Premier Wills (Southend) Limited

0800 015 3251

"And in the end, it's not the years in your life that count. It's the life in your years." - Abraham Lincoln
Please Provide The Following Details About Your Will(s)
(* = mandatory information)
Section 1A Your Details
Will Type Single Will (£55) Mirror Will (£100)
Full Name*
Email Address
Sex Male Female
Date of Birth (day/month/year)
Tel. No.*     Ext.
Fax No.  
Section 1B Spouse/Partner Details (only required for Mirror Wills)
Name of Spouse/Partner
Spouse/Partner Relationship
Spouse Partner
Fiancée Date to be married (if applic.)
Spouse/Partner Sex Male Female
Spouse/Partner Date of Birth (day/month/year)
  Does your Spouse or Partner live at the above address:
Spouse/Partner Address
(if different)
Section 2 Executors
  Do you wish to appoint each other as Sole Executor initially? Yes No
Full Names of Executors*
Name and Address of Executors (minimum two)
Relationship to
Relationship to
your Spouse/Partner
Section 3 Guardians
Full Names of Guardians and Relationship
Name of Guardian
Relationship to You
Relationship to
your Spouse/Partner
Section 4 Dependants
Dependants No of Dependants:     Equal Distribution:  Yes No
Full Names of Dependants
Name of Dependant                     Age
to You
to your Spouse/Partner
Section 5 Legacies - Amounts (in pounds)
Money - Enter Name and Amount Amount (£)
Amount (£)
Amount (£)
Amount (£)
Amount (£)
Section 6 Legacies - Gifts and Chattels
Gifts and Chattels -
(Enter Item and Name)
Gift and Chattel Name and Address (of recipient)
Section 7 Beneficiary details for the remainder of your estate
Section 8 Funeral Wishes
Funeral Method Burial Cremation (Ashes to be: Buried Scattered)
Funeral Service Religious Non-Religious
 If Religious, what religion are you?
Section 9 Foreign Property
Foreign Property Do you have any foreign property? Yes No

If Yes, please state in which country

Have you made a Will in that country? Yes No
Section 10 Other Comments
Other Comments
  I agree to pay Premier Wills (Southend) Limited for preparation of the above Will(s) upon request.
  Full Terms and Conditions are available on request.
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