Step 1 of 7

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Your details

1. Name

First Last

2. What is your biological sex?

Male

Female

3. Date of birth

DD slash MM slash YYYY

Age

Estate

4.Have you been left anything under a will?

Yes

Not sure

The Will

test test

If you answered 'yes' to the above question, can you explain in a few words what you have been left.

5. Have you been left anything under the Rules of Intestacy?

Yes

Not sure

Rule of Intestacy

Rules of Intestacy

xxx

If you answered 'yes' to the above question, can you explain in a few words what you have been left.

Property

6. Did you live with the deceased in their property immediately before their death?

Yes

Property

xvxvx

7. Do you currently live in a property which was owned or partly owned by the deceased?

Yes

Financial Information

8. Were you in receipt of regular monthly payments from the deceased person up to or shortly before they died?

Yes

Other

Regular Payments

Explain the regular payments

If you answered 'other' to the above question, can you explain in a few words in the free text box how they were supporting you.

9. Were you receiving regular ad hoc payments to support your income / lifestyle from the deceased person up to or shortly before they died?

Yes

Other

If you answered 'other' to the above question, can you explain in a few words in the free text box how they were supporting you.

10. Have you received any lump sum payments from the deceased person to purchase things in the five years before the Deceased died?

Yes

Other

If you answered 'other' to the above question, can you explain in a few words in the free text box how they were supporting you.

11. Do you support yourself alone, or do you have a shared household economy with a spouse, partner or cohabitee?

I support myself

I have a shared economy with a spouse, partner or cohabitee

12. Are you financially responsible for any children?

Yes

Financial Information

13. What is your total monthly income after tax (leave blank if it is not applicable).

If you have to estimate, please be as accurate as you can.

Type the amount into each box and the total will calculate.

Financial Breakdown

Explain why

Income from work

Income from pensions

Income from benefits

Income from other sources

Total

Financial Information

14. Below is a list of typical liabilities. Please insert a monthly figure for each applicable liability (leave blank if not applicable).

If you have to estimate - such as with monthly holiday spend, for example, please be as accurate as you can

Type the amount into each box and the total will calculate.

Mortgage

Rent

Ground rent/service charge

Council tax

Buildings and contents insurance

Water

Gas

Electricity

Mobile

Landline

Internet/broadband

TV satellite or cable

TV streaming services

Music streaming services

TV licence

Burglar alarm system

Interior / exterior decoration

Maintenance of domestic machines

Equipment insurance

Repairs, cleaning, replacement of items

Window cleaner

Garden necessities

House plants/cut flowers

Cleaner

Gardener

Food/Groceries

Pet food

Vet bills

Pet insurance

Childcare costs

Clothes

Footwear

PCP/PCH/HP

Road tax

Car insurance

Servicing

Maintenance / repairs

MOT

Tyres

Petrol

Oil

Parking costs

Car wash

Breakdwon subs

Public transport

Taxis

Gym membership

Hairdressing

Cosmetics/toiletries

Opticians

Dentist

Beautician

Chemist/prescription

Laundry/dry cleaning

Shoe/Clothes repairs

Magazines/newspapers

Restaurants/eating out/takeaways

Theatre/cinema/concerts

Other spectator events

Holidays

Weekend breaks

Christmas expenses

Birthday presents

Professional fees

Charitable donations

Other

Total

15. Below is a list of the typical assets people own.

Please insert an accurate figure for each asset you own (to the best of your knowledge), and leave blank anything not applicable.

Type the amount into each box and the total will calculate.

Property assets

Cars (not PCP/PCH or HP)

Money held in current accounts

Money held in savings and ISAs

Bonds

Crypto

Other investments

Pensions

Other

Total

16. Below is a list of the typical debts or liabilities people have.

Please insert an accurate figure for each debt or liability which you have (to the best of your knowledge), and leave blank anything not applicable.

Type the amount into each box and the total will calculate.

Credit cards

Personal loans

Mortgages

Student debt

Professional qualification loans

Money owed to individuals

Other

Total

Relationship

17. If we confirm that your claim has prospects of success, we will speak to you in more detail about the circumstances surrounding the same.

In the meantime, and to help us evaluate your claim, please tick as many of the following statements that are relevant to you or your relationship with the deceased person

Relationship

I was estranged from the person who has passed away and it was their fault

I tried to re-establish a relationship with them, but they were not interested

They made me promises regarding inheriting from their estate

I was subjected to emotional or financial abuse at the hands of the deceased person

I have mental health issues

I have physical health issues

I consider myself disabled

I consider myself to be disabled or have mental/physical health issues, and this impacts my ability to work

I want to retrain, go back to university or take a professional qualification

I am not currently employed and I am unlikely to be employed in the future

I was previously provided for by the deceased person, but he or she changed his mind

There are other relevant circumstances which I outline below

1975 Act Information Gathering

Intro content – what is the form for / how to use

Your details

Estate

The Will

Rule of Intestacy

Property

Property

Financial Information

Regular Payments

Financial Information

Financial Breakdown

Financial Information

Relationship

Relationship