Family name:

Christian name(s):

Usual residence:

Postcode:

Telephone Number:

Sex:

Date of birth:

Place of birth:

Period of residence in Australia:

Usual occupation (during working life): If pensioner, give details - type & number:

Current marital status:

Name of Spouse 1st

Spouse 2nd

Spouse 3rd

Age at date of marriage: 1st

Age at date of marriage: 2nd

Age at date of marriage: 3rd

Children:living males

Children:deceased males

Children:living females

Children: deceased females

Parents:Father:

Parents:Mother:

Parents:Mothers Maiden Name:

Funeral preferences:

Religion:

Church or Chapel, give details:

Minister/Celebrant:

Name of funeral firm:

Address:

Pre-arranged

Total monies paid:

Account number:

Location of related documents:

Existing grave or cremation deeds:

If yes, give details

People to contact: Name:

Next of kin Address:

Phone:

Relationship:

Estate details
These details will assist those charged with the responsibility of administrating your affairs at some stage in the future.

Solicitor:

Will in storage at:

Executor:

Bank or building society accounts:

Mortgage:

Hire Purchase agreements:

Credit cards:

Health benefit and medical insurance:

Details of assurance & insurance policies (eg. life, car, home, contents, etc.)

Superannuation:

Other assets: