Everything My Family Needs to Know... and, where to find it.

T ABLE O F C ONTENTS Organizing My Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Personal Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Family Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Wills/Trusts/Estate Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Personal Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Location of Safe Deposit Box(es) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Financial Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Credit Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Employee Pensions & Retirement Plans . . . . . . . . . . . . . . . . . . . . . 19 Life Insurance Policies & Annuities . . . . . . . . . . . . . . . . . . . . . . . . . 20 Other Insurance Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Miscellaneous Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

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ORGANIZING MY AFFAIRS When I was thinking about my own mortality, I thought it is never too soon to take charge of matters that are still within my control. Perhaps this booklet will inspire those who use it to create one as a gift for their loved ones. This workbook was designed so that I could record important personal and financial information that my survivors may need upon my death. Due to possible limited access to my safe deposit box in time of need, in addition to storing a copy of this information there, I may keep a copy in a safe location known by at least two other family members or close friends.

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PERSONAL INFORMATION My Legal Name: SSN:

Birthdate:

Place of Birth: Maiden Name (if applicable): Other Names I Have Used:

Former Spouse(s): Spouse’s Legal Name: SSN:

Birthdate:

Place of Birth: Other Names My Spouse Has Used:

Former Spouse(s):

CHILDREN OF THIS MARRIAGE Name: Address: Phone:

Birthdate:

Special Needs: Name: Address: Phone:

Birthdate:

Special Needs:

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CHILDREN OF THIS MARRIAGE (continued) Name: Address: Phone:

Birthdate:

Special Needs: Name: Address: Phone:

Birthdate:

Special Needs: Name: Address: Phone:

Birthdate:

Special Needs:

PARENTS/STEPPARENTS/IN-LAWS Name: Address: Relationship: Living/Deceased: Name: Address: Relationship: Living/Deceased:

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PARENTS/STEPPARENTS/IN-LAWS (continued) Name: Address: Relationship:

Living/Deceased:

Name: Address: Relationship:

Living/Deceased:

FORMER SPOUSE Name: Address: Phone:

Living/Deceased:

Date of Marriage:

Date of Termination:

CHILDREN OF TERMINATED MARRIAGE Name: Address: Phone:

Birthdate:

Special Needs: Name: Address: Phone:

Birthdate:

Special Needs:

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CHILDREN OF TERMINATED MARRIAGE (continued) Name: Address: Phone:

Birthdate:

Special Needs: Name: Address: Phone:

Birthdate:

Special Needs:

SIBLINGS OR OTHER RELATIVES Name: Birthdate:

SSN: Gender:

Marital Status:

Addresses: Phone:

Relationship:

Name: Birthdate:

SSN: Gender:

Marital Status:

Addresses: Phone:

Relationship:

Name: Birthdate:

SSN: Gender:

Marital Status:

Addresses: Phone:

Relationship:

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SIBLINGS OR OTHER RELATIVES (continued) Name: Birthdate:

SSN: Gender:

Marital Status:

Addresses: Phone:

Relationship:

Name: Birthdate:

SSN: Gender:

Marital Status:

Addresses: Phone:

Relationship:

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WILLS/TRUSTS/ESTATE PLANNING LAST WILL & TESTAMENT Date Executed:

Location:

Attorney for Will:

Phone:

Executor: Address:

Phone:

Successor Executor: Address:

Phone:

TRUSTS UNDER AGREEMENT Name of Trust: Attorney for Trust:

Phone:

Date Executed:

Location:

Trustee(s): Trustee Bank (if applicable): Address:

Phone:

Contact Person: Name of Trust: Attorney for Trust:

Phone:

Date Executed:

Location:

Trustee(s): Trustee Bank (if applicable): Address:

Phone:

Contact Person:

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DURABLE POWER OF ATTORNEY Date Executed:

Location:

Name(s) of agent(s) appointed: Name: Address:

Phone:

Co-Agent or Successor: Name: Address:

Phone:

Co-Agent or Successor:

LIVING WILL Date Executed:

Location:

The following individuals have copies: Name: Address:

Phone:

Name: Address:

Phone:

Name: Address:

Phone:

HEALTH CARE DIRECTIVE Name: Address:

Phone:

Name: Address:

Phone:

Name: Address:

Phone:

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PERSONAL DOCUMENTS My survivors or executor(s) may need the following information upon my death. Updated as of:

Description

Location of Information/Documents

Social Security number Driver’s license number Birth certificate / adoption papers Marriage license and certificate Divorce / separation papers Military Statement of Service (DD Form 214) / retirement orders / last active duty pay statement / first retired pay statement / VA disability Tax records for current and past years. Include copies of any gift or estate tax returns filed over the last 3 years. Passport number Tax identification numbers of Trusts Appraisals for valuables such as jewelry, furs and antiques Prepaid funeral arrangement paperwork Citizenship papers Other

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LOCATION OF SAFETY DEPOSIT BOX(ES) Name of Depository:

Box Number:

Address:

Phone:

Contact Person: Location of Key:

Contents/Inventory:

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CONTACTS The names of those who may need to be notified of my death.

Executor / Executrix: Address:

Phone:

Attorney: Address:

Phone:

Broker/Financial Manager: Address:

Phone:

Accountant / Tax Advisor: Address:

Phone:

Funeral Director/Cemetery/Mortuary: Address:

Phone:

Organ Donor Facility: Address:

Phone:

Employer/ Pension Provider: Address:

Phone:

Life Insurance Agent: Address:

Phone:

Other Insurance Agent: Address:

Phone:

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FINANCIAL INSTITUTIONS Name of Financial Institution: Address: Phone:

Contact Person:

Account Number(s)

Pin Number

Checking Savings Certificates of Deposit Money Market

Name of Financial Institution: Address: Phone:

Contact Person:

Account Number(s) Checking Savings Certificates of Deposit Money Market

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Pin Number

FINANCIAL INSTITUTIONS (continued) Name of Financial Institution: Address: Phone:

Contact Person:

Account Number(s)

Pin Number

Checking Savings Certificates of Deposit Money Market

CREDIT CARDS Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call:

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CREDIT CARDS (continued) Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call: Institution / Company: Number:

Type:

Lost or Stolen Card call:

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INVESTMENTS Financial Institution

Owners & Beneficiaries

Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number:

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INVESTMENTS (continued) Financial Institution

Owners & Beneficiaries

Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number: Name: Address: Phone: Investment Type: Account Number:

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EMPLOYEE PENSION & RETIREMENT PLANS Financial Institution

Beneficiaries

Name: Address: Phone: Type of Plan: Account Number: Name: Address: Phone: Type of Plan: Account Number: Name: Address: Phone: Type of Plan: Account Number: Name: Address: Phone: Type of Plan: Account Number:

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LIFE INSURANCE POLICIES & ANNUITIES Company

Beneficiaries

Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Face Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Face Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Face Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Face Value:

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OTHER INSURANCE POLICIES (HOME, AUTO, LIABILITY, DISABILITY, HEALTH) Company

Beneficiaries

Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value:

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OTHER INSURANCE POLICIES (HOME, AUTO, LIABILITY, DISABILITY, HEALTH) Company

Beneficiaries

Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value: Name: Address: Phone: Agent:

Location of Policy:

Policy No. / Value:

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MISCELLANEOUS CHECKLIST Miscellaneous Items

Details

Names & phone numbers of those who may want my pet(s). Secret hiding places for selected items. Security system company: name, phone and codes Locations of spare keys to home, vehicle, safe deposit box, garage, etc. Name and phone of any one or service provider who has keys Codes to combination locks Location of my address book(s) Location of rented storage units and key or code Names and contact information for services such as pest control, pool, lawn, etc. Other Other

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NOTES

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