ABOUT YOU

Are you completing this questionnaire:

Select an option For myself only For myself and my spouse/partner

Your Details

Preferred Name:

Have you ever been known by another name?

Yes

Please provide details:

No

Occupation:

Relationship Status:

Select an option Married De Facto Engaged Single Separated Divorced Widowed

Spouse/Partner Details

Full Legal Name:

Preferred Name:

Have you ever been known by another name?

Yes

Please provide details:

No

Date of Birth:

Occupation:

Residential Address (if different):

Mobile Number:

Email Address:

YOUR ESTATE PLANNING

Do you currently have any of the following?

WillEnduring Power of AttorneyEnduring Guardianship AppointmentAdvance Care DirectiveNone of the Above

If applicable, where are the original documents located?

Select an option At Home With a Law Firm Safe Custody Facility With Another Person Unsure

Please provide any additional information regarding your current documents:

What has prompted you to review your estate planning?

I have never prepared estate planning documentsMarriage or new relationshipSeparation or divorceBirth of a childDeath of a family memberHealth concernsUpcoming travelAsset or business changesGeneral reviewOther

FAMILY INFORMATION

Children

Do you have children from previous relationships?

Yes

No

Child #1:

Provide Details

Full Name: Date of Birth (DD/MM/YYYY): Relationship: Occupation (if applicable):

Not Applicable

Child #2:

Provide Details

Full Name: Date of Birth (DD/MM/YYYY): Relationship: Occupation (if applicable):

Not Applicable

Child #3:

Provide Details

Full Name: Date of Birth (DD/MM/YYYY): Relationship: Occupation (if applicable):

Not Applicable

Child #4:

Provide Details

Full Name: Date of Birth (DD/MM/YYYY): Relationship: Occupation (if applicable):

Not Applicable

Do any of your children have special circumstances we should be aware of? (e.g. disability, health concerns, vulnerability, financial management concerns)

Dependants

Dependant #1:

Provide Details

Full Name: Relationship: Nature of Dependency: Additional Comments:

Not Applicable

Dependant #2:

Provide Details

Full Name: Relationship: Nature of Dependency: Additional Comments:

Not Applicable

Dependant #3:

Provide Details

Full Name: Relationship: Nature of Dependency: Additional Comments:

Not Applicable

Dependant #4:

Provide Details

Full Name: Relationship: Nature of Dependency: Additional Comments:

Not Applicable

ASSETS & FINANCIAL POSITION

Which of the following assets do you own?

Real EstateBank AccountsShares or InvestmentsSuperannuationTrustsBusiness InterestsCompaniesLife InsuranceForeign AssetsCryptocurrency or Digital AssetsOther Assets

Real Estate

Property #1:

Fill Out Property Information

Property Address: Estimated Value: Mortgage? (Yes/No): Ownership Type (Sole Ownership, Joint Tenants, Tenants in Common or Unsure):

Not Applicable

Property #2:

Fill Out Property Information

Property Address: Estimated Value: Mortgage? (Yes/No): Ownership Type (Sole Ownership, Joint Tenants, Tenants in Common or Unsure):

Not Applicable

Property #3:

Fill Out Property Information

Property Address: Estimated Value: Mortgage? (Yes/No): Ownership Type (Sole Ownership, Joint Tenants, Tenants in Common or Unsure):

Not Applicable

Property #4:

Fill Out Property Information

Property Address: Estimated Value: Mortgage? (Yes/No): Ownership Type (Sole Ownership, Joint Tenants, Tenants in Common or Unsure):

Not Applicable

Superannuation

Name of Super Fund:

Approximate Balance:

Do you have life insurance attached to your superannuation?

Yes

No

Unsure

Do you have a Binding Death Benefit Nomination?

Yes

No

Unsure

Trusts

Trust #1:

Fill Out Trust Information

Trust Name: Trustee Name: Appointor Name: Approximate Value:

Not Applicable

Trust #2:

Fill Out Trust Information

Trust Name: Trustee Name: Appointor Name: Approximate Value:

Not Applicable

Trust #3:

Fill Out Trust Information

Trust Name: Trustee Name: Appointor Name: Approximate Value:

Not Applicable

Trust #4:

Fill Out Trust Information

Trust Name: Trustee Name: Appointor Name: Approximate Value:

Not Applicable

Business / Company Interests

Business/Company #1:

Fill Out Business/Company Information

Business/Company Name: Your Role (Director, Shareholder, Trustee, Partner, Other): Approximate Value:

Not Applicable

Business/Company #2:

Fill Out Business/Company Information

Business/Company Name: Your Role (Director, Shareholder, Trustee, Partner, Other): Approximate Value:

Not Applicable

Business/Company #3:

Fill Out Business/Company Information

Business/Company Name: Your Role (Director, Shareholder, Trustee, Partner, Other): Approximate Value:

Not Applicable

Business/Company #4:

Fill Out Business/Company Information

Business/Company Name: Your Role (Director, Shareholder, Trustee, Partner, Other): Approximate Value:

Not Applicable

Liabilities

Liability #1:

Provide Details

Liability Type: Approximate Amount Owing:

Not Applicable

Liability #2:

Provide Details

Liability Type: Approximate Amount Owing:

Not Applicable

Liability #3:

Provide Details

Liability Type: Approximate Amount Owing:

Not Applicable

Liability #4:

Provide Details

Liability Type: Approximate Amount Owing:

Not Applicable

PROFESSIONAL ADVISERS

Accountant:

Fill Out Accountant Information

Accountant Name: Firm: Email: Phone:

Not Applicable

Financial Adviser:

Fill Out Financial Adviser Information

Adviser Name: Firm: Email: Phone:

Not Applicable

ENDURING POWER OF ATTORNEY

Would you like us to prepare a new Enduring Power of Attorney?

Yes

No

Unsure

Proposed Attorneys

Attorney #1:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Attorney #2:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Attorney #3:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Attorney #4:

Provide Details

Full Name: Relationship: Address:

Not Applicable

How should multiple attorneys act?

Select an option Jointly Jointly and Severally Severally

When should the appointment take effect?

Select an option Immediately Only if I lose capacity Other

ENDURING GUARDIANSHIP

Would you like us to prepare an Enduring Guardianship Appointment?

Yes

No

Unsure

Proposed Enduring Guardians

Enduring Guardian #1:

Provide Details

Full Name: Relationship: Occupation:

Not Applicable

Enduring Guardian #2:

Provide Details

Full Name: Relationship: Occupation:

Not Applicable

Enduring Guardian #3:

Provide Details

Full Name: Relationship: Occupation:

Not Applicable

Enduring Guardian #4:

Provide Details

Full Name: Relationship: Occupation:

Not Applicable

Organ Donation Preferences:

Select an option Yes No Undecided

Medical Research Donation Preferences:

Select an option Yes No Undecided

YOUR WILL

Would you like us to prepare a new Will?

Yes

No

Executors

Executor #1:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Executor #2:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Executor #3:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Executor #4:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Substitute Executors

Substitute Executor #1:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Substitute Executor #2:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Substitute Executor #3:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Substitute Executor #4:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Guardians of Minor Children

Do you have children under 18?

Yes

No

Guardian #1:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Guardian #2:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Guardian #3:

Provide Details

Full Name: Relationship: Address:

Not Applicable

Guardian #4:

Provide Details

Full Name: Relationship: Address:

Not Applicable

DISTRIBUTION OF YOUR ESTATE

In broad terms, how would you like your estate distributed?

Do you wish to leave any specific gifts or assets to particular people?

Yes

Please provide details:

No

Are you concerned about any beneficiary because of:

DisabilityHealth IssuesSubstance AbuseBankruptcyRelationship IssuesVulnerabilityOtherNo Concerns

Could anyone potentially make a claim against your estate?

Yes

Please provide details:

No

Unsure

Please provide details:

FUNERAL & PERSONAL WISHES

If known, how would you prefer your remains be dealt with?

Select an option Burial Cremation No Preference Unsure

If cremated, what would you like done with your ashes?

If you passed away overseas, would you want your remains returned to Australia?

Yes

No

Unsure

Do you have pets?

Yes

Please tell us what you would like to happen to your pets:

No

FINAL QUESTIONS

Is there any urgency regarding your estate planning? (e.g. upcoming travel, planned surgery or medical treatment, serious illness or health concerns, marriage or a new relationship, separation or divorce, birth of a child or grandchild, significant changes to your assets or business interests)

Yes

Please provide further details:

No

Is there anything else you would like your solicitor to know before your appointment?

SUPPORTING DOCUMENTS

Do you have any relevant documents available?

Existing WillEnduring Power of AttorneyEnduring Guardianship AppointmentAdvance Care DirectiveBinding Death Benefit NominationTrust DeedCompany ConstitutionSuperannuation InformationOther Relevant DocumentsI do not have documents available at this stage

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ACKNOWLEDGEMENT AND CONSENT

Before submitting this questionnaire, please confirm the following:

I confirm that the information provided in this questionnaire is true and correct to the best of my knowledge.I understand that this questionnaire is intended to assist LMC Lawyers in preparing for my appointment and does not constitute legal advice.I understand that additional information and supporting documentation may be required before legal advice can be provided.I understand that any estate planning recommendations will be based on my instructions and the information provided to my solicitor.I understand that submitting this questionnaire does not create a solicitor-client relationship and that LMC Lawyers must agree to act before any retainer is established.I consent to LMC Lawyers collecting, storing and using the information provided for the purpose of assessing my estate planning requirements and providing legal services.

THANK YOU