Will Questionnaire - Riopelle Group

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Having a will is an effective, safe way to ensure that your wishes are carried out the way you intended them to be. We, at Riopelle Group, will provide expertise and advice to guide you through this process. The questions and answers are detailed and may be time consuming but it will result in your lawyer understanding exactly what your concerns and needs are in respect to the administration of your estate and even protecting the choice of a guardian for your children. If you don’t know how to respond to a question, simply make a note at the end of this questionnaire. Your lawyer will be happy to discuss with you at your appointment. Please note that the information on this form is held in the strictest confidentiality.

Part I – Personal and Family Information

Part 2 – Will Executors

Part 3 – Distribution of Estate

Part 4 – General

Part 5 – Guardianship of Minors and Dependents

Part 6 – Powers of Attorney

PART I - PERSONAL AND FAMILY INFORMATION

NOTE: Person 1 and Person 2 names must remain consistent throughout the questionnaire.
Person 1
Person 2
Person 1: Full Legal Name
First Middle Last
Residence for Tax Purposes
Street Address Address Line 2 City Province Postal Code Country
Date of Birth
Place of Birth
Citizenship
Home Phone
Cell Phone
Email
Address
Street Address Address Line 2 City Province Postal Code Country
Occupation
Annual Income
Marital Status
Date of Marriage
Place Of Marriage
Common Law Date
Cohabitation Date
Separation Agreement
Do you have a marriage contract?
Will made in contemplation of marriage?
Do you have a current Will?
Please bring it with you to your consultation.
Are you presently receiving benefits from an estate or trust?
Have you set up a trust for another person?
Do you own a business?
Do you have multiple wills?
International Property
Person 2: Full Legal Name
First Middle Last
Residence for Tax Purposes
Street Address Address Line 2 City Province Postal Code Country
Date of Birth:
Place of Birth
Citizenship
Home Phone:
Cell Phone:
Email:
Address
Street Address Address Line 2 City Province Postal Code Country
Occupation
Anual Income
Marital Status
Date of Marriage
Place Of Marriage
Do you have a marriage contract?
Will made in contemplation of marriage?
Common-law-date
Cohabitation date
Separation Agreement
Do you have a current Will?
Are you presently receiving benefits from an estate or trust?
Please bring it with you to your consultation
Have you set up a trust for another person?
Do you own a business?
Do you have multiple wills?
International Property
Children of present relationship (Person 1 and Person 2)
Full Name
First Middle Last
Date of Birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Would you like to add another child?
Full Name
First Middle Last
Date of birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Would you like to add another child?
Name
First Middle Last
Date of birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Person 1 – children from outside relationship with Person 2:
Full Name
First Middle Last
Date Of Birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Would you like to add another child?
Name
First Middle Last
Date
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Would you like to add another child?
Name
First Middle Last
Date of birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Person 2 - children from outside relationship with Person 1:
Name
First Middle Last
Date Of Birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability
Please describe
Would you like to add another child?
Name
First Last
Date of birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Would you like to add another child?
Name
First Last
Date of birth
Do they live at the same address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do they have a disability?
Please describe
Other dependents
Do you have any other dependents you would like to add?
Full Name
First Middle Last
Relationship
Would you like to add another dependent?
Full Name
First Middle Last
Relationship

PART 2 - WILL EXECUTOR(S)

NOTE: One person can act as your Executor and you may name an Alternate, in the event your first choice resigns, gets sick or dies. Example: You can name your spouse as Executor then name your brother as Alternate. You can also name more than one Primary Executor, but the co-Executors must act jointly. Each Executor has equal legal authority.
Person 1

Primary Executor
Full Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to add an additional Executor?
Full Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to add an Alternate Executor?
Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to provide compensation for acting as your Executor?
Compensation options
Amount
Are you currently acting as an Executor, Trustee, or Guardian?
Please provide a brief description
Person 2

Primary Executor
Full Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to add an additional Executor?
Full Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to add an Alternate Executor?
Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Would you like to provide compensation for acting as your Executor?
Compensation options
Amount
Are you currently acting as an Executor, Trustee, or Guardian?
Please provide a brief description

PART 3 - DISTRIBUTION OF RESIDUE

NOTE: By law, a person receives gift at age of majority. You can either gift entirely or through a staged distribution. Per Stirpes means one equal share is created for each then-living child of yours. If this child dies, his/her share goes to their heirs (children) in equal shares. Per Capita indicates that NO ONE except the named beneficiary receive that share of the estate (does NOT pass down to your child’s children) or class of beneficiary.
To Surviving Spouse?
If no surviving spouse, then to children?
What kind of distribution would you like?
Capital is distributed to children at the following ages:

NOTE: Example of distribution - Deliver 1/3 to children at age 21, deliver 1/3 to children at age 25, deliver balance to children at age 30. Power to encroach: You can decide in your Will whether or not you want to give the beneficiary the option to ask for an encroachment. If yes, encroachment means the Executor of your estate will then have the choice to say yes or no to any request for additional funds from the beneficiary.

FIRST
Age
Amount
Power to Encroach?
SECOND
Age
Amount
Power to Encroach?
THIRD
Age
Amount
Power to Encroach?
FOURTH
Age
Amount
Power to Encroach?
NOTE: Example of distribution - Deliver 1/3 to children at age 21, deliver 1/3 to children at age 25, deliver balance to children at age 30. Power to encroach: You can decide in your Will whether or not you want to give the beneficiary the option to ask for an encroachment. If yes, encroachment means the Executor of your estate will then have the choice to say yes or no to any request for additional funds from the beneficiary.

NOTE: Common Accident – if the above provisions no longer pertain due to a common accident divide the combined estate 50/50 amongst the following. This can be discussed with your lawyer during your appointment.
Person 1

Common Accident Provisions
Name
First Last
Relationship to you
Add another provision?
Name
First Last
Relationship to you
Add another provision?
Name
First Last
Relationship to you
Person 2

Common Accident Provisions
Name
First Last
Relationship to you
Add another provision?
Name
First Last
Relationship to you
Add another provision?
Name
First Last
Relationship to you

PART 4 - GENERAL
1. Pension Plan
Name of Company
Policy #
Named Beneficiary(s)
Add another pension plan?
Name of Company
Policy #
Named Beneficiary(s)
Add another pension plan?
Name of Company
Policy #
Named Beneficiary(s)
2. Life Insurance
Name of Company
Policy #
Named Beneficiary(s)
Add another insurance plan?
Name of Company
Policy #
Named Beneficiary(s)
Add another insurance plan?
Name of Company
Policy #
Named Beneficiary(s)
NOTE: If there are named beneficiaries in the life insurance policy(ies) or RRSP(s), the beneficiary designations over-ride the terms of the Will, unless the Will specifically states otherwise.
3. RRSPs/RRIFs/TFSAs
Name of Company
Policy #
Named Beneficiary(s)
Add another plan?
Name of Company
Policy #
Named beneficiary(s)
Add another plan?
Name of company
Policy #
Named beneficiary(s)
NOTE: A Holograph list (Memorandum of Personal Effects) is a handwritten itemized list of specific household or personal items designated to certain people. Example – My coin collection to my daughter Trudy Smith. Date and sign the list and update it regularly.
4. Specific Gifts – Indicate whether taxes to be paid by Estate (Est) or Beneficiary (Ben)
Disposition of residence
Payment of mortgage from residue?
Disposition of household goods
Cash legacies
Charitable donations
Holograph List
Reference to Holograph List in Will?
Special Funeral Instructions
Handling of remains

PART 5 – GUARDIANSHIP OF MINORS AND DEPENDANTS
Guardian Name
First Last
Relationship to you
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions
Substitute Guardian Name
First Last
Relationship to you
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions

PART 6 – POWERS OF ATTORNEY

NOTE: Jointly: Attorney 1 and 2 (more than two are allowed if desired) must work together as your Attorney. Severally: Any named Attorneys may make decisions separately of each other. Substitute: In the event your named Attorney(s) resigns, gets sick or dies, you may name a Substitute.
Person 1
Personal Care
Attorney 1 Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attorney 2 Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Would you like to name a substitute attorney?
Substitute Attorney Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Person 2
Personal Care
Attorney 1 Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attorney 2 Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Would you like to name a substitute attorney?
Substitute Attorney Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
LIVING WILL CLAUSE OPTIONAL INSTRUCTIONS (please indicate if you want the following clause included)

I do not want my life to be prolonged and I do not want life-sustaining treatment if I have a condition that is incurable or irreversible and, without the administration of life sustaining treatment, expected to result in death within a relatively short time, or if I am in a coma or persistent vegetative state which is reasonably concluded to be irreversible. I do, however, ask that medication be mercifully administered to me or medical or surgical procedures be taken to alleviate suffering even though this may shorten my remaining life. If I do not at any time have the capacity to give personal instructions to this effect, I direct any competent authority to have regard to this direction and to any instruction of my attorney. I relieve any person acting on this direction and the direction of my attorney from any and all liability for acting on such directions.
Person 1
Do you want to include the above living will clause?
Person 2
Do you want to include the above living will clause?
Person 1 Confirmation of Information
I hereby confirm my above information and acknowledge that this is not a drafted and executed Will but this document may serve as evidence of my intentions in the event of an untimely event causing death or incapacity.
Date
Person 2 Confirmation of Information
I hereby confirm my above information and acknowledge that this is not a drafted and executed Will but this document may serve as evidence of my intentions in the event of an untimely event causing death or incapacity.
Date
Questions and/or Comments?
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Step 1 of 7

Part I – Personal and Family Information

Part 2 – Will Executors

Part 3 – Distribution of Estate

Part 4 – General

Part 5 – Guardianship of Minors and Dependents

Part 6 – Powers of Attorney

PART I - PERSONAL AND FAMILY INFORMATION

Children of present relationship (Person 1 and Person 2)

Person 1 – children from outside relationship with Person 2:

Person 2 - children from outside relationship with Person 1:

Other dependents

PART 2 - WILL EXECUTOR(S)

Person 1

Primary Executor

Person 2

Primary Executor

PART 3 - DISTRIBUTION OF RESIDUE

Capital is distributed to children at the following ages:

FIRST

SECOND

THIRD

FOURTH

Person 1

Common Accident Provisions

Person 2

Common Accident Provisions

PART 4 - GENERAL

1. Pension Plan

2. Life Insurance

3. RRSPs/RRIFs/TFSAs

4. Specific Gifts – Indicate whether taxes to be paid by Estate (Est) or Beneficiary (Ben)

PART 5 – GUARDIANSHIP OF MINORS AND DEPENDANTS

PART 6 – POWERS OF ATTORNEY

Person 1

Person 2

LIVING WILL CLAUSE OPTIONAL INSTRUCTIONS (please indicate if you want the following clause included)

Person 1

Person 2