STATEMENT OF WISHES RELATING TOMY PERSONAL EFFECTS

I, would like the items listed below to be given to the following

beneficiaries on my death.

I understand that this Statement of Wishes is not binding and does not form part of my Will.

ITEM(describe as fully and

accurately as possible)NORMAL

LOCATIONBENEFICIARY

NAME ADDRESS

Dated: …………………………… ……………………………………………. Signature

Any changes made after you have completed this form must be signed and dated.

To be kept with your Will www.purelyprobate.co.uk