Personal information form - Couple

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What documents do you want to prepare

Will – allows you to legally appoint an executor and give instructions for what happens to your assets when you die.

Enduring Power of Attorney – allows you to legally appoint an attorney who can make financial and legal decisions for you while you are alive.

Enduring Guardianship – allows you to legally appoint a guardian who can make medical and personal decisions for you while you are alive.

You can find out more about these documents in our information guides or our videos on our website.

Who would you like to appoint as your executor?

Public Trustee

Another person

Who would you like to appoint as your attorney?

Public Trustee

Another person

Please note you cannot appoint the Public Trustee to be your guardian.

Section 1 – Contact Information

Client 1

Client 1 name:

Title Given names Surname

Preferred name:

Also known as name: (if applicable)

Occupation:

Date of birth:

DD slash MM slash YYYY

Contact number:

Mobile number:

Client 1 email address

Residential address:

Street no. and name: Suburb: State: Post Code:

Is your postal address the same as your residential address?

Yes

No – I have a different postal address

Postal address:

Street no. and name: Suburb: State: Post Code:

Client 2:

Client 2 name:

Title Given names Surname

Preferred name:

Also known as name: (if applicable)

Occupation:

Date of birth:

DD slash MM slash YYYY

Mobile number:

Contact number:

Client 2 email address:

Do Client 1 and Client 2 have the same address?

Yes – the same residential and postal address

No – different residential and postal address

Same residential address but a different postal address

Different residential address but same postal address

Client 2 – Residential address:

Street no. and name: Suburb: State: Post Code:

Client 2 – Postal address:

Street no. and name: Suburb: State: Post Code:

Your contact preferences

We may contact you about your documents or appointments. Your information is protected under the Personal Information Protection Act 2004.

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Section 2 – Relationship

Client One – Relationship status:

Single

Married

Significant Relationship (de facto)

Deed of Registered Relationship

Divorced

Separated

Widowed

Spouse/Partner name:

Place of marriage:

Date of marriage:

DD slash MM slash YYYY

Length of de facto relationship:

Length of registered relationship:

Ex Spouse/Partner full name:

Place of divorce:

Date of divorce:

DD slash MM slash YYYY

Are Client 1 and Client 2 relationship details the same?

Yes

Client Two – Relationship status:

Single

Married

Significant Relationship (de facto)

Deed of Registered Relationship

Divorced

Separated

Widowed

Spouse/Partner name:

Place of marriage:

Date of marriage:

DD slash MM slash YYYY

Length of de facto relationship:

Length of registered relationship:

Ex Spouse/Partner full name:

Place of divorce:

Date of divorce:

DD slash MM slash YYYY

If you’ve been married, divorced, or had other significant relationships in the past, please provide the details.

Section 3 – Children

Please include step children and/or any children you are estranged from.

Does either client have children?

Yes

How many children do you have between you?

Child 1

Child 1 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact number:

Email:

Client 1 relationship to child 1

Client 2 relationship to child 1

Is this child 1 under a disability?

If yes, state disability:

Child 2

Child 2 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact number:

Email:

Client 1 relationship to child 2

Client 2 relationship to child 2

Is this child 2 under a disability?

If yes, state disability:

Child 3

Child 3 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact number:

Email:

Client 1 relationship to child 3

Client 2 relationship to child 3

Is this child 3 under a disability?

If yes, state disability:

Child 4

Child 4 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact number:

Email:

Client 1 relationship to child 4

Client 2 relationship to child 4

Is this child 4 under a disability?

If yes, state disability:

Child 5

Child 5 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact Number:

Email:

Client 1 relationship to child 5

Client 2 relationship to child 5

Is this child 5 under a disability?

If yes, state disability:

Child 6

Child 6 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact Number:

Email:

Client 1 relationship to child 6

Client 2 relationship to child 6

Is this child 6 under a disability?

If yes, state disability:

Child 7

Child 7 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact Number:

Email:

Client 1 relationship to child 7

Client 2 relationship to child 7

Is this child 7 under a disability?

If yes, state disability:

Child 8

Child 8 full name:

Date of birth:

DD slash MM slash YYYY

Gender identity:

Address:

Contact Number:

Email:

Client 1 relationship to child 8

Client 2 relationship to child 8

Is this child 8 under a disability?

If yes, state disability:

Additional children

Please state any details about additional children:

Section 4 – Household goods and personal contents

Brief description of contents:

Eg: General household goods or if you have a special collection.

Estimated market value:

How are these assets owned?

If jointly owned by someone else please state with whom:

Does either client own any additional household goods and personal contents?

Yes

Please state any details about other household goods and personal contents

Section 5 – Motor vehicles, boats, campervans etc.

Does either client own a vehicle?

Yes

Description of vehicle(s):

E.g. Subaru Forester 2017

How is the vehicle owned?

If jointly owned with someone else please state with whom:

Estimated market value:

Do you have money owing against the vehicle?

Yes

Do you own any other types of vehicles?

Yes

Please state any details about other vehicle(s)

Section 6 – Property Details

Does either client own property?

Yes

Address of property:

Street no. and name: Suburb: State: Post Code:

How is the property held:

Property type:

How is the property owned?

If tenants in common, please state interest held:

If jointly owned with someone else please state with whom:

Location of title deeds:

Location of deed:

Estimated value:

Is there a mortgage over this property?

Yes

Mortgage Financial Institution:

Mortgage Outstanding:

Does either client own any additional properties?

Yes

Please state any details about additional property

Section 7 – Bank accounts and investments

Please state any additional bank accounts and investments at the end of the questionnaire

Does either client own a bank or Investment account?

Yes

Account 1

Financial Intuition:

How is this account owned?

If jointly owned with someone else please state with whom:

Estimated value:

Account Two

Account 2 – Financial Intuition:

How is this account owned?

If jointly owned with someone else please state with whom:

Estimated value:

Does either client own any other accounts or investments?

Yes

Please state any details about additional accounts or investments

Section 8 – Shares

Please state any additional shares at the end of the questionnaire

Does either client own any shares?

Yes

Share company holdings:

(eg. Woolworths, Telstra)

How are these shares owned?

If jointly owned please state with whom:

Estimated value:

Does either client have additional shares?

Yes

Please state any details about additional shares

Section 9 – Liabilities

Does either client have any liabilities?

E.g. Credit cards

Yes

Please provide details of liability:

How is the liability held?

If jointly held with someone else please state with whom:

Estimated value:

Does either client 1 or client 2 have additional liabilities?

Yes

Please state any details about additional liabilities?

Section 10 – Superannuation

Does either client have superannuation?

Yes

Client 1

Client 1 – Fund name:

Account type:

Account balance:

Death benefit:

If yes please state death benefit cover:

Nomination type:

Nominated to:

Beneficiary name(s) and relationship to you:

Client 2

Client 2 – Fund name:

Account type:

Account balance:

Death benefit:

If yes please state death benefit cover:

Nomination type:

Nominated to:

Beneficiary name(s) and relationship to you:

Does either client have additional superannuation accounts?

Yes

Please state any details about additional superannuation accounts

Section 11 – Funeral Arrangements

Does either client have any funeral arrangements?

e.g. Pre-paid funeral, pre-arranged funeral or funeral insurance.

Yes

Pre-paid funeral:

Pre-arranged funeral:

Funeral insurance:

Please state the details

Section 12 – Life Insurance

Does either client have life insurance?

Yes

Client 1

Client 1 – Fund name:

Nomination in place:

If yes, please state who it is nominated to:

Beneficiary name and relationship to you:

Insurance cover:

Client 2

Client 2 – Fund name:

Nomination in place:

If yes, please state who it is nominated to:

Beneficiary name and relationship to you:

Insurance cover:

Does either client have additional life insurance accounts?

Yes

Please state any details about additional life insurance accounts

Section 13 – Other Assets:

Does either client own any foreign assets?

Yes

Please state the details any foreign assets you own

Does either client own an interest in a business?

Yes

Please state the details any interests in a business

What prompted you to make an appointment?

I am a previous client and knew I had to update my document

I did a web search

I had a promotional voucher

I received an email reminder

I went to a seminar

I am a beneficiary of estate

I saw a display ad on social media

a TV/radio ad

A friend recommended me

I picked up a brochure at Service Tasmania

Other

What seminar did you attend?

Please state the details?

Personal information form – Couple

Section 1 – Contact Information

Your contact preferences

Section 2 – Relationship

Section 3 – Children

Section 4 – Household goods and personal contents

Section 5 – Motor vehicles, boats, campervans etc.

Section 6 – Property Details

Section 7 – Bank accounts and investments

Section 8 – Shares

Section 9 – Liabilities

Section 10 – Superannuation

Section 11 – Funeral Arrangements

Section 12 – Life Insurance

Section 13 – Other Assets:

What prompted you to make an appointment?

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