The Will Centre

This section is for everyone that wants a basic Will and Powers of Attorney. It is also part of our Annual Wills and Powers of Attorney Day event, please complete and submit information:

PLEASE READ CAREFULLY

Please make sure to carefully read the brief acknowledgment below because it forms an integral part of your participation in this fundraiser.

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

YOU MUST PROVIDE your complete home mailing address and phone number where you are most likely to be reached during the day and evening. Otherwise, we might not be able to contact you. We reserve the right to refuse your participation in this fundraiser event.

Your Information

First Name

Middle Name

Last Name

Street Address

City

City Type

Municipality

Province

Postal code

Home Telephone Number

Work Telephone Number

Cell Number

Spouse Information

First Name

Middle Name

Last Name

Information necessary for your Will

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

Full Name:
Relation:

Name an individual(s) who would be your second choice as the Executor of your
estate. (ie. Child(ren) or sibling or friend)

Full Name:
Relation:

Name the individual(s) you want to be the “primary” beneficiary of
your estate? (ie. Spouse)

Full Name:
Relation:

Name the individual(s) you want to be the “secondary”
beneficiary of your estate? (ie. Children)

Full Name:
Relation:

If your children are minors at the time of your death and the children’s
other parent predeceases you, name the individual(s) you prefer to be guardian of
your children.

Full Name:
Relation:

Information necessary for your Powers of Attorney

Financial Affairs

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

Full Name:
Relation:

Who would be a substitute person having decision-making authority for your
financial affairs if your first choice were not available.

Full Name:
Relation:

Personal Care

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

Full Name:
Relation:

Who would be a substitute person having decision-making authority for your
personal health care needs if your first choice were not available.

Full Name:
Relation:

OPTIONAL CLAUSES

Gift to Charity for General Purpose

I give to for its
general purposes the sum of . I declare that this sum shall be used
by as both capital and income for any
purposes permitted by the by-laws of either immediately or at
any time and in any amounts determined by the directors or other managing body.
Nothing in this paragraph shall prohibit the investment of this sum or any part of it
that is not required for immediate expenditure.

Gift to Charity for Endowment fund or Specific Purpose

I give to the sum of
(fill in below) for its endowment fund (or for the following specific
purpose:). The receipt of its treasurer or other proper officer shall fully discharge
my trustee.

ACKNOWLEDGEMENT

RE: Green Germann Sakran Law Office Wills and
Powers of Attorney

I understand that I should promptly speak with my financial and legal advisor(s) to confirm the
suitability of this basic Will and 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.

BY SUBMITTING THIS PAGE I ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND
AGREE TO THE ALL OF THE ABOVE.