Wills Form | Patricia Wright Notary Public

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Marital Status

Single Couple

Power of Attorney Required?

Yes No

Full Name

AKA

Birth Date

Occupation

Place of Birth

Name of Spouse

Occupation

Date of Marriage

Spouse DOB

Place of Birth

Address

Home Phone

Work Phone

Marital particulars (previous marriages or common law relationships, separation agreements)

Advice given (wills variation, estate administration, disinheriting spouse or child, gift declarations, joint tenancies, etc.)

Name(s) of children from this marriage

Child 1 Name

DOB

Child 2 Name

DOB

Child 3 Name

DOB

Name(s) of children from previous marriages

Husband (name)

Wife (name)

Child 1 Name

DOB

Child 2 Name

DOB

Child 3 Name

DOB

Predeceased Children

Child 1 Name

DOB

Child 2 Name

DOB

Executor Name

Relationship

Alt Executor

Relationship

General Distribution of Estate

Specific bequests of chattels/cash bequests to charities, relatives, and friends.

Division of Estate

To each other

Yes No

Alternate, equally to children

Yes No

Gift over to children of children

Yes No

Alternate distribution if spouse and children predecease you or no spouse/children

% to his family as follows

% to her family as follows

Guardian Information

Primary Guardian

Alternate Guardian

Relationships

Funeral Arrangements

Spouse 1 Arrangments

Spouse 2 Arrangments

General Information Regarding Estate

Do you own a company?

Yes No

Is it incorporated?

Yes No

Please describe any real estate you own. For example, principal residence, recreational properties, or investment properties.

Do you own any property outside British Columbia? Outside of Canada? If yes, please describe below.

Please outline any bank accounts or holdings.

Please outline any insurance policies.

Please outline any RRSPs, mutual funds, or investment portfolios.

Please outline any money currently owed to you.

Liabilities

Mortgages

Other

Approximate Net Worth

Do you have any safety deposit boxes?

Yes No

Please describe its location and relevant contents.

General Remarks

Representation Agreement

Power of Attorney

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