DECEASED ESTATE FORM

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1General Details

2Executors

3Beneficiaries

4Assets

5Liabilities

6Other Info

Details of Person Completing this Form(Required)

Email(Required)

Phone

GENERAL DETAILS

Full Legal Name of Deceased(Required)

Did the Deceased hold assets in any other name?

Other Name/s used by the Deceased

First Name

Middle Name

Surname

Last Known Address(Required)

Occupation

Place of Birth(Required)

Date of Birth(Required)

Place of Death(Required)

Date of Death(Required)

Marital Status(Required)

Did they leave a will?(Required)

Do you have a copy?

Yes

Do you know the location of the Original Will?

Yes

Date of Will(Required)

Location of the Original Will(Required)

Note: If you have the Original Will, please bring to our appointment

Do you have the death certificate?

Yes

Note: Please bring Death Certificate to our appointment

EXECUTORS

How many executors are listed in the Will?(Required)

Executor 1

Name in Full(Required)

Street Address(Required)

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Occupation

Relationship to Deceased

Phone Number

Executor 2

Name in Full(Required)

Street Address(Required)

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Occupation

Relationship to Deceased

Phone Number

Executor 3

Name in Full(Required)

Street Address(Required)

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Occupation

Relationship to Deceased

Phone Number

Executor 4

Name in Full(Required)

Street Address(Required)

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Occupation

Relationship to Deceased

Phone Number

BENEFICIARIES

How many beneficiaries are listed in the Will?(Required)

Beneficiary 1

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 2

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 3

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 4

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 5

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 6

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 7

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 8

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 9

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

Beneficiary 10

Name in Full(Required)

Street Address

Postal Address: As Above or Different Postal Address

Postal Address

Date of Birth

Relationship to Deceased

Phone Number

ASSETS

What assets were held by the deceased?

Choose one or more assets from the list.

What assets were held by the deceased?

Bank accounts

Life Insurance policy

Nursing home RAD

Property

What assets were held by the deceased?

Super fund

Vehicles

Water Shares

Other Assets

Property

How many properties do they own?

Property 1

Address

Title Description (if known)

Location of Original Title

Is there a mortgate on the title?

Is the property owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Opinion of Value

Please bring copies of the latest Rates Notice to our appointment

Property 2

Address

Title Description (if known)

Location of Original Title

Is there a mortgate on the title?

Is the property owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Opinion of Value

Please bring copies of the latest Rates Notice to our appointment

Property 3

Address

Title Description (if known)

Location of Original Title

Is there a mortgate on the title?

Is the property owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Opinion of Value

Please bring copies of the latest Rates Notice to our appointment

Property 4

Address

Title Description (if known)

Location of Original Title

Is there a mortgate on the title?

Is the property owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Opinion of Value

Please bring copies of the latest Rates Notice to our appointment

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Water Shares

How many Water Shares do they own?(Required)

Water Shares 1

Is the Water Share owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Wee No(Required)

Reliability

Water Authority

Trading Zone

Water Use Licence No.

Water Shares 2

Is the Water Share owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Wee No(Required)

Reliability

Water Authority

Trading Zone

Water Use Licence No.

Water Shares 3

Is the Water Share owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Wee No(Required)

Reliability

Water Authority

Trading Zone

Water Use Licence No.

Water Shares 4

Is the Water Share owned solely by the Deceased?

Name of Co-Owner/s

First Name

Middle Name

Surname

Wee No(Required)

Reliability

Water Authority

Trading Zone

Water Use Licence No.

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Bank Accounts

Include details of all accounts with Banks, and/or credit unions, building societies. (up to 4)

Bank Accounts

Financial Institution Name

Account Number

Estimated Balance of Account

Is Account Number held in the sole name of the Deceased? (Yes/No)

If "No", please input the Name of Joint Account Holder/s

Please bring copy of latest Statement to our appointment

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Life Insurance

Insurance Provider

Name of Insurance Provider

Policy Name

Policy No.

Policy Owner Name

Life Assured Name

Please bring copy of Policy Details or statement to our appointment

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Include details of all shares. (max of 5)

Share(s)

Share No.

Name of Company Shares Held In

No. of Shares

SRN/HIN

Registered Address on Shareholding

Is Shareholding held in the sole name of the Deceased? (Yes/No)

If "No", please input the Name of Joint Shareholder/s

Please bring copy of Share Certificate or Dividend notice to our appointment

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Nursing home details

Name of Nursing Home

Address

Phone

Value of Refundable Accommodation Bond

Please enter amount up to $ 750,000

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Superannuation

How many Super Funds did the Deceased Have?

Super Funds 1

Is Fund a self-managed Superannuation Fund or and Industry Fund?

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SMSF 1

Name of Self-Managed Super Fund

Name of Trustee

Name of Accountant Who Manages the Fund

Accountant Phone

Accountant Email

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Industry 1

Name of Super fund

Member number

Super Funds 2

Is Fund a self-managed Superannuation Fund or and Industry Fund?

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SMSF 2

Name of Self-Managed Super Fund

Name of Trustee

Name of Accountant Who Manages the Fund

Accountant Phone

Accountant Email

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Industry 2

Name of Super fund

Member number

Super Funds 3

Is Fund a self-managed Superannuation Fund or and Industry Fund?

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SMSF 3

Name of Self-Managed Super Fund

Name of Trustee

Name of Accountant Who Manages the Fund

Accountant Phone

Accountant Email

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Industry 3

Name of Super fund

Member number

Please bring copy of latest Superannuation statement to our appointment

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Motor vehicles

How many vehicles did they have?

Vehicle 1

Brand and Model

Registration No.

Vehicle 2

Brand and Model

Registration No.

Vehicle 3

Brand and Model

Registration No.

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Other Assets

Please provide details of any other assets not captured above.

DECEASED ESTATE FORM

GENERAL DETAILS

Other Name/s used by the Deceased

EXECUTORS

Executor 1

Executor 2

Executor 3

Executor 4

BENEFICIARIES

Beneficiary 1

Beneficiary 2

Beneficiary 3

Beneficiary 4

Beneficiary 5

Beneficiary 6

Beneficiary 7

Beneficiary 8

Beneficiary 9

Beneficiary 10

ASSETS

What assets were held by the deceased?

Property

Property 1

Property 2

Property 3

Property 4

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Water Shares

Water Shares 1

Water Shares 2

Water Shares 3

Water Shares 4

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Bank Accounts

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Life Insurance

Insurance Provider

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Shares

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Nursing home details

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Superannuation

Super Funds 1

SMSF 1

Industry 1

Super Funds 2

SMSF 2

Industry 2

Super Funds 3

SMSF 3

Industry 3

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Motor vehicles

Vehicle 1

Vehicle 2

Vehicle 3

Other Assets

Other Assets

LIABILITIES

Mortgages

MORTGAGE 1

MORTGAGE 2

MORTGAGE 3

MORTGAGE 4

Other debts

ACCOUNTANT

PENSION MATTERS

OTHER MATTERS

Lachlan Burns

Sharee Macfarlane

Anthea Toma

Molly

Christina Trinci

Belinda O’Halloran

Missy Moo or as I am affectionately called… Moo Moo

Hayley Whitfield

Louise Hatcher

Maree Coffey

Hayley Whitfield