Win Law

330 Bay Street
Toronto, ON
M5J 0B6

(437)703-7554

Estate Planning Worksheet

Thank you so much for contacting our law office. Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation.

Privacy Policy

All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your Social Security number and other personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

Social Security numbers are most often used to positively identify parties. Most courts require Social Security numbers of all parties in a case. Some other examples of how this information may be used include:

initial service
in court orders
in required reports or other documents filed with the State

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you.

CLIENT INFORMATION

Contact information

Prefix

First name *

Middle name

Last name *

Date of birth

Company

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Phone numbers

Phone number

Type

Add phone number

Other Names:

Aliases

Social Security #:

Separate Mailing Address:

if applicable

Are you a U.S. citizen?

Yes

No

Occupation:

Are you currently employed?

Yes

No

Are you a veteran?

Yes

No

SPOUSE’S INFORMATION

(If applicable)

Full Legal Name:

Other Names:

Aliases

Address:

if different

Phone:

Email:

Date of Birth:

Social Security #:

Is your spouse a U.S. Citizen?

Yes

No

Occupation:

Is your spouse currently employed?

Yes

No

Is your spouse a veteran?

Yes

No

MARRIAGE INFORMATION

(if applicable)

Date of Marriage:

Place of Marriage:

CLIENT - Do you have any previous marriages?

Yes

No

SPOUSE - Do you have any previous marriages?

Yes

No

Do you have a pre-marital agreement?

Yes

No

Previous Will

Do you have any previous will(s) or codicils?

Yes

No

CHILDREN’S INFORMATION (if applicable)

For each child, please select "Yes" and fill out the following information.

Child #1:

Yes

No

Child #2:

Yes

No

Child #3:

Yes

No

Child #4:

Yes

No

Child #5:

Yes

No

GRANDCHILDREN'S INFORMATION (if applicable)

For each grandchild, please select “Yes” and fill out the following information.

Grandchild #1:

Yes

No

Grandchild #2:

Yes

No

Grandchild #3:

Yes

No

Grandchild #4:

Yes

No

Grandchild #5:

Yes

No

Do you have any additional grandchildren?

Yes

No

DEPENDENTS OR OTHER BENEFICIARIES (if applicable)

For each dependent or other beneficiary, please select “Yes” and fill out the following information.

Other Dependent or Other Beneficiary #1:

Yes

No

Other Dependent or Other Beneficiary #2:

Yes

No

Other Dependent or Other Beneficiary #3:

Yes

No

Other Dependent or Other Beneficiary #4:

Yes

No

Other Dependent or Other Beneficiary #5:

Yes

No

Are there any other charitable organizations you wish to make provisions for at the time of your death?

Please explain below.

ADVISORS

Attorney:

(Name, Company & Phone Number)

Accountant:

(Name, Company & Phone Number)

Financial Advisor:

(Name, Company & Phone Number)

Life Insurance Agent:

(Name, Company & Phone Number)

Long-Term Care Insurance Agent:

(Name, Company & Phone Number)

Other Advisor #1:

(Name, Company & Phone Number)

Other Advisor #2:

(Name, Company & Phone Number)

ASSETS

For each asset, please select “Yes” and fill out the following information.

Real Property

Any interest in real estate including your family residence, vacation home, timeshare, or vacant land.

Real Property #1:

Yes

No

Real Property #2:

Yes

No

Real Property #3:

Yes

No

Real Property #4:

Yes

No

Furniture and Personal Effects

List separately only major personal effects such as jewelry, collections, antiques, furs, and all other valuable non-business personal property (give lump sum value for miscellaneous less separately listed valuable items).

Furniture or Personal Effect #1:

Yes

No

Furniture or Personal Effect #2:

Yes

No

Furniture or Personal Effect #3:

Yes

No

Furniture or Personal Effect #4:

Yes

No

Automobiles, Boats and RVs

For each motor vehicle, boat, RV, etc.

Vehicle #1:

Yes

No

Vehicle #2:

Yes

No

Vehicle #3:

Yes

No

Vehicle #4:

Yes

No

Bank & Savings Accounts

Bank Account #1:

Yes

No

Bank Account #2:

Yes

No

Bank Account #3:

Yes

No

Bank Account #4:

Yes

No

Investment Accounts, Bonds, Stocks and Stock Options

List any and all investment accounts (IA), bonds (B), stocks (S) and stock options (SO) you have an interest in. If including stock options, please indicate the value of vested and unvested options separately. If held in a brokerage account, lump them together under each account.

Investment Account, Bond, Stock or Stock Option #1:

Yes

No

Investment Account, Bond, Stock or Stock Option #2:

Yes

No

Investment Account, Bond, Stock or Stock Option #3:

Yes

No

Investment Account, Bond, Stock or Stock Option #4:

Yes

No

Life Insurance Policies and Annuities

Types: Term, Whole Life, Split Dollar, Group Life, Annuity.

Policy #1:

Yes

Name of Company: Type of Account: Face Amount:

(death benefit)

Whose Life is Insured: Who Owns the Policy: The Current Beneficiaries: Who Pays the Premium: Who Is The Life Insurance Agent:

No

Policy #2:

Yes

Name of Company: Type of Account: Face Amount:

(death benefit)

Whose Life is Insured: Who Owns the Policy: The Current Beneficiaries: Who Pays the Premium: Who Is The Life Insurance Agent:

No

Policy #3:

Yes

Name of Company: Type of Account: Face Amount:

(death benefit)

Whose Life is Insured: Who Owns the Policy: The Current Beneficiaries: Who Pays the Premium: Who Is The Life Insurance Agent:

No

Policy #4:

Yes

Name of Company: Type of Account: Face Amount:

(death benefit)

Whose Life is Insured: Who Owns the Policy: The Current Beneficiaries: Who Pays the Premium: Who Is The Life Insurance Agent:

No

Retirement Plans

Pension, Profit Sharing, H.R.10, IRA, SEP, 401K

Retirement Plan #1:

Yes

No

Retirement Plan #2:

Yes

No

Retirement Plan #3:

Yes

No

Retirement Plan #4:

Yes

No

Business Interests

General and Limited Partnerships, Sole Proprietorships, Privately Owned Corporations, Oil Interests, Farm and Ranch Interests

Business Interest #1:

Yes

No

Business Interest #2:

Yes

No

Business Interest #3:

Yes

No

Business Interest #4:

Yes

No

Money Owed to You

Mortgages or promissory notes payable to you, or other moneys owed to you

Money Owed to You #1:

Yes

No

Money Owed to You #2:

Yes

No

Money Owed to You #3:

Yes

No

Money Owed to You #4:

Yes

No

Anticipated Inheritance, Gift, or Lawsuit Judgment

Gifts or Inheritances that you expect to receive at some time in the future; or moneys that you anticipate receiving through a judgment in a lawsuit.

Anticipated Inheritance, Gift, or Lawsuit Judgment:

Describe in appropriate detail.

Safe Deposit Box

Safe Deposit Box Details:

(Name of Bank, Value, Etc.)

Other Assets

Other property is any property that you have that does not fit into any listed category.

Other Asset #1:

Yes

No

Other Asset #2:

Yes

No

Other Asset #3:

Yes

No

Other Asset #4:

Yes

No

LIABILITIES

Mortgages, Loans Credit Cards or Other Liabilities

Liability #1:

Yes

No

Liability #2:

Yes

No

Liability #3:

Yes

No

Liability #4:

Yes

No

Liability #5:

Yes

No

NOMINATION OF POWERS

Identify all potential Trustees, Executors, Financial Agents, Health Care Agents, Long-Term Guardians, Short-Term Guardians, and Guardians for Pets

Executors

Upon your death, who do you want to manage and distribute the assets you leave in your estate?

CLIENT - Would you like to list your EXECUTORS?

Yes

No

SPOUSE - Would you like to list your EXECUTORS?

Yes

No

Trustees

Upon your death, who do you want to manage and distribute the assets you leave in your trust estate for children?

CLIENT - Would you like to list your TRUSTEES?

Yes

No

SPOUSE - Would you like to list your TRUSTEES?

Yes

No

Guardians of Minor Children

If you have children under the age of 18, list those persons who you would wish to raise and love them in the manner closest to the way you.

CLIENT - Would you like to list your GUARDIANS OF MINOR CHILDREN?

Yes

No

SPOUSE - Would you like to list your GUARDIANS OF MINOR CHILDREN?

Yes

No

Durable Power of Attorney

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your financial affairs?

CLIENT - Would you like to list your DURABLE POWER OF ATTORNEY AGENTS?

Yes

No

SPOUSE - Would you like to list your DURABLE POWER OF ATTORNEY AGENTS?

Yes

No

Health Care Power of Attorney

If you were incapacitated for any period of time, who would you want to make decisions for you with regard to your health care?

CLIENT - Would you like to list your HEALTH CARE AGENTS?

Yes

No

SPOUSE - Would you like to list your HEALTH CARE AGENTS?

Yes

No

ADDITIONAL INFORMATION

Additional Information or Concerns:

Your estate plan should address all your hopes, fears, and wishes. Please list any other items you want included or want to discuss.

Who Referred You To Us?

THANK YOU

When you are finished, please click the "Submit" button.