200 Ronson Drive, Suite 310
Toronto, Ontario
M9W 5Z9
Office: 416-243-3394
Fax: 416-243-9692
Leonard A. Banks, B.A., LL.B - Ext. 209
lbanks@banksandstarkman.com
ESTATE PLANNING WORKBOOK
PERSONAL INFORMATION
FULL NAME:
THE NAME YOU COMMONLY USE, IF DIFFERENT:
HOME ADDRESS:
HOME PHONE NUMBER:
WORK PHONE NUMBER:
CELL NUMBER:
EMAIL ADDRESS:
OCCUPATION:
EMPLOYER INFORMATION:
DATE OF BIRTH:
CITIZENSHIP:
S.I.N. NUMBER:
PLACE OF BIRTH:
MARITAL STATUS:
DATE AND PLACE OF MARRIAGE IF APPLICABLE:
DO YOU HAVE A DOMESTIC CONTRACT?
ANY PREVIOUS MARRIAGES?
FULL NAME(S) OF EX-SPOUSE(S):
DO YOU HAVE ANY SUPPORT OBLIGATIONS?
SPOUSAL OR CHILD
REFERRED BY:
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SPOUSAL INFORMATION (IF APPLICABLE):
FULL NAME OF SPOUSE:
THE NAME YOU COMMONLY USE IF DIFFERENT:
DATE AND PLACE OF MARRIAGE:
DO YOU HAVE A DOMESTIC CONTRACT?
ADDRESS (IF DIFFERENT FROM ABOVE):
CITY AND POSTAL CODE:
WORK PHONE NUMBER:
CELL NUMBER:
OCCUPATION:
DATE OF BIRTH:
CITIZENSHIP:
PLACE OF BIRTH:
S.I.N. NUMBER:
ANY PREVIOUS MARRIAGES?
FULL NAME(S) OF EX-SPOUSE(S):
DO YOU HAVE ANY SUPPORT OBLIGATIONS? SPOUSAL OR CHILD
CHILDREN AND GRANDCHILDREN:
FULL NAMES AND AGES OF ALL CHILDREN FROM PREVIOUS
MARRIAGES:
DATE AND PLACE OF BIRTH OF ALL CHILDREN FROM PREVIOUS
MARRIAGES:
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FULL NAMES AND AGES OF ALL CHILDREN FROM CURRENT
MARRIAGE:
DATE AND PLACE OF BIRTH OF ALL CHILDREN FROM CURRENT
MARIAGE:
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ARE ANY OF YOUR CHILDREN NON-RESIDENTS OF CANADA? IF SO, PLEASE PROVIDE ADDRESSES.
ARE ANY OF YOUR CHILDREN MARRIED? IF SO, PLEASE PROVIDE DETAILS OF SPOUSE AND GRANDCHILDREN, IF ANY:
ARE YOU LEGALLY OBLIGATED TO SUPPORT ANY OTHER PERSON IN ADDITION TO YOUR SPOUSE AND CHILDREN? HAVE YOU BEEN
PROVIDING SUPPORT TO ANYONE OTHER THAN YOUR SPOUSE AND CHILDREN? IF YES, PLEASE PROVIDE THE DETAILS:
DETAILS OF ANY RELEVANT PERSONAL SITUATIONS RELATING TO CHILDREN OR OTHER BENEFICIARIES e.g. disabled dependants or
children.
GENERAL:
NAME OF ACCOUNTANT:
TELEPHONE NUMBER:
ADDRESS:
NAME OF FINANCIAL ADVISOR:
TELEPHONE NUMBER:
ADDRESS:
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PROPERTY/FINANCIAL INFORMATION:
1. REAL ESTATE – YOUR HOME
NAMES ON TITLE AND HOW IS IT OWNED? (ie) as joint tenants,
as tenants in common:
CURRENT MARKET VALUE:
VALUE OF MORTGAGES OR OTHER ENCUMBRANCES:
ACQUISITION COST AND DATE:
2. OTHER REAL ESTATE – PROPERTY 1
STREET ADDRESS OR LOCATION:
NAMES ON TITLE AND HOW IS IT OWNED? (ie) as joint tenants,
as tenants in common:
CURRENT MARKET VALUE:
VALUE OF MORTGAGES OR OTHER ENCUMBRANCES:
ACQUISITION COST AND DATE:
3. OTHER REAL ESTATE – PROPERTY 2
STREET ADDRESS OR LOCATION:
NAMES ON TITLE AND HOW IS IT OWNED? (ie) as joint tenants,
as tenants in common:
CURRENT MARKET VALUE:
VALUE OF MORTGAGES OR OTHER ENCUMBRANCES:
ACQUISITION COST AND DATE:
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4. RRSP’s
PLAN HOLDER
ISSUED BY
BENEFICIARY
VALUE TO ESTATE
ISSUED BY
BENEFICIARY
VALUE TO ESTATE
POLICY 2
POLICY 3
5. DPSP’s
PLAN HOLDER
6. INSURANCE
NAME AND PHONE NUMBER OF INSURANCE ADVISOR:
POLICY 1
ISSUED BY AND POLICY
NUMBER
NAME OF OWNER
NAME OF LIFE INSURED
NAME OF BENEFICIARY
VALUE OF ESTATE
7. MONEY ON DEPOSIT
NAME AND ADDRESS OF
BANK OR DEPOSITORY
TYPE OF ACCOUNT AND NO.
OWNERSHIP
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APPROXIMATE AMOUNT
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8. INVESTMENT PORTFOLIO OUTSIDE RRSP’S e.g. Stocks, Bonds, Debentures,
Guaranteed Investment Certificates, etc.:
NAME OF INVESTMENT ADVISOR:
APPROXIMATE VALUE OF PORTFOLIO: (attach a copy of most
recent portfolio statement(s).)
DO YOU OWN ANY STOCKS, BONDS, DEBENTURES, GICs, ETC.
OUTSIDE OF YOUR PORTFOLIO(S)?
IF YE S, PLEASE ATTACH A LIST INCLUDING CURRENT VALUE,
ACQUISITION COST AND DATE, AND THE LOCATION OF THE
INSTRUMENT:
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9. BUSINESS INTERESTS:
DO YOU HAVE ANY INTERESTS IN A PARTNERSHIP OR AN
UNINCORPORATED BUSINESS?
IF YES, PLEASE PROVIDE A COPY:
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DO YOU OWN SHARES IN A PRIVATE ONTARIO CORPORATION? IF SO, PLEASE PROVIDE:
BUSINESS NAME:
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BUSINESS NUMBER:
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NUMBER OF SHARES: _______________________
COMMON: __________ SPECIAL: ______________
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DEBTS:
1. DEBTS OWING BY YOU INCLUDING PROMISSORY NOTES:
NAME OF CREDITOR
AMOUNT
MATURITY
OTHER TERMS
2. DEBTS OWING TO YOU INCLUDING PROMISSORY NOTES:
NAME OF CREDITOR
AMOUNT
MATURITY
MISCELLANEOUS:
DO YOU HAVE A PREVIOUS WILL?
DOES YOUR SPOUSE HAVE A WILL?
ARE YOU AN EXECUTOR/TRUSTEE FOR SOMEONE ELSE? IF SO, PLEASE PROVIDE DETAILS:
ARE YOU PRESENTLY RECEIVING BENEFITS FROM AN ESTATE OR TRUST? IF SO, PLEASE GIVE PARTICULARS:
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OTHER TERMS
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DO YOU OWN ANY AUTOMOBILES?
IF YES, PLEASE PROVIDE DESCRIPTION, OWNERSHIP, AND
VALUE:
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DO YOU OWN ANY BOATS OR RECREATION VEHICLES?
IF YES, PLEASE PROVIDE DESCRIPTION, OWNERSHIP, AND
VALUE:
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DO YOU OWN ANY HEIRLOOMS, ARTWORK, JEWELLERY, AND
ANY COLLECTIONS, ETC. OF SPECIAL NOTE?
DO YOU OWN ANY HOUSEHOLD GOODS AND FURNITURE OF
SPECIAL NOTE?
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APPROXIMATE TOTAL VALUE OF ASSETS:
$ _____________________________________________
APPROXIMATE TOTAL VALUE OF DEBTS:
$ __________________________________________________
APPROXIMATE NET VALUE OF ESTATE:
$ _____________________________________________
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PERSONAL PROPERTY:
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