Form

Name_of_person_submitting_this_form

Name of person submitting this form

Email*

Email

Telephone_Number*

Telephone Number

I_am_submitting_the_form_for_my

I am submitting the form for my

Name_of_client

Name of the person you are submitting on behalf

The_content_of_the_wills_is_to_be_explained_to_the_client_in

The contents of the Will is to be explained to the client in

I_get_to_know_SimplyWills_through

I get to know SimplyWills through

My_VIP_code

My VIP code, voucher No. or BBX m'ship No., if any:

Are_any_of_beneficiaries_below_21_years_of_age_?

Are any of the beneficiaries below 21 years of age?

Please select if you have any of the following types of assets:

House_in_single_name

House in single name

House_in_joint_names_(_joint_tendency_)

House in joint names (joint tenancy)

House_in_joint_names_(_tendency_in_common_)

House in joint names (tenancy-in-common)

Mortgage_insurance_policy_for_outstanding_housing_loan

Mortgage insurance policy for outstanding housing loan

Insurance_investment-linked_or_annuity_policy

Insurance, investment-linked or annuity policy

Joint_bank_or_investment_amount

Joint bank or investment amount

Jewellery_or_safe_deposite_box

Jewellery or safe deposit box

Business_interest_in_private_company

Business interest in private company

House_or_land_in_other_country

House or land in other country

Existing_funeral_arrangements

Existing funeral arrangements

Any_additional_information

Any additional information

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