names in which the accounts are registered:

___________________________________________________________ $__________

RRSP/RHOSP/DPSP. Please note the name of trustee, registration number and beneficiary:

___________________________________________________________ $__________

Mortgages/Agreements for sale owing to you:

___________________________________________________________ $__________

Other debts owing to you (family debts, notes, etc.):

___________________________________________________________ $__________

Life insurance policies you hold. Please state company with which policy is held. number of the policy and beneficiary named in the policy:

___________________________________________________________ $__________

Are you a recipient or potential recipient of a pension? Please give details:

___________________________________________________________ $__________

Stocks and bonds (estimated total value of portfolio. Please give name of brokerage firm and account number as well as location of certificates):

___________________________________________________________ $__________

Interest you have in business (proprietorship/partnership/unincorporated/incorporated). Also please provide a copy of latest financial statements and any buy/sell agreements with respect to private company shares (consider necessity of buy/sell agreement):

___________________________________________________________ $__________

Interest you have as a beneficiary in another estate, trust or power to appoint:

___________________________________________________________ $__________

List any other substantial assets:

___________________________________________________________ $__________

ESTIMATED GROSS VALUE OF ESTATE:

LIABILITIES

Personal loans owing:

___________________________________________________________ $__________

Guarantees:

___________________________________________________________ $__________

Alimony/Maintenance:

___________________________________________________________ $__________

List any other substantial liabilities:

___________________________________________________________ $__________

ESTIMATED NET VALUE OF ESTATE:

$__________

PART III - ORGANIZATION OF WILL

The following is a guide for the organization of the typical will. Complete as much as you can or telephone us to arrange an interview.

GUARDIANS

You should appoint a guardian for your children in the event you and your spouse do not survive their minority (under age 19). Please give full names, addresses, occupations and relationship to you. Please name two guardians (either together or in the alternative) in the event your first choice is unable to act as guardian.

___________

EXECUTORS

The executor(s) step(s) into the shoes of the deceased, gather in his/her assets, pay his/her debts and distribute the estate in accordance with the terms of the will. Please give full names, addresses, occupation and relationship to you. Please name two executors (either together or in the alternative) in the event our first choice is unable to act as executor. If you spouse is the sole beneficiary in the first instance he/she should probably be sole executor.

___________

DISTRIBUTION

Special Bequests

Bequests of specific items and/or sums of money. Please give full names of each beneficiary, address, occupation and relationship to you. Please note that these specific items and/or sums of money will be given and paid to the beneficiaries before the bulk of the estate is distributed and will therefore reduce the amount passing to beneficiaries of the "residue".

___________