• Personal Details
  • Particulars of client
  • Appointment

  • Particulars of the person submitting the information

  • Name of person submitting this form
  • Email
  • Telephone Number
  • I am submitting the form for my
  • Name of the person you are submitting on behalf
  • The contents of the Will is to be explained to the client in
  • I get to know SimplyWills through
  • My VIP code or voucher No., if any:
  • Are any of the beneficiaries below 21 years of age?


  • Please select if you have any of the following:

  • House in single name
  • House in joint names (joint tenancy)
  • House in joint names (tenancy-in-common)
  • Mortgage insurance policy for outstanding housing loan
  • Insurance, investment-linked or annuity policy
  • Joint bank or investment amount
  • Jewellery or safe deposit box
  • Business interest in private company
  • House or land in other country
  • Have you done your Afterlife Pre-planning yet?
  • Religion
  • Any additional information

  • Section Break