| PERSONAL INFORMATION |
Full Name:
______________________________________________________________________________________
(as on your birth certificate or latest change of name certificate) |
Street Address 1:
______________________________________________________________________________________ |
Street Address 2:
______________________________________________________________________________________ |
Home Telephone:
______________________________________________________________________________________ |
Office Telephone:
______________________________________________________________________________________ |
Occupation:
______________________________________________________________________________________ |
Date of Birth:
______________________________________________________________________________________ |
Domestic Status:
______________________________________________________________________________________ |
Estate Trustee (Executor):
(This information must be included.)
______________________________________________________________________________________
(Address, Relationship & Occupation) |
Alternate Estate Trustee:
______________________________________________________________________________________ |
Alternate Estate Trustee:
______________________________________________________________________________________ |
Funeral Instructions:
______________________________________________________________________________________ |
Donation of Organs:
______________________________________________________________________________________ |
|
| DISPOSITION OF ASSETS: (Please
note that not everything listed below will apply to your situation.) |
Personal (Household) Effects:
______________________________________________________________________________________ |
Real Estate:
______________________________________________________________________________________ |
RRSP Funds & Life Insurance:
______________________________________________________________________________________ |
RESIDUE: (For everything not listed above.) A residue provision must be included.
|
First Choice:
______________________________________________________________________________________ |
Alternate:
______________________________________________________________________________________ |
SPECIAL INSTRUCTIONS: |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
| ______________________________________________________________________________________ |
