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1.  Surname
2.  Forenames(please state all names)
3.  Address
E-mail:
5.  Telephone :
W:
M:
6.  Occupation
7.  Full name of Husband/Wife/Partner
8.   Are you married or in a civil partnership?
Yes
No
9.  If you are divorced, seperated or are contemplating marriage, then please telephone for further advice.
4.  Date of Birth
10.  Your house may be in joint names.  If it is then depending on the type of ownership it may on the first death automatically pass to the survivor
       and will not pass under your Will.  If you require further advice in this respect please telephone use.  This is important.
11.  Do you own property overseas?  
Yes
No
If so, where?
12.  It is normal to appoint firstly your HUSBAND/WIFE/PARTNER and ourselves as professional co-executors
Yes
No
13.  If you do not wish to appoint ourselves, then please state below the full names and addresses of at least two other people to be Executors
14.  If you have children under the age of 18 years, then we recommend you appoint two adult Guardians.  Please state the Guardians full names and
       Addresses.
Name:
Address:
Name:
Address:
Name:
Address:
Name:
Address:
15.  WHO DO YOU WANT YOUR ESTATE TO GO TO?
15.1  The whole estate to your HUSBAND/WIFE/PARTNER
Yes
No
15.2   If you are both dead, to your children
Yes
No
15.3   If you have no children now, you may in the future, would you
          Like your estate to go to them?
Yes
No
H:
Your Children
Full Name
Age
Full Name
Full Name
Full Name
Age
Age
Age
15.4 Who will receive your estate if you are both dead, and there are no children?  Please state here the full names and addresses of the beneficiaries.
         If they are not to share the estate equally, then please state the percentage or fraction each is to receive.
15.5 If you wish to leave precuniary legacies (sums of money) or specific bequests e.g. Jewellery, furniture, cars etc. to anybody, please give details
        and say who is to receive what.
16. Please state what you would like to happen to your remains:
A:     Burial
B. Cremation
Yes
Yes
No
No
17.  Do you have any health problems or other reasons that exist of which
        it is necessary for your Will to be executed as a matter of urgency?
Yes
No
18.           A.      Do you want a single Will for yourself?
                                             or
                B.      A mirror Will for yourself and your spouse/partner?
Yes
Yes
No
No
This questionnaire is intended to enable us to prepare a simple basic Will, but there may be other matters that you require advice and help with.  If this is the case, then you should telephone use to discuss them.  Please note if detailed advice relating to tax or if complicated provisions are required then it would be necessary to advise you as to additional costs.
19.   Any other information that you consider relevant:
20.  When the form has been completed, please submit it to us and we will prepare you a draft Will.
      The likely legal cost will be £125.00 + VAT for a single Will or £175.00 +VAT for two Wills with similar terms.
Will Questionnaire
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Estate Offices, Coronation Drive, Elm Park, Hornchurch, Essex, RM12 5BL   T: 01708 474019   F:01708 452465      
 111 High Street, Billericay, Essex, CM12 9AJ     T: 01277 633355   F: 01277 633377            
 Knight Court, 47 Crown Street, Brentwood, Essex, CM14 4BD   T: 01277 202500 F: 01277 202555
 19/21 Ongar Road, Brentwood, Essex, CM15 9AU   T: 01277 262822  F: 01277 232418