Personal Information
Full Name
Date of Birth
Phone Number
Email Address
Address
Relationship Status
Status
Single
Married
Partnered
Divorced
Children / Dependents
Do you have children or dependents?
Yes
No
If yes, please provide their names and ages
Assets
Please list your significant assets (e.g., real estate, bank accounts, retirement accounts):
Liabilities / Debts
Please list your significant debts (e.g., student loans, mortgages, credit cards):
Executor/Guardian Choices
Who would you like to name as your executor?
If you have children, who would you like to appoint as guardian?
Beneficiaries
Who would you like to name as primary beneficiaries?
Would you like to name contingent (secondary) beneficiaries?
Additional Notes / Special Instructions