Client Name
Address
Telephone
Any other names by which you are/may be known:
Name of Spouse/Partner:
Address
Telephone
Are you married/intending to remarry – if so when?
Names of Children/Stepchildren:
1
2
3
4
5
6
Address:
Ages:
Name of Executors (who you wish to manage your Estate when you die):
Address:
Name of Alternatives (If chosen pesron cannot act):
Address:
Name of Guardianship - If children under 18 – who would you wish to care for them:
Address:
Home:
Select One
Owned
Rented
By whom (Yourself, partner etc):
Do you own a business?:
Select One
Yes
No
What type of business (Sole trader, limited etc):
Other Assets - List all other assets And approximate values:
Joint Assets - List all assets owned jointly by you and another including value and who owned by:
Assets Abroad - List any assets you own abroad and the value:
Gifts: (Special gifts of Property or Money). Please list any gifts of money or specification of property:
Age of Beneficiary:
Names of Residue: (Who would you wish to inherit the rest of your Estate:
Ages of Residue:
Addresses of Residues:
Names of Alternative Residue -
(Who would you wish to inherit the rest of your Estate if the above die before you):
Ages of alternative Residues:
Addresses of Alernative Residues:
If there are any gifts to two or more persons jointly, is the gift to be divided between them in equal shares:
Select One
Yes
No
Are the Trustees to have power to invest money due to a child under 18 in any investments that they wish:
Select One
Yes
No
Are the Trustees to have power to use interest received from investments for the maintenance, education or benefit of the child whose money has been invested:
Select One
Yes
No
Any other Details:
Are the Trustees to have power to give the capital money invested to the child whilst the child is under 18:
Select One
Yes
No
Any other details:
Any other items you wish to include in the Will:
DECLARATION
I CONFIRM that I am over 18 years of age, and that I am of sound mind, I am fully sighted and confirm these instructions and acknowledged that they represent my intentions as to the disposal of my estate. I UNDERSTAND that by virtue of Section 9, Wills Act 1837, my Will must be signed by me before two witnesses who are both present when I sign my Will, and I FURTHER UNDERSTAND that instructions relating to the attestation of my Will shall Be sent to me with my Will in due course. I THEREFORE agree that no person, company or agent of such company responsible for the drafting of my Will shall be liable if my Will is incorrectly attested (signed).
I Accept the Declaration
I DON'T Accept the Declaration
Signed
Date
