We've detected that Javascript is not enabled. It is required for an optimal survey taking experience.
Please check your browser's settings and make sure Javascript is turned on. Learn how to enable Javascript.

Surveys should never ask for any sensitive or secure data. Do not provide passwords, credit card numbers, identification numbers, or other sensitive information. Report Abuse.

Skip survey header

PRE-NUPTIAL/COHAB/MARITAL Questionnaire

Planning for your future with your new spouse... let's get started!

This literary work is protected by the Copyright Act of Canada R.S.C., 1985, c. C-42

1. Full Legal Name: *This question is required.

2. Date of birth: This question requires a valid date format of MM/DD/YYYY.

calendar

3. Email: This question requires a valid email address.

4. Address & Postal Code: *This question is required.

5. Home/Cell Phone:

6. Work Phone:

7. Your current marital status:

Please enter an 'other' value for this selection.

8. Your future SPOUSE's Full Legal Name: *This question is required.

9. Your future SPOUSE's date of birth: This question requires a valid date format of MM/DD/YYYY.

calendar

10. Your future SPOUSE's marital status:

Please enter an 'other' value for this selection.

11. Date of marriage to your future spouse: This question requires a valid date format of MM/DD/YYYY.

calendar

12. If you have resided, or are residing, with your future spouse, what is the total length of cohabitation to date (including all times away for work, travel or other reason):

13. YOUR Occupational History:

14. Your future SPOUSE's Occupational History:

15. YOUR Educational Graduation History:

16. Your future SPOUSE's Educational Graduation History:

17. Wealth Stability

Space Cell	YOU	Your future SPOUSE
Income stability	Reset star selection 1 out of 5 stars for Income stability: YOU 2 out of 5 stars for Income stability: YOU 3 out of 5 stars for Income stability: YOU 4 out of 5 stars for Income stability: YOU 5 out of 5 stars for Income stability: YOU	Reset star selection 1 out of 5 stars for Income stability: Your future SPOUSE 2 out of 5 stars for Income stability: Your future SPOUSE 3 out of 5 stars for Income stability: Your future SPOUSE 4 out of 5 stars for Income stability: Your future SPOUSE 5 out of 5 stars for Income stability: Your future SPOUSE
Employment stability	Reset star selection 1 out of 5 stars for Employment stability: YOU 2 out of 5 stars for Employment stability: YOU 3 out of 5 stars for Employment stability: YOU 4 out of 5 stars for Employment stability: YOU 5 out of 5 stars for Employment stability: YOU	Reset star selection 1 out of 5 stars for Employment stability: Your future SPOUSE 2 out of 5 stars for Employment stability: Your future SPOUSE 3 out of 5 stars for Employment stability: Your future SPOUSE 4 out of 5 stars for Employment stability: Your future SPOUSE 5 out of 5 stars for Employment stability: Your future SPOUSE

18. Your place of birth:

19. Where do you own assets:

Please enter an 'other' value for this selection.

20. Insert your most educated estimate of the NET (after related debt) FAIR MARKET VALUE of the assets you own:

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

21. Insert your future SPOUSE's most educated estimate of the NET (after related debt) FAIR MARKET VALUE of the assets your SPOUSE owns:

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

22. Are you only a Canadian citizen?

23. Of which other country are you a citizen?

24. Please list the full names, dates of birth and addresses of all of YOUR birth/adopted children .

Space Cell	Childs full legal Name	Childs Birthdate
Child 1	Child 1: Childs full legal Name	Child 1: Childs Birthdate
Child 2	Child 2: Childs full legal Name	Child 2: Childs Birthdate
Child 3	Child 3: Childs full legal Name	Child 3: Childs Birthdate
Child 4	Child 4: Childs full legal Name	Child 4: Childs Birthdate
Child 5	Child 5: Childs full legal Name	Child 5: Childs Birthdate
Child 6	Child 6: Childs full legal Name	Child 6: Childs Birthdate

25. Please list the full names, dates of birth and addresses of all of your FUTURE SPOUSE's birth/adopted children .

Space Cell	Childs full legal Name	Childs Birthdate
Child 1	Child 1: Childs full legal Name	Child 1: Childs Birthdate
Child 2	Child 2: Childs full legal Name	Child 2: Childs Birthdate
Child 3	Child 3: Childs full legal Name	Child 3: Childs Birthdate
Child 4	Child 4: Childs full legal Name	Child 4: Childs Birthdate
Child 5	Child 5: Childs full legal Name	Child 5: Childs Birthdate
Child 6	Child 6: Childs full legal Name	Child 6: Childs Birthdate

26. Do you have a Will? (please note that a marriage nullifies your Will unless your will was made in contemplation of that marriage)

27. Have/do you contemplate buying any of the following assets with your future spouse?

House
Cottage
Vehicle
Camper/motor home
Other - Write In Please enter an 'other' value for this selection.

28. When you buy assets with your future spouse, is it your intention that your share goes to your spouse or to someone else if you die?

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

29. Do you and your future spouse want to waive any spousal support in the future?

Please enter an 'other' value for this selection.

30. If your spouse is not on your title to the homestead, would you like your future spouse to be able to continue to reside there if you die? Who would pay the expenses? Check all that apply.

Yes for the following number of months Please enter an 'other' value for this selection.
Yes until my spouse dies.
Utility and Maintenance expenses paid by my estate.
Utility and Maintenance expenses paid by spouse.
No

31. Do you have life insurance?

Space Cell	Amount	Beneficiary	Insurance Company	Term
Policy 1	Policy 1: Amount	Policy 1: Beneficiary	Policy 1: Insurance Company	Policy 1: Term
Policy 2	Policy 2: Amount	Policy 2: Beneficiary	Policy 2: Insurance Company	Policy 2: Term
Policy 3	Policy 3: Amount	Policy 3: Beneficiary	Policy 3: Insurance Company	Policy 3: Term

32. Does your NEW SPOUSE have life insurance?

Space Cell	Amount	Beneficiary	Insurance Company	Term
Policy 1	Policy 1: Amount	Policy 1: Beneficiary	Policy 1: Insurance Company	Policy 1: Term
Policy 2	Policy 2: Amount	Policy 2: Beneficiary	Policy 2: Insurance Company	Policy 2: Term
Policy 3	Policy 3: Amount	Policy 3: Beneficiary	Policy 3: Insurance Company	Policy 3: Term

33. Do you have items that you have inherited/been gifted?

Please enter an 'other' value for this selection.

34. Does your FUTURE SPOUSE have items that he/she inherited/been gifted?

Please enter an 'other' value for this selection.

35. Do you have support obligations to any other person?

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

36. Does your FUTURE SPOUSE have support obligations to any other person?

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

37. Do you own property that:

You previously resided in with a prior spouse?
Is adjacent to property that you previously resided in with a prior spouse?

38. Is there a separation agreement or divorce/court order applicable to a prior relationship?

Please enter an 'other' value for this selection.

39. Please list the approximate current balances of your debt:

Mortgages
Line of Credits
Other

40. Copy of Please list the approximate current balances of your FUTURE SPOUSE's debt:

Mortgages
Line of Credits
Other

41. If you are living/plan to live in a home that is only in the name of one of you, if that title holder dies (or becomes disabled and moves into care home), will the non title holding spouse be intended to have life time right of occupancy, or less? And while they live there alone, who pays utilities/taxes/maintenance:

42. If you or your spouse die (or become disabled and have to move into a care home) and you have assets owned as TENANTS IN COMMON with each other, do you intend the survivor/non-disabled to be able to continue to use and enjoy the asset:

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

43. REMINDER CHECKLIST: Please bring the following documents with you to your first appointment (as applicable to you/spouse):

Survey Software powered by SurveyGizmo