Estates

In order to properly advise you in relation to your estate planning affairs it is necessary for your legal advisers to consider all the information sought in this document. Please complete this form as best you can prior to your initial meeting and bring it with you along with other relevant documents.

Atkinson Vinden P/LLevel 8, 10 Help StreetCHATSWOOD NSW 2067Tel: (02) 9411 4466Fax: (02) 9412 3657Email: email@avlawyers.com.au

Atkinson Vinden Estate Planning Questionnaire

Estate Planning Questionnaire PRIVATE & CONFIDENTIAL Page 1 of 4

Your Personal Details Client 1 (you) Client 2 (your spouse/partner)

Your Title Mr Mrs Ms Miss Dr Mr Mrs Ms Miss Dr

Your Full Given Name/s

Your Surname

Your Preferred Name

Your Date Of Birth

Your Occupation

Your Marital Status Married De-facto Widowed Married De-facto Widowed

Separated Single Separated Single

Your Home Address

Your Contact Details

Home Phone ( ) ( )

Work Phone ( ) ( )

Fax ( ) ( )

Mobile

Email

Do you have particular 'privacy' issues you want observed

You were referred to us by

Prior Relationships(if applicable)

Have you ever been in a prior married or de facto relationship? Full details including:• Date of divorce• Date of property order• Full names and agesof children of prior relationshipsDo you have any ongoing financial commitments from previous relationships ie child support

If possible please attach copies of relevant Family Court Orders

Please provide all relevant details Please provide all relevant details

If possible please attach copies of relevant Family Court Orders

P R I V A T E & C O N F I D E N T I A L

Children of your Relationship (Please complete details)

Full Name Child 1 Child 2

Address

Phone Number

Date Of Birth

Financially Dependant? Yes (Support to age ) No Yes (Support to age ) No

Occupation/School

# of Children (if any)

Full Name Child 3 Child 4

Address

Phone Number

Date Of Birth

Financially Dependant? Yes (Support to age ) No Yes (Support to age ) No

Occupation/School

# of Children (if any)

Full Name Child 5 Child 6

Address

Phone Number

Date Of Birth

Financially Dependant? Yes (Support to age ) No Yes (Support to age ) No

Occupation/School

# of Children (if any)

Does any child have special needs because of a physical or intellectual handicap, drug, alcohol, gambling addiction?

Please provide full details

Estate Planning Questionnaire PRIVATE & CONFIDENTIAL Page 2 of 4

Investment Real Property

Bank AccountsIncluding debentures & term deposits

Insurance

Bonds

Assets Details Owner Value

Personal LifestyleIncluding home, car etc

Estate Planning Questionnaire PRIVATE & CONFIDENTIAL Page 3 of 4

Assets (continued) Details Owner Value

Managed Funds

Shares

Superannuation

Other Assets

TOTALLiabilities Details Debtor Amount

TOTAL

Mortgages & Other Loans

Life Insurance Insurance 1 Insurance 2 Insurance 3 Insurance 4

Life Insured Client 1 Client 2 Client 1 Client 2 Client 1 Client 2 Client 1 Client 2

Amount of Life Cover

Nominated Beneficiary

Are you interested in learning more about testamentary trust Wills and their benefits: Client 1 Yes NoBenefits include: Client 2 Yes No• Delaying entitlements of beneficiaries• Protection of beneficiaries where family law settlement or bankruptcy• Concern about health or money management by beneficiaries• Streaming of income to different family members

Current Arrangements Client 1 (you) Client 2 (your spouse/partner)

Accountant

Address

Phone

Financial Advisor

Address

Phone

Documents You Want Prepared

Document Client 1 (you) Client 2 (your spouse/partner)

Will Yes No Yes No

Enduring Power of Attorney Yes No Yes No

Appointment of Enduring Guardian Yes No Yes No

Please list here any other requirements: Preparation of binding nomination for Superannuation Altering/updating self-managed Superannuation Trust Deed Altering/updating Family Trust Deed Preparing Business Succession Agreements Other (please describe):

Guardian of Infant Children (Please tick appropriate box)

Your Beneficiaries

In the event that both you and your spouse die while you have infant children under your care do you wish to appoint one or more persons to be guardian of those infant children?

Client 1 (you)

Yes we wish to appoint (insert name & address of person(s) you wish to nominate)

No not necessary

Client 2 (your spouse/partner)

Estate Planning Questionnaire PRIVATE & CONFIDENTIAL Page 4 of 4

Important: The Role of your EXECUTOR

Your executor is responsible for carrying out your wishes when you die. A beneficiary can be the Executor. You can have more than one but it is not a good idea to have too many. You should appoint someone you trust and who is familiar with your affairs. In most cases people appoint their spouse first and then their children as back-up Executors. It is a good idea to nominate a second choice for Executor in case your first choice dies before you or cannot act because of incapacity.

If you are in any doubt about your choice of Executor then this is a matter which can be discussed at our meeting.

EXECUTOR 1st Choice

Do you wish to appoint your spouse as EXECUTOR of your WILL

Client 1 (you)

Yes I appoint my spouse as my Executor

No I wish to appoint the person named below

Client 2 (your spouse/partner)

Yes I appoint my spouse as my Executor

No I wish to appoint the person named below

I appoint

of

to act as my Executor to act as my Executor

If you DO NOT WISH to appoint your spouse then please write in the space provided below the FULL name and address of your nominated Executor.

Notes:

EXECUTOR 2nd Choice

If the person I nominated as first Executor is not available to act then:

I appoint

of

AND

of

to act as my substitute Executor to act as my substitute Executor

If you do not wish to appoint a 3rd substitute Executor amend this paragraph as necessary