Personal Intake Form for Estate Planning

The information you are about to provide will be the basis for your discussions with your lawyer and other financial advisers about your will and other estate and personal planning. You do not need evaluations or appraisals for listing assets and liabilities — your best estimates should be sufficient for most discussions. However, how you own the legal title to your assets is important and, if you are not sure whether, for example, your house is owned jointly with another person, ask your lawyer to investigate since assumptions can cause later problems. Also, if possible, check with your financial institutions for beneficiary designations on life insurance policies and pension plans.

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Submission Date
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Part 1 - Personal Information
Name (as is on government issued ID)
First Middle (include all) Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth
MM slash DD slash YYYY
Place of Birth
Citizenship
Phone (Home)
Phone (Business)
Email
Are you a status Indian
- Yes
- No

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Marital Status
Date of Marriage
MM slash DD slash YYYY
Spouse's Name
First Last
Spouse's Date of Birth
MM slash DD slash YYYY
Spouse's Citizenship
How many children do you have?
Please enter a number greater than or equal to 0.
Use the arrow keys (up and down) to change the value.

Children

Child's Name	Child's Date of Birth	Actions

There are no Children.

Other Financial Dependants?
- Yes
- No
(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?)
Have you ever promised someone a share of your estate in exchange for that person assisting you personally or with your finances or assets?
- Yes
- No

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Part 3 - Assets
Do you have any automobiles/boats?
If yes, please provide details and in whose name the vehicle/boat is in.
Approximate value of household goods and contents.
Do you have any antiques, artwork, jewelry of significant value? Please provide details.
Do you own any real estate (Including a cottage)?
- Yes
- No
Add Real Estate
Property Information Actions
There are no Real Estates.
Maximum number of real estates reached.
Do you have any bank accounts in YOUR name only?
- Yes
- No
Add Bank Account
Bank Account Information Actions
There are no Bank Account.
Maximum number of bank account reached.
Do you have any joint bank accounts?
- Yes
- No

Add Joint Bank Account

Joint Bank Account Information	Actions

There are no Joint Bank Accounts.

Do you have a safety deposit box?
- Yes
- No

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Do you have any RRSP's, RIF's, Pensions and/or Annuities?
- Yes
- No
If there is more than one, please click the button to add another beneficiary.

Named Benificiary

First Name	Last Name	Actions

There are no Beneficiaries.

Make sure ALL beneficiaries are named to avoid probate

Do you have any RESP's, RDSP's, TFSA's?
- Yes
- No
If there is more than one add beneficiary

Named beneficiary

First Name	Last Name	Actions

There are no Beneficiaries.

Make sure ALL beneficiaries are named to avoid probate

Do you have any investments?
- Yes
- No

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Part 4 - Liabilities
Do you have any mortgages?
- Yes
- No
Do you have any other debts?
- Yes
- No
Does anyone or company owe you money?
- Yes
- No

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Part 5 - Will Instructions
Executor(s) and trustee(s) - First Pick (Usually Spouse)
First Last
Please include full names and addresses:
Executor(s) and trustee(s) - Second Pick
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are both spouses picking the same second pick?
- Yes
- No
Will you make a memorandum or list to help your family make a fair division?
- Yes
- No
Cash gifts (to a person or charity):
Disposition of residue (the person who will be the beneficiary [usually spouse])
Disposition of Alternative Residue - If first beneficiary is not alive.
Is there any Executor/Beneficiary who lives outside Ontario?
- Yes
- No
Name of Guardians and Custodians for Children
First Last
Address for Guardians and Custodians for Children
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Alternate Guardians and Custodians for Children
First Last
Address of Alternate Guardians and Custodians for Children
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Funeral, burial and other special instructions:

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Personal Intake Form for Estate Planning

Personal Intake Form for Estate Planning

Step 1 of 10

Part 1 - Personal Information

Part 2 - General

Part 3 - Assets

Part 4 - Liabilities

Part 5 - Will Instructions

Part 6A - Powers of Attorney for Property/Assets

Part 6B - Powers of Attorney for Personal Care (Medical)

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