SIMPLY WILLS & LPAs

Lasting Power of Attorney questionnaire
for couples

This tells me what I need to prepare your Lasting Powers of Attorney. Fill in as much as you can; anything you’re unsure of can be left blank, and we’ll go through it together.

Allow about 15 to 20 minutes. Only Person 1’s name, email and phone number are needed now.

When you press Continue to payment, your answers are sent to me and you’ll go to a secure SumUp page to pay.

1. About you both

Only Person 1’s name, email and phone are needed now. Everything else can be filled in later.

Person 1

Person 2

Your address

Your relationship

Person 1’s LPAs

2. Which LPAs does Person 1 want?

There are two types. Most people make both.

Tick any that apply
3. Attorneys

Your attorneys are the people who can make decisions for Person 1. You can have one or several. They must be 18 or over and must not be bankrupt (for property and financial affairs).

Attorney 1

If there is more than one attorney, how should they make decisions?
4. Replacement attorneys Optional

A replacement steps in if an attorney can no longer act, for example if they die or lose capacity.

Replacement attorney 1

5. Key choices
Property and financial affairs: when can attorneys use it?
Health and welfare: life-sustaining treatment

This decides whether attorneys can make decisions about treatment needed to keep Person 1 alive.

6. Preferences and instructions Optional

Preferences are wishes your attorneys should consider. Instructions are rules they must follow. Don’t worry about the wording; I’ll check it so it won’t cause problems at registration.

7. Certificate provider

This person confirms Person 1 understands the LPA and is not being pressured. They must have known Person 1 well for at least 2 years, or be a professional such as a doctor or solicitor. They cannot be a family member, a partner, an attorney, or a replacement attorney.

How do they qualify?
8. People to notify Optional

You can name up to 5 people to be told when the LPA is registered, so they can raise any concerns. Attorneys can’t be people to notify.

Person to notify 1

Person 2’s LPAs

Same as Person 1?

Many couples choose each other as first attorney and the same people after that. If Person 2’s choices mirror Person 1’s, tick below and just tell me any differences.

9. Which LPAs does Person 2 want?

There are two types. Most people make both.

Tick any that apply
10. Attorneys

Your attorneys are the people who can make decisions for Person 2. You can have one or several. They must be 18 or over and must not be bankrupt (for property and financial affairs).

Attorney 1

If there is more than one attorney, how should they make decisions?
11. Replacement attorneys Optional

A replacement steps in if an attorney can no longer act, for example if they die or lose capacity.

Replacement attorney 1

12. Key choices
Property and financial affairs: when can attorneys use it?
Health and welfare: life-sustaining treatment

This decides whether attorneys can make decisions about treatment needed to keep Person 2 alive.

13. Preferences and instructions Optional

Preferences are wishes your attorneys should consider. Instructions are rules they must follow. Don’t worry about the wording; I’ll check it so it won’t cause problems at registration.

14. Certificate provider

This person confirms Person 2 understands the LPA and is not being pressured. They must have known Person 2 well for at least 2 years, or be a professional such as a doctor or solicitor. They cannot be a family member, a partner, an attorney, or a replacement attorney.

How do they qualify?
15. People to notify Optional

You can name up to 5 people to be told when the LPA is registered, so they can raise any concerns. Attorneys can’t be people to notify.

Person to notify 1

16. Registration and fees
Who will apply to register the LPAs?
Do either of you receive means-tested benefits, or have a gross income of under £12,000 a year?

You may be able to pay a reduced fee, or no fee, to the Office of the Public Guardian. I’ll check this with you.

17. Anything else
How would you both like to meet to go through and sign the forms?
Before you send

Your details are kept securely, only used to prepare your LPAs, and never sold. They are only shared with the Office of the Public Guardian where needed to register your LPAs.