Estate Document Preparation Worksheet

Full Legal Name of person needing the Will (The Testator):(Required)

First Middle Last

Date of Birth(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Cell

Marital Status(Required)

Is this a blended family?:(Required)

Children

Name

Gender

DOB

Address

Phone

Does a child or spouse qualify for the Disability Tax Credit?:(Required)

Grandchildren

Name

Gender

DOB

Parent(s) If different than above

Deceased Family Members

Name

Relationship

Guardians for minor children

Child Name

Guardian Name

Address

Phone

Alternative Guardian

Guardian Name

Address

Phone

Executor (name of person carrying out the instructions of your Will)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Relationship(Required)

Phone(Required)

Cell

Tips to consider about your Executor:

Your Primary Executor is usually your spouse. If there is not a spouse, it’s best to select a person to serve as executor that is;
• Geographically close to you
• A trusted friend or colleague
• A Professional Executor (ask about your options)
• A person capable of taking care of administrative tasks
• Your executor could be a close friend, or family member or child

Do you prefer your executor to work INDEPENDENTLY or JOINTLY with another executor?(Required)

Your Alternate Executor

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Relationship

Phone

Cell

Bequests to Charities

Type

Amount

Details of Charity

Care of a Pet

Animal Type

Life Expectancy

Date of Birth

Annual Maintenance

Name of Carer

Special Gifts

Description

Beneficiary

Alternate Beneficiary

Distribution of Estate (after taxes, expenses, and specific gifts have been dispursed)

1

I would like to distrubute my estate equally between my children

AND/OR I have special “other” instructions for the distribution of my estate

Instructions

Trusts for Children

Name of minor child

Age to receive inheritance in full, or portions (eg 1/3 at 21, 1/3 at 25. the remainder at 30)

Describe any Debts

This is usually funds the testator has lent to a beneficiary and the funds should be included as part of the inheritance

Additional Notes

Is there anything else you would like to make sure is mentioned in your Will or addressed as a concern regarding your estate?

Instructions for Alternate Distribution of Estate

If one of your primary beneficiaries passed away before you, your executor requires alternate instructions to follow.
If your primary beneficiaries include your children, and one of your children passed away BEFORE you did, please select an option to best suit your alternate plan:

Distribution Options

My surviving grandchildren would receive my deceased child’s share of my estate

My other surviving children would receive my deceased child’s share of my estate equally

I would like to appoint the following alternate beneficiaries in the event my primary beneficiaries are not able to receive a bequest

Alternate Beneficiaries

Name

Relationship

Address

NOTE: If a minor is a beneficiary in this section, please name a Trustee:

Name

Relationship

Address

A Trustee is the person appointed to administer your estate on behalf of your child until they reach the age of majority OR until the following provisions are met:

If none of your children survive to the date of final distribution, whom do you wish to leave your estate to? (Common answers; grandchildren, siblings, niece, nephew)

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Are there other special circumstances you would like us to know about, please describe here: (Common answers include; estranged relationships, disabled children, gifts already given - anything that may change the distribution of your estate)

Power of Attorney for Health:

The Living Will (also known as a Power of Attorney for Health Care), is a very important document that should be created and updated at the same time as your Will. The Living WIll specifies your health care wishes in case you are ever unable to communicate due to a period of incapacity.

Primary Health Agent

You should name a person you would like to make medical or other decisions for you i f you become too sick to speak for yourself. This person is called a "Health Care Representative" (or "Health Care Agent" or "Health Care Proxy" or "Health Care Surrogate").

This person will have the authority to make all health care decisions regarding any care, treatment, service, or procedure to maintain, diagnose, treat, or provide for your physical or mental health or personal care, including decisions regarding the providing, withholding or withdrawing of life-sustaining treatment.

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Relationship:

Phone

Cell

Alternate Health Agent

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Relationship

Phone

Cell

Personal Directive

If a situation arises in which there is no reasonable expectation of my recovery from severe physical or mental disability to a state of meaningful interaction with loved ones, family or friends, I feel especially strongly about the following forms of treatment:

The artificial life-support measures, I refuse, based upon the above statement are: (please check all that apply)

Personal Directive Choices

Cardiopulmonary resuscitation and admittance into an intensive care unit

Mechanical respiration when I cannot breathe myself

Prolonged gastric tube or intravenous feeding when I am indefinitely unable to eat through my mouth

Antibiotic medication to treat or prevent infection

Please tick ALL BOXES you agree with:

I request to live my last days at home rather than a hospital, if my family agrees

If any of my tissues or organs are healthy and useful for other people I give permission for all such donations

I do wish to have medication mercifully administered to me in order to avoid suffering even though this may shorten my remaining life

Financial Power of Attorney:

Power of Attorney grants powers to handle issues such as your financial, real estate and business a airs. A Power of Attorney is different from a Will, since a Will is only effective after your death.
If you are ever in a position to not be able to look after your own a airs, a Power of Attorney is critical and is one of the most important documents in your estate planning portfolio.
An Enduring Power of Attorney (EPA) is called "enduring" because it is effective even when you are mentally incapable. A springing power of attorney has authority over your finances only IF you become incapacitated and unable to act for yourself.
An immediate power of attorney has authority over your finances as soon as you sign the POA document.

Which is right for you?

Springing POA

Immediate POA

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Relationship

Phone

Cell

Alternate person to serve as your POA for Financial

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Relationship

Phone

Cell

Do you own a corporation or business?(Required)

Corporation or Alternate Business Discovery:

Corporation

How many?

Joint Venture

How many?

Partnership Agreement

How many?

Proprietorship

How Many?

Do you have a corporate resolution passed and on file for alternate signing authority in the event of POA representation?

Do you have a Business Succession Plan?

Current Exit Strategy?

Do you have a successor in mind?

What is the relationship?

What is your ideal year to retire?

How many employees do you have?

Are you profit sharing within your business?

With whom? Are there any blood relations?

Are your Minute Book(s) in good order?

When were they last updated?

Is there a Unanimous Shareholder Agreement?