Use this informational sheet to assist the attorney in preparing your Will.

Mr. Mrs. Ms. Miss. ___________________________________

Address ______________________________________________

Marital Status: Single ( ) Married ( ) Divorced ( ) Widowed ( )

Birth Date___________________

Telephone ( )______________

Soc. Sec. # __________________

Immediate Family (Spouse, Children, Parents, and Others):

Mr. Mrs. Ms. Miss _____________________________________________

Address ____________________________________________

Relationship to Donor _____________________

Birth Date___________________

Telephone ( )______________

Soc. Sec. # __________________

Mr. Mrs. Ms. Miss _____________________________________________

Address ____________________________________________

Relationship to Donor _____________________

Birth Date___________________

Telephone ( )______________

Soc. Sec. # __________________

Mr. Mrs. Ms. Miss _____________________________________________

Address ____________________________________________

Relationship to Donor _____________________

Birth Date___________________

Telephone ( )______________

Soc. Sec. # __________________

How I want my estate distributed:

( ) To my spouse: ______%

( ) To my children (equally, unless otherwise designated): ______%

( ) To other individuals:

Name ___________ ___________ ___________

Address _______________________ _______________________ ______________________

Relationship _________ _________ _________

%/Amount ____ ____ ____

( ) To Christian organizations:

Name ___________ ___________ ___________

Address _______________________ _______________________ _______________________

Relationship _________ _________ _________

%/Amount ____ ____ ____

I want the following person or organization to be the Personal Representative (Executor) of my estate and to serve (with/without) bond:

Name of Executor ______________________

Address ______________________________

______________________________

Alternate Executor ______________________

Address ______________________________

______________________________

I want the following person(s) to be the Guardian(s) of my minor Children:

Name(s) of Guardian(s) _________________

Address _____________________________

_____________________________

Alternate Guardian(s) ___________________

Address _____________________________

_____________________________

Additional Information for my attorney:

An attached copy of my present Will(s) ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________

Be sure to contact your attorney for the preparation of your Will.

Copyright 1997 Christ Temple Church of the Apostolic Faith Inc.

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