ESTATE & FINAL PLANNING

Do NOT include your SIN or any account numbers.
Please complete the form below so we can help you organize your estate wishes and funeral pre-planning needs.

Full Name *

Date of Birth *

Email *

Mobile Number *

City & Province of Residence *

Preferred Languange *

English

Français

Both / Either

Marital Status *

Single

Married

Common-law

Widowed

Divorced

Do you have children? *

Yes

If YES, please list the following for each:

Full Name
Date of Birth (YYYY-MM-DD)
Are they financially dependent? (Yes/No)n 3

Do you currently have a legal will? *

Yes

Not sure

Do you have a Power of Attorney (POA) for personal care or property?

Yes – Personal Care

Yes – Property / Financial

Yes – Both

Not sure

Have you discussed your wishes with your family?

Yes

Partially

Do you own any of the following assets? (Check all that apply)

Home / Real Estate

Business

Investments (RRSP, TFSA, Non-registered, etc.)

Life Insurance

Vehicles

Savings

Other

Do you have any outstanding debts?

Yes

Not sure

Type of service you prefer:

Burial

Cremation

Not sure yet

Preferred style of service:

Traditional funeral

Celebration of life

Simple service

No preference / Not sure

Have you discussed funeral preferences with your family?

Yes

Would you like to explore a plan that covers: (select all that apply)

Funeral expenses

Final taxes

Outstanding debts

Legacy gifts / leaving money behind

Protecting family from financial burden

All of the above

Not sure yet

Do you currently have any life insurance? *

Yes

Not sure

If YES, please list company & coverage amount:

Are you looking for:

Funeral insurance

Estate-planning insurance (permanent coverage)

Simple final expense plan

A quote only

Unsure — need guidance

Consent to be contacted
I agree that a representative from JK Infinite Solutions may contact me by phone, email, or text message to discuss my financial needs and potential solutions.

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This form is for planning purposes only and does not constitute legal advice, funeral arrangements, or insurance approval. All recommendations depend on proper underwriting, provincial regulations, and carrier eligibility.