1. Personal Details
Full Name (including any middle names)*
Are you known by any other names?
Address
Post Code
Date
Nationality
Home Telephone Number*
Work Telephone Number
Mobile Telephone Number
Email Address*
Occupation
2. Marriage / Partnership Details
If yes, date of marriage or registration of civil partnership?
Your spouse's / partner's full name?
3. Your Children (include children from any previous
1. Name and Address
Date of Birth
2. Name and Address
Date of Birth
3. Name and Address
Date of Birth
4. Instructions for your will
1. Your Executor and Substitute Executor
Executor’s Name and Address:
Substitute Executor’s Name and Address:
Other (eg. donation of organs) or any other wishes you would like included.
3. Cash Gifts / Gifts of Specific Items
Please give details of the beneficiaries as well as the amount/item bequeathed. Please say if the beneficiary is under 18 years of age. If so, would you like their parent or guardian to receive it on their behalf prior to 18?
1. Name and Address
Amount/Item
2. Name and Address
Amount/Item
3. Name and Address
Amount/Item
Please use a separate sheet of paper if necessary
The Residue of your Estate
If you do not wish to use the common provisions listed above, please provide details of your residual beneficiaries on the 'Other Information' section at the end of this form.
5. Alternative Beneficiaries
It is advisable to name alternative beneficiaries in case your original beneficiaries have died before you:
1. Name and Address
Share of Estate
2. Name and Address
Share of Estate
6. Your Assets
b. Is your home
In your sole name
option 2
c. If in joint names, is it owned as
d. Is there a mortgage? If so, please give an approximate value.
a. Do you have any jointly owned assets (other than your home)? If so, please give details and approximate values below.
b. Do you have a business? If so, please give an approximate value and details as to whether it is a Company, Partnership or in your sole name and also provide copies of any Memorandum & Articles of Association or Partnership Agreement.
c. Do you own any assets abroad? If so, please provide details and approximate values below.
d. Please provide details and approximate values of any other assets below.
7. Other Information
Please use this section to tell us about any other information that is necessary or use this as a continuation sheet.
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