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Will Drafting Application Form

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Please select whether this will is to be prepared as a single or joint will:		Single Joint


Personal Details

Title:
Surname:
Full Name(s):
Telephone Home:	code:	number:
Telephone Work:	code:	number:
E-Mail:
Address:

Date of Birth:	day: month: year:

ID / Passport number:
Occupation:

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Marital Status


Marital Status:	Single Divorced	Widow/er Married

Marital Agreement (if married):	Married ANC Accrual	Married COP

	Full Name of Spouse:	Identity Number:


	Full Names of Children:	Identity Number:





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Assets / Liabilities


Assets	(*check the applicable items)	Client: Spouse:
Fixed Properties	Town Farm Mineral Rights*	N$ N$

Business	Sole Proprietor Partnership CC Private Coy*	N$ N$

Investments	(Bank deposits, quoted shares, unit trusts etc)	N$ N$

Movables	(Vehicles, furniture, jewellery, collectable's)	N$ N$

Life Assurance	(Payable to estate only - see also below)	N$ N$

Other Assets (Describe)		N$ N$

Gross Value of Assets		N$ N$

Life Assurance / other lump sums payable to spouse or dependants		N$ N$

Liabilities		N$ N$

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Special Requests (Cash amounts or items to be specially bequeathed)


Full Names of Beneficiary	Relationship	Amount / Description of Item




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Heir/s to the Residue of the Estate


Full Names	Relationship: Proportion :	ID Number: Date of Birth:




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Alternate Heirs to the Residue (Should any or all of the heirs named fail)


Full Names	Relationship: Proportion :	ID Number: Date of Birth:




Trusts for Minor Children Required:	Yes No	Age 21 Age 25 Other age:
Guardian for Minor Children :
Full Names	Address


Bank Name:
Banking Branch:

Notes:

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