QUESTIONNAIRE

Please complete the following questionnaire to enable us to help you with setting up your Trust.

Information Required		Mr/Mrs/Ms	Mr/Mrs/Ms
Full Names
Occupations
Your Address
Phone Number
Fax Number
E-mail Address
Accountant
Name
Address
Phone Number
Financial Advisor
Name
Address
Phone Number
Medical
Date of Birth
Do you have any serious health problems
Children
The full names of your children, their ages, places of residence and occupations	1.
	2.
	3.
Trustees
Full names, places of residence and occupations of those to be trustees of your wills NOW and following the death of the first of you		The other of you Yes No	The other of you Yes No
		Others now Yes No	Others now Yes No
		If others specify:	If others specify:
Others to be appointed as trustees of the death of the first/last of you
Guardians
Full names, residence, and occupations of guardians of your infant children	1.
	2.

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