confidential personal financial organizer · 2015-03-22 · health care plan id # group id # blood...
TRANSCRIPT
Your NamePlace of BirthDate of BirthMother’s Maiden NameSocial Security #Home Address
Driver’s License Number
EmployerAddress of Employer
Employee ID #Human Resource Contact
Telephone Number
Health Care Plan ID #Group ID #Blood TypeOrgan Donor
Passport NumberReligion
CONfIDENTIAL PERSONAL fINANCIAL ORGANIzER
Purpose of this form:This form is meant to be used as a tool to help you organize your personal/confidential information. This form is only a tool. This form is NOT a legal document.
How to use this form:Print form, complete all information. Be sure to provide a copy for your spouse, adult child, trusted friend or advisor. Do not place the only copy in a safe deposit box.
Date this form was completed:
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Personal Information ........................................................................................................................................
Your NamePlace of BirthDate of BirthMother’s Maiden NameSocial Security #Home Address
Driver’s License Number
EmployerAddress of Employer
Employee ID #Human Resource Contact
Telephone Number
Health Care Plan ID #Group ID #Blood TypeOrgan Donor
Passport NumberReligion
TM
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Trusted Advisors ......................................................................................................................................................
Physician
Physician
Physician
Attorney
Accountant
financial Planner
Location of Documents .....................................................................................................................................
Marriage Certificate
Divorce/ Separation Decrees
Military Service Records
Passport (number, location, make a copy of the first page and attach to this inventory)
Important Documents:
Title to Home
Mortgage Documents
Home Equity Loan
Property Insurance
Cost of Home Improvement files
Property Records:
Checkbook/Statements
Income Tax Records (7 years)
Stock Transaction Records
401K Statements or Pension
IRA Statements
Savings Accounts
financial Records:
Make/Model/Year
Make/Model/Year
Make/Model/Year
Auto Insurance Contact
Policy Numbers
Automobile Records:
2
TMLife Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Location of Documents continued ...........................................................................................................................
Living Trust/ Will (Location of copy, attorney contract, latest date revised)
Successor Trustee/ Executor (Name, phone number)
Living Will (Attach copy, name, contact of empowered person)
Health Care Power of Attorney (Name of empowered person, location of document)
Location of Medical Records
Organ Donor Instruction Card
funeral Instructions/Cemetery Deed
Agents Name/Phone/Email
Location of Policies
Company Policy # Type (cash, term)
On Life of Beneficiary
Company Policy # Type (cash, term)
On Life of Beneficiary
Company Policy # Type (cash, term)
On Life of Beneficiary
Estate Planning Records:
Life Insurance ........................................................................................................................................................
Notes .........................................................................................................................................................................
3
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Stored Numbers as of: Date(Take the time to make a list of names/numbers, just in case your phone is lost or stolen!)
Contact Number for Cell Phone Provider to Report Lost/Stolen Phone:
......................................................................................................................................................................Children
Cell Phone ....................................................................................................................................................
Name Birth Date Social Security No.Contact Number:
Name Birth Date Social Security No.Contact Number:
Name Birth Date Social Security No.Contact Number:
Name Birth Date Social Security No.Contact Number:
Name Birth Date Social Security No.Contact Number:
Name Birth Date Social Security No.Contact Number:
Additional Information .................................................................................................................................................
Contact Number:
Provider:
Contact Number:
Provider:
4
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
...................................................................................................................................In Case of An Emergencyfamily & friends to Notify
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Name: Contact Number:
Notes .........................................................................................................................................................................
5
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Disclaimer: The information contained in this form has been completed by the individual and is under the direct control of the individual who has completed this form. All information on this form is deemed highly personal and confidential. Any copies made and provided to any person including a trusted advisor or trusted family
member should be done so with caution and discretion. Be sure to consult an attorney for written legal documents as required.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
Life Income Management Copyright 2010
Any and all notations made on this form are NOT legally binding. Please consult your attorney.
TM
Notes .........................................................................................................................................................................
6