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Relationship Property Information.

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Client Information

First Name *

Last Name *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Occupation

Phone number *

Date Of Birth

Age

Partner/Spouse

First Name *

Last Name *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Occupation

Lawyer

Date of Birth

Age

Are you:

Married
Civil Union
De Facto

Years committed

Years married

Do you have any children? *

Yes
No

Do you plan to have children in the future? *

Yes
No
Undecided

Children

Name *

Date of Birth

Age

Assets of Parties/Relationship

Do you have a family home? *

Yes
No

Homes

Address *

Year purchased

Value when purchased

Current value

Valuation Obtained

Valuation provided

Owner/s (names or Trust name)

Keep separate or share equally?

Lifetime or set timeframe?

Timeframe

Do you have other Houses/Land/Property? *

Yes
No

Houses/Lands/Properties

Address *

Year purchased

Value when purchased

Current value

Valuation Obtained

Valuation provided

Owner/s (names or Trust name)

Keep separate or share equally?

Do you own a business? *

Yes
No

Businesses

Name *

Year set up/purchased

Estimated Value

No of Shares

Directors

Shareholders

Valuation obtained?

Yes
No

Main Assets

Main Liabilities

EOY Accounts Provided

Yes
No

Do you have any Trusts? *

Yes
No

Trusts

Name *

Year set up

Settlor(s)

Trustees

Final Beneficiaries

Discretionary Beneficiaries

Main Assets

Main Liabilities

EOY Accounts Provided

Yes
No

Add Shares/Investments? *

Yes
No

Shares/Investments

Company Name *

No of shares

Value when purchased

Current value

Date purchased

Statement provided

Other investments? *

Yes
No

Other Investments

Name / Type *

No of shares

Value when purchased

Current value

Statement provided

Bank accounts? *

Yes
No

Bank Accounts

Joint / Separate *

Bank name *

Type of account

Account no

Balance of account (credit/debit)

Statement provided

Kiwisaver? *

Yes
No

Kiwisaver

Company name *

Balance *

Date set up *

Statement provided *

Life insurance policies? *

Yes
No

Life insurance policies

Company name *

Policy owner *

Insured value *

Surrender Value? *

Motor vehicles? *

Yes
No

Motor vehicles

Make / model *

Registration *

Purchase date *

Estimated value *

Valuation provided *

Keep separate or share equally?

Other vehicles? *

Yes
No

Other vehicles

Type *

Make / model *

Registration *

Purchase date *

Estimated value *

Keep separate or share equally?

Valuation provided *

High value chattels / furniture? *

Yes
No

High value chattels / furniture

Chattel type *

Purchase date *

Value when first purchased *

Current value *

Keep separate or share equally?

Pets? *

Yes
No

Pets

Name *

Type *

Liabilities

Mortgage secured over family home

Bank

Balance

Statement provided

Mortgage secured over other house/land/property

Bank

Balance

Statement provided

Bank overdraft

Bank

Balance

Statement provided

Credit cards

Bank

Balance

Statement provided

Hire purchases

Entity

Item

Balance

Statement provided

Personal loans

Bank

Balance

Statement provided

Business loans

Bank

Balance

Statement provided

Other Debts (including secured and unsecured)

Type of liability

Entity

Amount owed

Statement provided

Other information

Previous relationship property agreements

Yes
No

Existing wills?

Yes
No

Further information

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Tauranga 3110, New Zealand

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