Please enable JavaScript in your browser to complete this form.Full Name *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email *Spouse's Full Name *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Home Address *Phone Number *State of OriginReligion *ChristainityIslamOtherMarital Status *SingleMarriedWidowIf married, what type of marriage *Marriage by the ActCustomary MarriageIslamic MarriageHave you been married before?YesNoAre there any customary traditions common to people from your region?YesNoIf Yes, kindly give detailsCHILDREN OF PRESENT MARRIAGEChild 1Full NameDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child 2Full Name Date of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child 3Full NameDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child 4Full NameDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920CHILDREN FROM OTHER MARRIAGES AND DATE OF BIRTHFull NameDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Full Name Date of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Full NameDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DEPENDANTSFull Name Full Name Full NamePERSONAL ESTATE PLANNING OBJECTIVESWhat are your personal and specific goals? E,g financial dependence for children, charitable causes, management of asset in the event of incapacitation etc *DO YOU HAVE ANY OF THE DOCUMENTS LISTED BELOW EXECUTED OR FILED? (Please provide us with a copy)A WillA Living TrustDeed of GiftJoint OwnershipPower of AttorneyPERSONAL AND FAMILY FINANCIAL ASSETSAssets mean cash, shares in publicly quoted companies and property interests such as interests in real estate. With regards to real estate, it is important for us to know the location (city and state) of the real estate and the type of the property, e.g., residence, shopping center, apartment house, or similar description.REAL ESTATETYPE OF PROPERTY, VALUE, LOCATION AND ADDRESS TITLE DOCUMENTS ON THE ASSETSCASHBANK NAME, VALUETANGIBLE PROPERTY (AUTOS/JEWELRY/ART/ETC.)DESCRIPTION OF PROPERTY, VALUESHARES OF LISTED COMPANIES (PUBLIC)NAME OF COMPANY, UNITS, NAME SHARES ARE HELD,STOCKBROKING HOUSE SHARE IS DOMICILED SHARES OF COMPANIES (PRIVATE)NAME OF COMPANY, VALUE OF SHARE, NAME SHARES ARE HELD,STOCKBROKING HOUSE SHARE IS DOMICILED DIGITAL ASSETSDigital assets mean any asset that exists in binary form and include but not limited to emails, documents, images, audio, videos and similar digital files which currently exist or may exist as technology develops, stored on desktops, laptops, tablets storage devises, smart phones and any other similar digital device.Paragraph TextDIGITAL ASSETS, BENEFICIARYLIFE INSURANCE.Ordinary life insurance. List Company, name, address, and policy number.Face amount of policies (proceeds):Beneficiaries:Cash value:ASSET DISPOSITIONPlease give a list of your intended beneficiariesBENEFICIARY – ASSETWhat is the likely duration of your estate plan?Is there anyone you specifically like to exclude from your estate plan?OTHER MATTERS Describe or list here any facts or matters that do not seem to be covered by this questionnaire and that you believe may be important for us to know.APPOINTMENT OF EXECUTORS/PROTECTORWould you wish to appoint Protector of the Trust in your absence or incapacitation? Please indicate the persons and your expectations from themNOTICEKindly note that this is optional and depends on your wishes. The role of the Protector can only commence on the demise of the Settlor and the Protectors are not competent to terminate the trust and they are to work with the Trustee to ensure that the settlor’s objectives are fulfilled. Their roles are not to clash with the Trustee at any point in time.NameSubmit