All Information will be treated in strictest confidence
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1. Full Name (required) : MrMrsMissMsOther
2. Full Address including post code :
3. Date of Birth :
4. Phone Number : Home Work
5.Email* :
6. Marital Status : SingleMarried/Civil PartnerSeparatedDivorcedWidowedPartner/Common Law Spouse
7. If married/civil partner, date of marriage/civil partnership :
Note: If you are married and living with your spouse or in a civil partnership and living with your civil partner or living with a partner he/she is strongly advised to make a Will. If they wish to do so, please contact us and we shall forward the appropriate questionnaire for completion.
Generally divorce/dissolution of civil partnership treats a former spouse/civil partner as if he or she had predeceased you so that no gift will pass to them nor can they act as Executors even if named as such. In other respects however, the rest of the Will remains valid.
If you have made a Will and then marry or remarry, or enter into a Civil Partnership, the Will may be cancelled and the rules of the intestacy would apply. However, a valid Will can be made taking into account a planned marriage/civil partnership or remarriage/new civil partnership which you should indicate below if appropriate.
8. Notwithstanding the above, do you have any financial dependants whom you do not wish to benefit under your Will (e.g. spouse, former spouse, civil partner, former civil partner, or partner or children?) If yes, we will be pleased to advise you : YesNo
9. Do you intend to marry/remarry/enter into a civil partnership : YesNo
10. Would you like your new Will to take this into account? : YesNo
11. Is your permanent home in England or Wales? If not, please state which country :
12. Is your ability to read and sign your Will affected by any condition? If yes, please supply details: YesNo
13. Give the full names and dates of birth of any children you have. Please indicate whether your child is male or female :
Executors are persons whom you appoint in your Will to carry out your wishes and administer your Estate.
You may consider appointing a relative or close friend with additional or substitute Executors.
This is a responsible position with some duties imposed by law and you may therefore consider appointing a professional Executor such as a solicitor. As a firm, we would be pleased to accept an appointment solely or with other persons and can offer full services for the efficient administration of your Estate.
An Executor can be a beneficiary under your Will
14. Whom do you wish to appoint as Executor(s)? Please tick the appropriate box from the following statements: Give full names and addresses of all persons named below. Please state their relationship to you. (i.e. my sister, brother-in-law, friend etc.)
A I wish to appoint the person(s) named above to act as my Executor(s): A
B I wish to appoint the person(s) named to: B PRACTICE NAME TO BE ENTERED :
C I wish to appoint : C PRACTICE NAME TO BE ENTERED :
Please give full names, addresses and relationships to you of each person named above
15. Do you hold any assets outside England and Wales? If so, please give full details including where situate :
16. Assets owned by you
ASSETS OWNED BY YOU
DETAIL
Land & Property :
Furniture :
Personal Effects:
Motor Cars :
Bank Accounts :
Building Society Accounts :
National Savings :
Stocks & Shares :
Personal Equity Plans :
Tessas :
Life Assurance:
Superannuation Benefits :
Interest in another Estate or Trust :
Cash :
Other Assets :
TOTAL :
LIABILITIES
Mortgages Outstanding :
Credit Cards :
NET ASSETS/ LIABILTIES :
Some Assets may fall outside your Will:
Pension fund trustees usually have discretion to distribute the pension scheme death benefits and your wishes should be notified to the trustees. Similar consideration may apply to death in service schemes.
The proceeds of a Life Assurance Policy written in trust are payable to the person named.
Jointly owned assets may pass to surviving owner(s)
17. Please specify if, in the last 7 years, you have made any gifts of sums of money or property the total value of which exceeded £3,000 in any one tax year:
18. Do you wish to leave your body for medical research? : YesNo
19. Do you wish to donate your organs for transplantation? : YesNo
20. If yes, do you wish to donate all of your body? : YesNo
21. If no, please specify which parts of your body you wish to donate :
22. Is it your wish to be buried or cremated? Please specify : BuriedCreamtedNo preference
23. Please detail any specific funeral instructions :
If you have any children under the age of 18, you should consider appointing at least one Guardian. When one parent dies, the surviving parent normally becomes the legal Guardian, but it is of course possible that both parents may die together, or you may be a single parent. Where a man is not married to the mother of his children he will not automatically become their guardian on the death of the mother.
Please indicate if you require further advice.
We will provide in your Will for your Trustees to have power to make payments to the Guardian for the maintenance, education and general benefit of you children.
24. If you wish to make a Guardianship appointment, please give full details:
1st or Sole Guardian : Name: Address: Relationship to you:
2nd Joint Guardian (if appropriate) : Name: Address: Relationship to you:
25. If the person(s) named above are unable or unwilling to act, do you wish to make a substitute appointment? If so, please give full details :
Please give full name(s) and address (es) and relationships to you of the Guardians
26. Before dealing with the residue of your Estate are there any specific sums of money which you wish to leave to a particular person or charity? If so, please give the Amount(s) you wish to give and the full name(s) of the recipient(s) together with their address(es) and, if appropriate, relationships to you:
In the event of the person(s) named above dying before you, do you wish the gift to pass to any child or children they may have?: YesNo
27. Before dealing with the residue of your Estate are there any specific items (for example jewellery) which you wish to leave to a particular person? If so please, give the description of the item(s) and the full name(s) of the recipient(s) together with their address(es) and, relationship(s) to you: If you wish to leave a number of specific items, we suggest that you provide the full details in a separate list. In turn this list will be referred to in you Will . Should you wish to make any changes to the list in the future, you will not have to change your Will.
specific items
28. Please tick the appropriate box from the statements made below:
A . I wish my Estate to pass to the person or charity named below A
In the event of the person named above dying, do you wish the gift to pass to any children they may have? YesNo
OR
B . I wish my estate to be shared between the persons and/or charity (ies) named below. B
29. If the above beneficiary (ies) named in A or B above die before me, I wish the Estate to pass to the person(s) and /or charity (ies) named below:
In the event of the person(s) named above dying, do you wish the gift to pass to any children they may have? : YesNo
30. Please state at what age you would wish any minor beneficiary (ies) to inherit if other than 18, (e.g. 21, 25 etc.) :
31. Are any of your beneficiaries or potential beneficiaries mentally or physically handicapped? If so, please give details :
