Siksay & Fraser Law Offices Will And Estate Planning Information Form - Spousal Page 6

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xii) HOUSEHOLD GOODS AND FURNITURE:
Approximate Value of Household Goods/Furniture: $___________________
xiii) OTHER ASSETS:
Asset:
Approximate Value:
Location:
_____________________________________
________________________ ___________________
_____________________________________
________________________ ___________________
_____________________________________
________________________ ___________________
Do you have any of the following:
G Yes
G No
Interests in trusts?
G Yes
G No
Power of appointment?
G Yes
G No
Tax Shelters?
G Yes
G No
Royalties?
G Yes
G No
Brokerage accounts?
TOTAL ESTIMATED VALUE OF ALL ASSETS:
$__________________
C.
DEBTS, INCLUDING MORTGAGES OWING:
Creditor:
Principal:
Interest:
Maturity:
1.______________________
_______________________
___________ ___________________
2.______________________
_______________________
___________ ___________________
3.______________________
_______________________
___________ ___________________
4.______________________
_______________________
___________ ___________________
5.______________________
_______________________
___________ ___________________
6.______________________
_______________________
___________ ___________________
TOTAL VALUE OF DEBTS:
$__________________
D.
TOTAL NET VALUE OF ASSETS:
$__________________
(ASSETS MINUS DEBTS)

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