Will and Powers of Attorney Individual Questionnaire

Thank you for your interest in our Will and Powers of Attorney Questionnaire.

Upon submitting the completed form below, you will be contacted to review the information and schedule an appointment to sign your basic Will and Powers of Attorney.

Download Questionnaire
For more information about Wills and Powers of Attorney visit our Wills and Estates Legal Page

1General Information

2Family Information

3Will Information

4Powers of Attorney Information

5Confirm and Submit

General Information
Your Full Legal Name*
First* Middle(s) Last* Name you are commonly known as (if different from your first name)
Your Gender*
- Male
- Female
Your Date of Birth*
DD slash MM slash YYYY
Your Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Regional Municipality
Regional Municipality
Your Email*
Contact Numbers*
Phone numbers where you are most likely to be reached during the day and evening.
Primary Number* Secondary Number

Family Information
Do you have a spouse?*
- Yes
- No
Spouse's Full Legal Name*
First* Middle(s) Last* Commonly known as (if different from your first name)
Spouse's Gender*
- Male
- Female
How do you define your relationship with your spouse*
This person is my ...
- Husband
- Wife
- Partner
- Spouse
- Common-law Spouse
Are you legally married?*
- Yes
- No
Do you have children of this current relationship?*
- Yes
- No

Childrens Full Legal Name from current relationship*

First*	Middle(s)	Last*	Commonly known as (if different)	If currently under 18 years of age, enter birthdate (format: DD/MM/YYYY)

Are you previously divorced?*
- Yes
- No
Do you have children of previous relationship(s)?*
- Yes
- No

Child's Full Legal Name from past relationship*

First*	Middle(s)	Last*	Commonly known as (if different)	If currently under 18 years of age, enter birthdate (format: DD/MM/YYYY)

Will Information

Estate Trustee(s)*

Name an individual(s) who you want to be the Estate Trustee of your estate. The Estate Trustee(s) is the person that carries out your wishes and ensures that your estate is distributed in accordance with your wishes (ie. spouse or adult child(ren)).

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Relation*	City/Town*

Secondary Choice for Estate Trustee(s)*

Name an individual(s) who you want as your second choice to be the Estate Trustee of your estate if your first choice were not available. (ie. adult child(ren), sibling or friend).

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Relation*	City/Town*

Primary Beneficiary of Estate
Name an individual(s) who you want as the “primary” beneficiary of your estate. A beneficiary is a person who is eligible to receive a distribution from your estate.
First Middle(s) Last Commonly known as (if different from your first name) Gender (Male/Female) Relation
- I would like to name a charity as my Primary Beneficiary
Charity as Primary Beneficiary of Estate
Name the charity who you want as the “primary” beneficiary of your estate.
Charity Name City Amount ($ or %) Other info.

Secondary Beneficiary(ies) of Estate

Name an individual(s) who you want as the “secondary” beneficiary of your estate if your “primary” beneficiary predeceases you.

First	Middle(s)	Last	Commonly known as (if different from your first name)	Gender (Male/Female)	Relation

- I would like to name a charity as my Secondary Beneficiary
Charity as Secondary Beneficiary of Estate
Name the Charity who you want as the “secondary” beneficiary of your estate.
Charity Name City Amount ($ or %) Other info.
Guardian's Full Legal Name
Name the individual(s) you prefer to be the guardian of your children in the event that you have children under the age of 18 years at the time of your death and the children’s other parent predeceases you.
First Middle(s) Last Commonly known as (if different from your first name) Relation

Powers of Attorney Information

Financial Power of Attorney*

Name an individual(s) you want to have decision-making authority for your property and financial affairs (ie. spouse or adult child).

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Gender (Male/Female)*	Relationship to you*

Substitute Financial Power of Attorney(s)*

Who would be the substitute individual(s) having decision-making authority for your property and financial affairs if your first choice were not available?

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Gender (Male/Female)*	Relationship to you*

Personal Care Power of Attorney*

Name an individual(s) you want to have decision-making authority for your personal health care needs (ie. spouse or adult child).

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Gender (Male/Female)*	Relationship to you*

Substitute Personal Care Power of Attorney(s)*

Who would be the substitute individual(s) having decision-making authority for your personal health care needs if your first choice were not available?

First*	Middle(s)	Last*	Commonly known as (if different from your first name)	Gender (Male/Female)*	Relationship to you*

Please provide any information or concerns you consider important for the lawyer in the preparation of your documents.
Acknowledgement*
- I understand that I should promptly speak with my financial advisor(s) to confirm the suitability of this basic Will and these Powers of Attorney to my own personal circumstances. I understand that I should routinely review my basic Will and Powers of Attorney as circumstances in my life change, and to ensure their suitability to my circumstances and compliance with legislative changes.
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Green Germann Sakran (GGS) is a law firm with a long tradition of excellence in serving its clients with a combined experience of more than 70 years. GGS specializes in the areas of Real Estate, Wills, Trusts and Estates, Corporate and Commercial, Family Law, Civil Litigation and Personal Injury. We are a law firm with a long tradition of excellence in serving its clients.

Will and Powers of Attorney Individual Questionnaire

General Information

Family Information

Will Information

Powers of Attorney Information

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