Divorce Buy Sell Agreement

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Divorce Buy Sell Agreement Powered By Docstoc
					                                                       SECTION A

                                    PERSONAL AND FAMILY INFORMATION

Full Name:
(Please circle first name used) Surname                            First given name   Other names

Any other names used:

Residence Address:

                                                                   Postal Code:
Is your present address
permanent?:

If not, please explain:



Home Telephone:

Occupation:

Business Address:

                                                                   Postal Code:

Business Telephone:

Date of Birth:                                                     Citizenship:

Place of Birth:



Name of Spouse:
                                  Surname                          First given name   Other names

Spouse’s Date of Birth:                                            Citizenship:

Spouse’s Place of Birth:

Spouse’s Residence:
(if different from yours)
                                                                   Postal Code:



Date of Marriage:

Place of Marriage:

Place of Residence when married:

Have you been married previously?:

        If yes, place and date of divorce (if any)?:

Has your spouse been married previously?:

                                                                                                    1
        If yes, place and date of divorce (if any)?:

Do you have a marriage contract or separation agreement?:

Do you presently have a Will?:                                      Does your spouse?:

Are you cohabiting with anyone at the present time?:

If yes, do you have a cohabitation agreement?:



                                            Children of present marriage:

1.                                                            2.
        Full Name                                                   Full Name


        Address                                                     Address




        Birth date                                                  Birth date


        Marital Status                                              Marital Status


        Name of child’s spouse                                      Name of child’s spouse



                                               Other children of yours:

1.                                                            2.
        Full Name                                                   Full Name


        Address                                                     Address




        Birth date                                                  Birth date


        Marital Status                                              Marital Status


        Name of child’s spouse                                      Name of child’s spouse



                                                                                             2
                              Other children of your spouse:

1.                                              2.
     Full Name                                        Full Name


     Address                                          Address




     Birth date                                       Birth date


     Marital Status                                   Marital Status


     Name of child’s spouse                           Name of child’s spouse




                                                                               3
                                                        SECTION B

                                            FINANCIAL INFORMATION

REAL ESTATE:
                                                        Residence
Address:

Year Purchased:                                           Cost when purchased:       $

Current value:          $                                 Outstanding mortgage(s):   $
                        (approximate)                                                (approximate)

Manner of ownership:
                        (alone, joint tenants, tenants in common)

Do you hold mortgage life insurance on this property?


                                               Recreational Property
Address:

Year Purchased:                                           Cost when purchased:       $

Current value:          $                                 Outstanding mortgage(s):   $
                        (approximate)                                                (approximate)

Manner of ownership:
                        (alone, joint tenants, tenants in common)

Do you hold mortgage life insurance on this property?


                                Other Property (e.g. rental, farm or business)
Address:

Year Purchased:                                           Cost when purchased:       $

Current value:          $                                 Outstanding mortgage(s):   $
                        (approximate)                                                (approximate)

Manner of ownership:
                        (alone, joint tenants, tenants in common)

Do you hold mortgage life insurance on this property?


PENSION AND OTHER PLANS:
Do you belong to or contribute to a company pension plan?:

Who is the beneficiary (if any) designated to receive benefits on death?:

Current Value: $                                                                                     (approximate)



                                                                                                                4
Do you have a Registered Retirement Savings Plan (RRSP)?:

Company:

Name of designated beneficiary (if any)?:

Current Value: $                                                                                                  (approximate)



Do you have a Registered Retirement Income Fund (RRIF)?:

Company:

Name of designated beneficiary (if any)?:

Current Value: $                                                                                                  (approximate)



Do you have any annuities or other types of benefit plans such as deferred profit sharing plans, stock option plans, etc.? If so,
please provide details of same:




What are the survivor benefits of these annuities and/or benefit plans (if any)?:




Does your spouse own any of the above plans?




INSURANCE ON YOUR LIFE:
Name of insurance company

Owner of the policy if not yourself

Face value of policy     $                                                   Policy No.

Type of policy (e.g. term or whole life)

If term, what is the last date on which it can be renewed?

Name of beneficiary

Are there accrued dividends on the policy?




                                                                                                                               5
INSURANCE ON ANOTHER PERSON’S LIFE OWNED BY YOU:
Name of insurance company

Face value of policy       $                                          Policy No.

Type of policy (e.g. term or whole life)

Name of life insured

Name of beneficiary

Are there accrued dividends on the policy?


GROUP INSURANCE:
Name of insurance company

Face value of policy       $                                          Policy No.

Type of policy (e.g. term or whole life)

Name of beneficiary

Do you have disability coverage?


INVESTMENTS:
(e.g. bonds, stocks, money owed to you by mortgage or otherwise)

Approximate total value           $

Approximate total cost            $

Are there any foreign investments?

If so, please indicate approximate total value and country:   $


BUSINESS OR PROFESSIONAL INFORMATION:
Business Name (in full):

Address:

Nature of business:

Value (approximate):              $                                   Year purchased:

Cost when purchased:              $

Has a Buy-Sell or other agreement (e.g. partnership agreement, shareholder agreement) been entered into?


PERSONAL AND HOUSEHOLD ITEMS:

Approximate total value           $                                   Insured value: $


                                                                                                           6
LISTED PERSONAL PROPERTY:
(e.g. paintings, jewellery, stamps, antiques, sculptures, etc.)

Approximate total value            $                                     Insured value: $


BANK ACCOUNTS:
(Please provide name and address of bank or trust company, account number, approximate amount on deposit, and whether
account is joint or single)

Name of bank or trust company               Account No.                  Amount on Deposit           Joint/Single

                                                                         $

                                                                         $

                                                                         $


INTEREST IN ESTATES, TRUSTS, EXPECTED INHERITANCES:
(Provide details)




Has anyone given you a power of appointment under a Will or Trust?
(e.g. the right to determine the disposition of another’s property?)




OTHER ASSETS:
(Provide details)




APPROXIMATE INFORMATION ABOUT YOUR ANNUAL INCOME:

Employment income (e.g. salary, commission, bonus, etc.)          $

Investment income:        $

Will this total change significantly in the future?:

How much of your lifetime capital gains exemption have you utilized to date?:

Does your spouse have independent income?:                        Approximate amount:   $

What income will your spouse need after your death?:       $

                                                                                                                    7
LIABILITIES:
(List bank loans and other significant debts or contingent liabilities)
$
(amount)                                            (owed to)

$
(amount)                                            (owed to)

$
(amount)                                            (owed to)


ADDITIONAL DETAILS OR COMMENTS:




DOCUMENTS:

Please provide us with a copy of any of the following documents in your possession which pertain to your circumstances:

        Marriage Contract
        Cohabitation Agreement
        Separation Agreement
        Divorce Decree
        Will/Codicil(s)
        Buy-Sell Agreement
        Shareholder Agreement
        Partnership Agreement

        Trust Deed in which you have an ongoing administrative or beneficial interest

        Will of a deceased person or a Trust Deed which names you as a beneficiary




                                                                                                                          8
                                                      SECTION C

                                            OTHER CONSIDERATIONS

OTHER BENEFICIARIES TO BE CONSIDERED

(Please list the full names and addresses, and relationship to you, of any persons, other than your spouse and children, to
be considered in your planning: e.g. parents, grandchildren, brothers and sisters of yourself and your spouse, friends,
and charitable organizations.)

1.                                                               2.
        Full Name                                                         Full Name


        Address                                                           Address




        Relationship to you                                               Relationship to you


3.                                                               4.
        Full Name                                                         Full Name


        Address                                                           Address




        Relationship to you                                               Relationship to you

Do any of these people have a financial need now?

Will any of these people have a financial need in the event of your death?

Are you currently supporting or providing funds to anyone?

If so, whom?


EXECUTOR(S) AND GUARDIAN(S):

                                               Proposed Executor(s):
1.                                                               2.
        Full Name                                                         Full Name


        Address                                                           Address




                                                                                                                         9
                                           Proposed Alternate Executor(s):
1.                                                                 2.
        Full Name                                                        Full Name


        Address                                                          Address




                                                Proposed Guardian(s):
1.                                                                 2.
        Full Name                                                        Full Name


        Address                                                          Address




                                           Proposed Alternate Guardian(s):
1.                                                                 2.
        Full Name                                                        Full Name


        Address                                                          Address




Where will the children be residing?


ADDITIONAL THINGS TO CONSIDER:

1.      Special burial instructions (if any).

2.      Bequests of specific assets to individuals and/or charities.

3.      Cash legacies to individuals and/or charities.

4.      Distribution of balance of estate to (please provide names and addresses if not already provided):

        (a)     spouse
        (b)     children
        (c)     others
        (d)     alternate (if spouse and children predecease you)


ADDITIONAL DETAILS OR COMMENTS:




                                                                                                             10
             SECTION D

ADDITIONAL COMMENTS AND/OR QUESTIONS




                                       11

				
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Description: Divorce Buy Sell Agreement document sample