Tenenbaum & Solomon – Will Questions

    Part I. Family Information

    Full name *
    Full Address *
    Date and place of birth
    Phone(home)
    Phone (business)
    Facsimile
    Email *
    Occupation
    Annual income
    Residence for income tax purposes
    Citizenship
    Marital status
    Spouse name
    Spouse Date of Birth
    Spouse Birth Place

    Children Prior

    Child name
    Child Date of Birth
    Child Address
    Child name
    Child Date of Birth
    Child Address
    Child name
    Child Date of Birth
    Child Address
    Child name
    Child Date of Birth
    Child Address

    Other dependants. (Do you have any legal obligation to support another person in addition to your spouse and children, or have you been providing actual support to anyone other than your spouse and children?)

    Name
    Address
    Date of birth
    Nature of support

    Have you ever promised someone a share of your estate in exchange
    for that person assisting you personally or with your finances or assets?
    If yes, please provide particulars.
    Others persons to be named in your will (not dependants)
    Name
    Date of birth
    Address

    Part II. General

    Do you have a will? YesNo
    Does your spouse have a will? YesNo

    Are you presently receiving benefits from an estate or trust?
    If so, please give particulars.

    Have you set up a trust to benefit another person? If so,
    please give particulars.
    Are you an executor or trustee of any estate? YesNO

    Do you have your own financial planner. investment adviser, account¬ant or life insurance agent?

    Name
    Firm
    Telephone

    Do you own or have an interest in a business (i.e.. sole
    proprietorship. partnership or limited company)? Please
    provide copies of business agreements. Please give details.

    Do you and your spouse have a marriage contract? Please
    provide a copy.
    Have you been married more than once

    Part III. Assets

    Boats / Cars
    Make / Model / Year
    Estimated Value
    Make / Model / Year
    Estimated Value
    Approximate value of household goods and contents
    Real estate
    Location
    Value
    Orginal cost
    In whose name
    Location
    Value
    Orginal cost
    In whose name
    Bank accounts
    Name of bank
    Address of bank
    Account number
    In whose name
    Average balance

    If any of these accounts are held in your name with another person,
    do you intend that the other person should inherit the balance in
    such account(s) upon your death?

    		 YesNo
    Name of bank
    Address of bank
    Account number
    In whose name
    Average balance

    If any of these accounts are held in your name with another person,
    do you intend that the other person should inherit the balance in
    such account(s) upon your death?

    		 YesNo
    Safety deposit box
    Location
    Box number
    Life insurance
    Name of company
    Type of plan
    Named beneficiary
    Policy number
    Value to your estate
    RRSPs, RRIFs, pensions and annuities
    Name of company
    Contract number
    Type of plan
    Named beneficiary
    Value
    Name of company
    Contract number
    Type of plan
    Named beneficiary
    Value
    Name of company
    Contract number
    Type of plan
    Named beneficiary
    Value

    Investments [attach a separate sheet if necessary]: Please list
    all stocks and/or bonds, their original costs, estimated market values,
    and names of registered owner(s): Please indicate whether you
    intend that any of these investments will pass to another person
    on your death

    Part IV. Liabilities

    Mortgages payable by you
    Amount owing
    Name of mortgagee
    Is/are this/these mortgage(s) insured? YesNo
    Amount owing
    Name of mortgagee
    Is/are this/these mortgage(s) insured? YesNo
    Other debts
    Amount owing
    Name of creditor
    Amount owing
    Name of creditor
    Are any such debts (e.g.. line of credit)
    secured by way of a collateral mortgage
    on real property? Provide particulars

    Part V. Summary

    Total value of assets $
    Less total value of liabilities $
    Net value of estate $

    Part VI. Will Instructions

    Disposition of household goods. personal effects, jewellery,
    automobiles. etc.
    Will you make a non-binding memorandum or list to help your
    executor make a fair division?    		 YesNo
    Disposition of residence and/or cottage
    Cash legacies (charitable. personal or sentimental)
    Disposition of RRSPs. RRIFs. annuities. pensions
    Disposition of residue (including trusts for spouse and/or children
    and other issue, payments of income from trust. payment of capital
    from trust, time of distribution of trust. provision should any
    beneficiaries predecease, etc.)
    Executor(s) and trustee(s): please include full names and addresses
    Are death taxes to he paid from capital without recourse to
    beneficiaries? Are there special provisions for beneficiaries in other
    jurisdictions?    		 YesNo
    If a specific gift to a named beneficiary is an asset on which the
    estate will have to pay income tax, should the estate pay that tax or
    should the tax be borne by the named beneficiary?    		 Estate should payBeneficiary pay
    Are executors to have broad powers for retention, sale
    and investment of assets and, if a trust company, investment in own
    securities, etc.    		 YesNo

    Special clauses to be included: (to be reviewed with lawyer) Appointment of guardians and custodians for children

    Name(s)
    Address(es)
    Exclude illegitimates
    Family Law Clauses

    Tenenbaum & Solomon
    Tenenbaum & Solomon
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