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The purpose of this questionnaire.


MERISTEM WEALTH MANAGEMENT LIMITED (MWML) will use the information you provide in this questionnaire:


1. To help you organize personal and financial information so that we can assess your estate plans and evaluate whether changes are desired or required.


2. The details provided in this questionnaire will be used to generate an initial proposal for your Evergreen plan. We crave your patience to thoroughly fill in the required information.


The information you provide must be as accurate as possible. If you are uncertain about exact information, please give your best assessment. We recognize that this questionnaire is an intrusive document and may require the divulgence of very private details and wish to reassure you that the information revealed or given in this questionnaire would be kept confidential unless you authorize or request its release to others.


Please be advised that the more complete the information is, the better it will equip you and MWML throughout the planning process to come up with the best possible plan.


State the names requested below exactly as you want them to appear in your account.