1. INFORMATION ABOUT YOU

Full Legal Name*

First

Middle

Last

(also known as:)

Birth Place (City, Country):

Marital Status:

Name of Previous Spouse:

1. INFORMATION ABOUT YOUR SPOUSE/PARTNER

Full Legal Name Spouse/Partner*

First

Middle

Last

(also known as:)

Birth Place (City, Country):

Marital Status:

Name of Previous Spouse:

Contact Information

Address:

Email address*

Phone - Home

Phone - Work

Phone - Cell

List Children's Full Legal Names /Birthdate/Child of:

Include (and identify) any adopted children, step-children or biological children of either yourself or your spouse.

First Choice for Executor/Trustee:

WHO IS YOUR PRIMARY CHOICE FOR EXECUTOR/TRUSTEE (INCLUDE FULL LEGAL NAMES AND RELATIONSHIP TO YOU):

Address:

Phone

Email address*

Alternate Choice for Executor/Trustee:

WHO IS YOUR ALTERATE CHOICE FOR EXECUTOR/TRUSTEE (INCLUDE FULL LEGAL NAMES AND RELATIONSHIP TO YOU):

Address:

Phone

Email address*

First Choice for Guardianship of Children

WHO IS YOUR CHOICE FOR GUARDIAN OF YOUR CHILD OR CHILDREN: (INCLUDE FULL LEGAL NAMES AND RELATIONSHIP TO YOU):

Address:

Phone

Email address*

Alternate Choice for Guardianship of Children

WHO IS YOUR ALTERNATE CHOICE FOR GUARDIAN OF YOUR CHILD OR CHILDREN: (INCLUDE FULL LEGAL NAMES AND RELATIONSHIP TO YOU):

Address:

Phone

Email address*

ASSETS

WHO DO YOU WISH TO RECEIVE YOUR ASSETS:

To each other, then equally to my children

Or as follows:

As stated below (NOTE: if you have a young family or if you travel together, you should consider who you would want to receive your estate in the event something happens to all of you - INCLUDE FULL LEGAL NAMES AND RELATIONSHIP TO YOU)

If you are excluding a spouse or child or treating them differently, please include notes with your reasons for doing so.

POWER OF ATTORNEY

Ensure the name on your Power of Attorney is the same as on any land owned by you. The name on the Power of Attorney must be exactly the same as the name on the title to the land.

Address:

Phone

Email address*

REPRESENTATION AGREEMENT

Each Other or Alternative? If alternative, list full legal, name and date of birth.

Address:

Phone

Email address*

1. INFORMATION ABOUT YOU

1. INFORMATION ABOUT YOUR SPOUSE/PARTNER

Contact Information

First Choice for Executor/Trustee:

Alternate Choice for Executor/Trustee:

First Choice for Guardianship of Children

Alternate Choice for Guardianship of Children

ASSETS

POWER OF ATTORNEY

REPRESENTATION AGREEMENT

PLEASE NOTE: