Existing WillDo you have an existing Will?* Yes No Testamentary CapacityDo you have any diseases/ disorder that may influence the mind? Or any medical condition that could affect your memory of making your Will?* Yes No Please provide details* Do you have a medical sign off by a doctor for testamentary capacity?* Yes No General QuestionsAre you making this Will of your own volition?* Yes No Is another person helping you complete this form?* Yes No Full Name* Date of Birth* DD slash MM slash YYYY Your relationship to this person* Do you want to store your Will in our Will Bank?* Yes No Is English your 1st language?* Yes No Please provide the name of your primary language* Do you live in the state of Western Australia* Yes No Your Personal DetailsWhat is your full name (including any middle names)* What is your date of birth* DD slash MM slash YYYY What is your occupation* Where do you live, please provide full address?* What is your email address?* Contact Number* What is your relationship status* Single De Facto Married Divorced Widowed Current Spouse/Partners full name* Current Spouse/Partners date of birth* DD slash MM slash YYYY Contemplation of Marriage?* Yes No Do you have a Binding Financial Agreement (Pre-nuptial agreement)?* Yes No Please seek direct legal assistanceFamily DetailsHow many children from current relationship* Name a GuardianName of child - if child under the age of 18 can name a guardian Date of Birth* DD slash MM slash YYYY Residential Address* Add Guardian NameRemove Guardian NameHow many children from previous relationship* Children From Previous RelationshipName of child - if child under the age of 18 can name a guardian Date of Birth* DD slash MM slash YYYY Residential Address* Add Previous Guardian NameRemove Previous Guardian NameHow many Grandchildren*Do you wish to include your Grandchildren* Yes No Please provide the full name, date of birth and residential address for each child. (Full name of the parent of the grandchild if included) GrandchildFull Name* Date of Birth* DD slash MM slash YYYY Residential Address* Add GrandchildRemove GrandchildOther BeneficiariesHow many other intended beneficiaries*Please provide the full name, date of birth, residential address and your relationship to this person. Intended BeneficiariesFull Name* Date of Birth* DD slash MM slash YYYY Residential Address* Your relationship to this person.* Add BeneficiariesRemove BeneficiariesHave you omitted anyone from the Will?* Yes No Why* CharityAre there any charity organisations you wish to include?* Yes No How many charity* (please advise how many)Please provide full name, ABN and the registered address of the charity CharityFull Name* ABN* Registered address of the charity* Add CharityRemove CharitySelect the type of gift to the charity* Residual Specific Whole estate Percentage ExecutorsDid you wish to nominate the public trustee as executor or substitute executor* Yes No Who do you wish to name as executor(s)? Name #1 Name #2 Name #3 Name #4 Do you wish to have a substitute executor? (i.e if one person cannot act then can fall onto the substitute)* Yes No Substitute executor* Select which type of Liability you wish the executors to have* Joint Several Joint and Several Liability Assets/LiabilitiesDetail list of the assets in your sole name (i.e House, Car, Savings amount)* Detail list of the liabilities in your sole name* List of assets in your name plus others* List of liabilities in your name plus others* Please select which bank(s) you are with* International Assets/ LiabilitiesDo you have any assets outside the state of Western Australia/Australia?* Yes No Assets outside* Do you have any liabilities outside the state of Western Australia/Australia?* Yes No Liabilities outside* TrustDo you have a family trust?* Yes No Please provide details* Superannuation detailsDo you have a Superannuation?* Yes No Please provide details* Do you have a Self-Managed Superannuation Fund (SMSF)?* Yes No Please provide details* Is there a nominated beneficiary of the Superannuation fund?* Yes No Full Name* Date of Birth* DD slash MM slash YYYY Residential Address* Your relationship to this person* Life insurance detailsCompany name* Policy number* Company name* Policy number* Specific Estate Directions Percentages of the Estate" (All percentages must add up to 100%) How many beneficiaries?* Percentages of the Estate" (All percentages must add up to 100%)Name of Beneficiary* Please advise percentage* Add PercentagesRemove PercentagesSpecial Bequests (i.e Jewellery, motor vehicle or other items ) and to whom you wish to have the items* Yes No Please advise how many Special BequestsName* Address* Item bequested* Add Special BequestsRemove Special BequestsClauses you wish to includeDo you wish to include the details of your accountant without including any contractual obligation?* Yes No Please advise* The executor entitled to fees paid for the work done by them or their firm.* Yes No Please advise* Do you wish to include a survivor clause?* Yes No Please advise* Disposal of BodyDo you wish for your remains to be donated for science?* Yes No Specific instructions for your remains*Do you have any religious rights and instructions?* Yes No Please explain* How did you hear about usSpecify if other?* Social Media Google Referral Radio Newspaper Family Other Your DeclarationDo you declare this information have been completed to the best of your knowledge.* Yes No
