Estate Planning & Asset Protection

Questionnaire

Your Name and Address

Your Name(Required)

Prefix First Middle Last

Your Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Date of Birth(Required)

Your Email(Required)

Your Mobile Number(Required)

Do you have a spouse/partner?(Required)

Yes

Your Spouse's Name

Prefix First Middle Last

What is their relationship to you?(Required)

Your Spouse's Date of Birth(Required)

Your Spouse's Email

Your Spouse's Mobile Number

Do you have any children?(Required)

Yes

Add your child/children's full name, relationship to you, home address, date of birth, email and mobile number.(Required)

Family Protection Trust

Similar to the British Royal family whose line of succession is unquestioned, we need to know your line of succession. It may start with yourself, then your spouse then your child / children, and then other relatives. Your successor(s) need to have common sense and also be financially and preferably business aware. We refer to the initial person as the “Leading Member”, the next in line is the Successor Leading Member, the next the Second Successor Leading Member and so on, From this line of succession, we can then form initial advice about who should be your Enduring Power of Attorney, the Executor of your Will, the Leading Member of any Trusts and the Successor Director of any companies. These may be single persons or jointly more than one person – and the persons may be different for different roles if required. It is generally best to have the same person / persons as your Executor and your Power of Attorney.

Leading Member:(Required)

Successor Leading Member:(Required)

2nd Successor Leading Member:(Required)

3rd Successor Leading Member:(Required)

Enduring Powers of Attorney (EPOA)

Your attorney will look after your personal and financial affairs and if you have a SMSF, they can act as your replacement Director of the Trustee Company of your SMSF. You can give them unrestricted control or provide limits – such as “ensure that any health care is of the highest standard” just to provide them with some guidance. If you would like to put in some guidance (including what not to do), then please add this below:

Do you want this EPOA to start now or when you have lost capacity?(Required)

Now

When I have lost capacity

Do you have any health instructions? Please note them down here(Required)

Financial attorney: Do you want any $ limits and is your Financial Attorney the same person as for Personal / Health matters?(Required)

If you have an SMSF, do you want your attorney to step into your Trustee shoes as the Replacement Trustee? Or would you like to nomiate another person for this role?(Required)

Excluded Beneficiaries from Your Will and Trusts

Are there any beneficiaries you would like to exclude from your will?(Required)

Yes

List the full name/s of any beneficiaries you would like excluded from your Will.(Required)

Guardian Board

If you would like a board of people to assist to oversee the actions of your Successor Leading Member(s), please list them below.

List the full name and preferred role for each Family Advisory Board Member.

Superannuation Death Benefit Nominations - Non SMSF only

Your Will does not determine who is to receive your superannuation in the event that you die. Instead, when a person dies, in most cases their super fund pays their remaining super to their nominated beneficiary. Super paid after a person’s death is called a “super death benefit”. If the super fund rules allow a binding death benefit nomination (BDBN), you can nominate one or more dependants and/or your legal personal representative to receive your super. NOTE: If you have a SMSF, please do not complete this section, and instead complete the “SMSF Will” section later in this document.

Name of Super Beneficiary, Amouth of Death Benefit ($ or %) and Your Relationship to this Person(Required)

Wills – Specific Gifts before the rest of the Estate

After appointing a chain of Executors to manage your estate, the next step is to guide your Executor with your desire to make a specific gift to a spouse, child, grandchild, or other person. Once this is done and the gifts are made, anything left over forms the remaining estate which may be passed in its entirety to a spouse or children individually or to be shared. Importantly. specific gifts rank higher in importance than the remaining estate so please spend time on your specific gifts. Do you want to make any specific gifts to any person? Here are some examples: “My investment property at 5 Smith Street Collingwood Vic is to go equally to my eldest daughter Jane and my son Mark” or “My sister Jonie Smith is to receive $100,000” or “All my estate is to go to my wife Janelle” or “My Executor is to distribute my personal effects and jewellery in a fair and reasonable manner.” Feel free to make as many gifts as you want – the more specific gifts you complete it makes the role of the Executor that much easier and faster. Specific Gifts – Nominating these provides your Executor with the authority to transfer property, shares, jewelry, cash, or a percentage of all your assets, after any specific bequests to a certain person or group of persons. Please be as specific as possible and identity the assets and persons (which may include a charity) both in Australia and overseas. If the person receiving the gift is not alive, then the asset forms part of the remaining estate. If the specific gift is not in your possession at the time of your death, you can make a note that it is the gift or dollar equivalent of the gift.

Specific Gift/s, Person to receive it, Your relationship to this person(Required)

Gifts - Digital Assets

Digital Assets - Please complete the section below to gift digital assets such as social media, databases or crypto currencies such as Bitcoin.

Note the digital asset, person to receive the digital asset and your relationship to this person

eg Facebook account, Cryptocurrency details, Apple iCloud account, Microsoft OneDrive Account, Online Accounts

Wills and your remaining Estate

If there are any assets or monies left over after paying all expenses of the estate and also paying out all specific gifts, then the remainder of the estate (called the “residual estate“) is to pass to the primary beneficiaries if they are alive.

Primary Beneficiary

Who are the primary beneficiaries, and if more than one, are they to receive benefits equally? Please list any specific percentages for any beneficiary or beneficiaries. Generally, this would be your spouse / partner. In some circumstances, it may be your bloodline children.

Name of each primary beneficiary, percentage of estate and your relationship to this person(Required)

If the primary beneficiary or beneficiaries are not alive, then who is to receive their benefits? Choose one:(Required)

Their bloodline children - which may be held on trust subject to the Executor’s discretion and on the advice of the adviser of the Estate.

Any surviving primary beneficiary in equal proportions

To be paid to the secondary beneficiary.

To be paid to any bloodline (family) beneficiary at the Executor's discretion

Primary Beneficiary - Testamentary Trusts

Would you like this to go into a Testamentary Trust?(Required)

Yes

Is this Beneficiary's share of the estate to be automatically transferred to a Testamentary Trust?(Required)

Yes

Do you want the Secondary Beneficiary to be included along with the Primary Beneficiary?(Required)

Yes

Do you want to include a clause limiting capital distributions to beneficiaries under the age of 25 to health care, education expenses or a house deposit for the first time?(Required)

Yes

Insert age:(Required)

If you have any further conditions, list them out here:

Secondary Beneficiary

If the primary beneficiary has passed their share of estate (in the event of their death) to a secondary beneficiary or beneficiaries, are they to receive benefits equally? Please note down any specific percentages for any beneficiary or beneficiaries. Generally, a secondary beneficiary will be your bloodline children.

Full name of secondary beneficiary, percentage of estate and your relationship to this person(Required)

If the secondary beneficiary or beneficiaries are not alive, then who is to receive their benefits? Choose one:(Required)

Their bloodline children - which may be held on trust subject to the Executor's discretion and on the advice of the adviser of the Estate.

Any surviving secondary beneficiary in equal proportions.

To be paid to the tertiary beneficiary.

To be paid to any bloodline (family) beneficiary at the Executor’s discretion.

Secondary Beneficiary - Testamentary Trusts

Would you like this to go into a Testamentary Trust?(Required)

Yes

Is this Beneficiary’s share of the estate to be automatically transferred to a Testamentary Trust?(Required)

Yes

Do you want the Tertiary Beneficiary to be included along with the Secondary Beneficiary?(Required)

Yes

Do you want the Tertiary Beneficiary to be bloodline or lineage?(Required)

Yes

Do you want to include a clause limiting capital distributions to beneficiaries under the age of 25 to health care, education expenses or a house deposit for the first time?(Required)

Yes

Insert age:(Required)

If you have any further conditions, list them out here:

TERTIARY BENEFICIARY

If the secondary beneficiary has passed their share of estate (in the event of their death) to a secondary beneficiary or beneficiaries, are they to receive benefits equally? Please note down any specific percentages for any beneficiary or beneficiaries. Generally, a tertiary beneficiary will be any family members that you want to receive your estate if you and all of your bloodline children have died (eg. Parents, brothers and sisters).

Full name of tertiary beneficiary, percentage of estate and your relationship to this person(Required)

If the tertiary beneficiary or beneficiaries are not alive, then who is to receive their benefits? Choose one:(Required)

Their bloodline children - which may be held on trust subject to the Executor’s discretion and on the advice of the adviser of the Estate.

Any surviving tertiary beneficiary in equal proportions.

To be paid to any bloodline (family) beneficiary at the Executor’s discretion.

Tertiary Beneficiaries - Testamentary Trusts

Would you like this to go into a Testamentary Trust?(Required)

Yes

Is this Beneficiary’s share of the estate to be automatically transferred to a Testamentary Trust?(Required)

Yes

Do you want the Tertiary Beneficiary to be bloodline or lineage?(Required)

Yes

Do you want to include a clause limiting capital distributions to beneficiaries under the age of 25 to health care, education expenses or a house deposit for the first time?(Required)

Yes

Insert Age:(Required)

If you have any further conditions, note them down here.

Funeral Wishes

Do you want to be buried or cremated? Any specific religious requirements? Any music preferences? Please list out your requests below:

What are your funeral wishes?(Required)

Child Guardianship

If you have children, who is to be their guardian? Please identify specifically with name of the guardian and any financial provision to be made to them to act as guardian.

Name of Child, Name of Guardian, Succeeding Guardian if first is not able or is not alive.(Required)

Conditions for Child Maintenance

Are there any conditions for your Child’s Guardian and also the Executor of your Estate to follow when it comes to child maintenance? For example: The Executor is to organise the payment of a monthly allowance of $1,500 per child for living and educational purposes

PET GUARDIANSHIP

Do you have any pets?(Required)

Yes

Pet Name, Name of Guardian, Financial Provision for Pet(Required)

Are there any conditions for your Pet’s Guardian and also the Executor of your Estate to follow when it comes to pet maintenance?

Life Tenancy

If you own a property outright (not jointly), you can gift this to one or more of your beneficiaries or let it pass to the remainder of your estate to go to your principal beneficiaries. Alternatively, you may request that one or more persons (such as a spouse or de facto) live in the property for the remainder of their life – commonly known as a life interest. If you desire this, please list the property address and who is to live in it below:

Property Address/es & Life Interest Name/s

Inheritances

Do you expect to receive an inheritance? Please insert the details below so we can take this into consideration.

Person Receiving Inheritance

Person giving Inheritance and their Relationship to Person Receiving Inheritance

Details of Inheritance and expected date of receiving Inheritance

Assets

Please list your assets and liabilities below so we understand the wealth that you would like to pass on to your beneficiaries. Note down the Owner of each Asset and Estimated $ Value of each Asset.

Property - Family Home. Note the Owner of Asset and Estimated $ Value of Asset(Required)

Property - Investment. Note the Owner of Asset and Estimated $ Value of Asset(Required)

Bank – Savings Account. Note the Owner of Asset and Estimated $ Value of Asset(Required)

Bank – Term Deposit. Note the Owner of Asset and Estimated $ Value of Asset

Home Contents. Note the Owner of Asset and Estimated $ Value of Asset

Motor Vehicle. Note the Owner of Asset and Estimated $ Value of Asset

Loan to? Note the Owner of Asset and Estimated $ Value of Asset

Superannuation 1 - Note the Owner of Asset and Estimated $ Value of Asset(Required)

Superannuation 2 - Note the Owner of Asset and Estimated $ Value of Asset(Required)

Shares & Managed Funds - Note the Owner of Asset and Estimated $ Value of Asset(Required)

Cryptocurrency - Note the Owner of Asset and Estimated $ Value of Asset

Business – Estimated Value - Note the Owner of Asset and Estimated $ Value of Asset

Any Other Assets? Note Owner and Estimated Value.

Liabilities

Home Loan - Note the Owner of Liability and Estimated $ Value of Liability

Investment Loan 1 - Note the Owner of Liability and Estimated $ Value of Liability

Investment Loan 2 - Note the Owner of Liability and Estimated $ Value of Liability

Business Loan - Note the Owner of Liability and Estimated $ Value of Liability

Credit Card - Note the Owner of Liability and Estimated $ Value of Liability

Vehicle Loan - Note the Owner of Liability and Estimated $ Value of Liability

Loan from? - Note the Owner of Liability and Estimated $ Value of Liability

Tax Owing - Note the Owner of Liability and Estimated $ Value of Liability

Any other Liabilities? Note owner and estimated value for each.

This information is important to have your Advance Health Directive prepared.

Health Conditions, Concerns, Views, Wishes and Preferences

Individual 1 - Full Name (you!)(Required)

First Middle Last

Full name of Individual 1's doctor(Required)

First Last

Name of medical practice(Required)

Address of medical practice(Required)

Phone number of medical practice(Required)

Individual 1 - List any major health concerns or conditions(Required)

Individual 1 - List your Views, Wishes and Preferences – what’s important to you?(Required)

Individual 1 - List anything that you worry about in the future(Required)

Individual 1 - State any cultural, religious or spiritual values, rituals or beliefs you’d like considered in your health care(Required)

Individual 1 - State the important things if you’re nearing death(Required)

Individual 1 - List the names of people that you DO WANT involved in your health care(Required)

Individual 1 - List the names of people that you WOULD NOT WANT involved in your health care(Required)

Individual 1 - Which life-sustaining treatment would you want?(Required)

I'd like all treatments aimed at sustaining or prolonging my life

refuse any treatments aimed at sustaining or prolonging my life

can’t decide at this point – I’d like my Power of Attorney to make the decisions

None of the above – I give the following specific directions about life sustaining treatments, and indicate which answer applies to:

Other

Individual 1 - Assisted Ventilation(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - CPR(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Artificial Nutrition(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Artificial Hydration(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Antibiotics(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Experimental Treatments &/or Medications(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Alternative Treatments, Therapies &/or Medications(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

I consent to this treatment in the following circumstances:

Other

Individual 1 - Blood Transfusions(Required)

I consent to a blood transfusion

I do not consent to a blood transfusions

Other

Individual 1 - Health Care Other Than Life-Sustaining Treatment(Required)

Would you like to fill this out for a second individual?(Required)

Yes

Individual 2 - Full Name (e.g. your spouse)(Required)

First Middle Last

Full name of Individual 2's doctor(Required)

First Last

Name of medical practice(Required)

Address of medical practice(Required)

Phone number of medical practice(Required)

Individual 2 - List any major health concerns or conditions(Required)

Individual 2 - List your Views, Wishes and Preferences - what's important to you?(Required)

Individual 2 - List anything that you worry about in the future(Required)

Individual 2 - State any cultural, religious or spiritual values, rituals or beliefs you’d like considered in your health care(Required)

Individual 2 - State the important things if you’re nearing death(Required)

Individual 2 - List the names of people that you DO WANT involved in your health care(Required)

Individual 2 - Which life-sustaining treatment would you want?(Required)

I'd like all treatments aimed at sustaining or prolonging my life

refuse any treatments aimed at sustaining or prolonging my life

can’t decide at this point – I’d like my Power of Attorney to make the decisions

None of the above – I give the following specific directions about life sustaining treatments, and indicate which answer applies to:

Other

Individual 2 - Assisted Ventilation(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - CPR(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Artificial Nutrition(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Artificial Hydration(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Antibiotics(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Experimental Treatments &/or Medications(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Alternative Treatments, Therapies &/or Medications(Required)

I consent to this treatment in all circumstances

I refuse this treatment in all circumstances

Other

Individual 2 - Blood Transfusions(Required)

I consent to a blood transfusion

I do not consent to a blood transfusion

Other

Any other health conditions?(Required)

Company or SMSF?

Do you have a company?

Yes

Do you have a Self Managed Super Fund?(Required)

Yes

Successor Directors

Only for Company directors. If you are a director of a company and you become incapacitated or die, control of that company may be lost and you could lose control of your family’s share of those company assets (particularly if you are a sole director). You may want to put in place a Successor Director to look after your interests. This can be done with a binding resolution that we can prepare. Please list out below each company you have an interest in or are a Director of, its Australian company number (ACN) and who you would like as Successor Director. Please add additional rows if needed for more than 3 companies.

Company Name/s and ACN/s(Required)

Successor Director Name(Required)

SMSF Will

Your superannuation benefits may pass to your estate or directly to one or more of your dependants. A dependant includes your spouse, de facto, any child, any person living with you at home, or any person who is financially dependent upon you (their quality of life is enhanced by ongoing and continuous contributions to their wellbeing). A SMSF Will is a set of instructions for the Trustee of your SMSF to follow in the event of your death. You can pay a lump sum to your estate to be included as part of your Will or pay it directly to a dependant who can then use that money as they wish, or you can direct it to be paid into a trust for them (SMSF Death Benefits Trust) or let them transfer it to any company or trust that they own. In some cases, such as with a spouse, child under the age of 18 or financial dependant (including disabled children), an income stream or pension may be paid. This can be very tax effective. Like your Will, the SMSF Will provides the ability to pay an amount to a dependant or your estate.

Name of Beneficiary, Percentage of Super, Income or Lump Sum or Beneficiary's Choice (BC)?(Required)

Secondary beneficiary - If the principal beneficiary of your superannuation estate is not alive, choose to whom your superannuation benefits are to go:(Required)

If the secondary superannuation beneficiary is not alive, choose where it is to go(Required)

The deceased’s estate for the sole benefit of the deceased’s bloodline or lineage, unless a SMSF Death Benefits Trust can be established under the Superannuation Laws for the bloodline or lineage of the deceased member only.

The deceased’s estate for the benefit of their family and estate beneficiaries and charities.

The deceased’s estate for the benefit of the bloodline children of the succeeding beneficiary to be held in trust with income to be paid quarterly but no capital distribution until they reach age 25. If there are no bloodline children of the succeeding beneficiary. then the share of my superannuation interest is to be paid to the remainder of my children that remain alive in equal proportions.

Other

If other, note Beneficiary Name, Percentage of Super and Income or Lump Sum or Beneficiary’s Choice (BC)

Hit submit to complete this Data Capture Form for your Estate Planning advice.

We’ll be back to you soon with our initial Estate Planning and Asset Protection Advice Report for us to discuss.

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