Preliminary Estate Planning Questionnaire

Your Information

Full Legal Name(Required)

Prefix First Middle Last

Other Name(s) Used

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Occupation

Email(Required)

Enter Email Confirm Email

Phone(Required)

Date Of Birth(Required)

Marital Information

Marital Status(Required)

Marital Plans

Do you have plans to marry or divorce? If yes, when?

Current Estate Information

Do you have an existing Will?(Required)

Yes

Do you have an Accountant?(Required)

Yes

Accountant's Details(Required)

Do you have a Financial Advisor?(Required)

Yes

Financial Advisor's Details(Required)

Other relevant information

e.g. Urgent Will required, medical condition, etc

Family Details

Name	Date of Birth	Actions

There are no People.

Details of partner, children, stepchildren, grandchildren etc. Please include full names, dates of birth, addresses and any other relevant information (i.e. medical conditions, ongoing Family Court proceedings, bankruptcy etc.)

Other Family Information

Assets(Required)

Details of all assets, owned individually and jointly, located in Australia and/or overseas, expected inheritances, joint assets and sole assets. For example, real estate, shares, bank accounts, personal effects.

Estimated value of all assets(Required)

Debts(Required)

Details of all debts you owe to another person or entity and debts owed to you by another person or entity.

Estimated value of all debts(Required)

Interest(Required)

Details of any interest that you have in any Family Trust, Unit Trust, Self-Managed Superannuation Fund, Company, Business, Partnership, Superannuation and Life Insurance Policy.

New Will Information

What are your wishes for your new will?(Required)

Please include the following: Preferred Executor Full Name, Preferred Executor Date of Birth, Preferred Executor Address, Substitute Executor Full Name, Substitute Executor Date of Birth, Substitute Executor Address

Details of your wishes:(Required)

For example: Specific Gifts (cash, jewelry, artwork etc), Funeral requests, Guardians of minor children, Right of residence

Distribution of Estate

Do you want a Testamentary Trust? If so, please specify the Trustee, Beneficiary, Purpose and Term.

Enduring Power of Attorney (EPA)

Do you have an existing EPA?(Required)

Yes

Is your existing EPA registered at Landgate?(Required)

Yes

Attorney 1 Full Name

Attorney 1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Attorney 2 Full Name

Attorney 2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you want your Attorneys to act Jointly or Jointly and Severally?

Jointly

Jointly and Severally

Attorney Conditions/Restrictions

Do you want the authority of your Attorneys to be subject to any conditions or restrictions? If yes, please specify.

Attorney Authority

I would like the authority of my Attorney to be immediate and continue notwithstanding subsequent legal incapacity

I would like the my Attorney to have authority only upon a declaration being obtained from the State Administrative Tribunal

Please choose how you would like your Attorney's authority to be granted.

Enduring Power of Guardianship (EPG)

Do you have an existing EPG?(Required)

Yes

Guardian(s) Full Name(s)

Guardian(s) Address(es)

If you have named more than 1 Guardian, do you want them to act jointly or jointly and severally?

Jointly

Jointly and Severally

If you have named more than 1 Guardian, upon the death of 1 Guardian, do you want the survivor to act?

Yes

Guardian Authority

Do you want the authority of your Guardian(s) to be subject to any conditions or restrictions? If yes, please specify.

Advance Health Directive

Do you have an existing AHD?(Required)

Yes

Have you obtained medical advice about making an AHD?

If yes, please specify the name of the medical professional that provided the advice.

Specific wishes regarding your AHD?

Your Information

Marital Information

Current Estate Information

New Will Information

Enduring Power of Attorney (EPA)

Enduring Power of Guardianship (EPG)

Advance Health Directive

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