personal financial information
TRANSCRIPT
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PERSONAL FINANCIAL INFORMATION
FOR
____________________________
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Personal Financial InformationTable of Contents
1. Introduction
2. Personal Information
3. Personal Finances
4. Insurance Checklist
5. Pension and Investment Checklist
6. Tangible Assets Checklist
7. Tax Information
8. Wills/Trusts/Estate Planning
9. Professional Contacts
10. Important Papers
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Introduction
Developing and maintaining a personal financial plan is essential foryou in achieving financial security.
Your personal financial plan is composed of many elements, whichinter-relate in a dynamic way as you progress through the variousstages of your life.
This information is offered to you with the hope that it may behelpful to you in developing and maintaining your personal financialplan by:
Suggesting a variety of financial planning
elements that might be helpful.
Providing a centralized place where your financialplanning information can be maintained.
In the event of an emergency or at death, information can beextremely important. Thus, having everything listed in anorganized planner makes things simpler.
When you have completed the information, place this binder in asafe location. Make sure that its location is known by at least two
other family members or close friends. Do not place it in a safedeposit box because of the limited access to it in time of need.
This information is intended for your general use only. You maywant to obtain professional advice from either a lawyer or acertified financial planner regarding your specific financial planning.
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Personal Information
Check if information is included
Personal Information
Parents Information
Siblings or Other Relatives Information
Employment History
Salary History
Instructions to the Family
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Personal Information
Legal
Name___________________________________________________
_______
SSN ______________________________ Birthdate
________________________
Maiden Name (if
applicable)________________________________________
Place of Birth
______________________________________________________
Spouses Name ______________________ Maiden Name
________________
SSN ______________________________ Birthdate
_______________________
Place of Birth
______________________________________________________
Parents
Name and Address
Relationship
Birthdate
Living Deceased_______________________________________
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__________________
_____________
_______________________________________
__________________
____________________________________________________
Name and Address
Relationship
Birthdate
Living Deceased_______________________________________
__________________
____________________________________________________
__________________
____________________________________________________
Name and Address
Relationship
Birthdate
Living Deceased
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_______________________________________
__________________
____________________________________________________
__________________
____________________________________________________
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Siblings or Other Relatives
Name_________________________________________
SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________
Phone_______________________________
Name_________________________________________
SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________
Phone_______________________________
Name_________________________________________
SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________
Phone_______________________________
Name__________________________________________
SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________
Phone_______________________________
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Name__________________________________________SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________
Phone_______________________________
Name__________________________________________SSN____________________________________
Birthdate_______________________Gender ______ MaritalStatus_________________________
Address_______________________________________Phone_______________________________
Employment History
Present Employer UC RiversideDepartment ______________________________ Phone
___________________Title_______________________________________________________________Supervisor _______________________________ Phone____________________Hire Date___________________________________________________________
Retirement Benefits Yes No
Contact the UCR Benefits Office Phone: (909) 787-4766E-mail:
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Former Employer__________________________________________________
Address __________________________________ Phone__________________
Employment Date: From:_________________ To:______________________
Retirement Benefits Yes NoContact person for benefits_________________________________________Phone______________________________________________________________
Former Employer__________________________________________________Address __________________________________ Phone__________________Employment Date: From: _______________ To:
______________________
Retirement Benefits Yes NoContact person for benefits
_______________________________________Phone_____________________________________________________________
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Salary History
Employer:
___________________________________________________________Employment Dates:
_________________________________________________
Year Annual Salary
__________ ____________________
__________ ____________________
__________ ______________________________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
__________ ____________________
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__________ ____________________
* Enter the amount from your annual W2 form
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Instructions to My Family
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
__________________________________________________________________________________________________
_________________________________________________
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Personal Finance
If information is included
Budget
Cash Flow Analysis
Net Worth Analysis
Other
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Financial Institutions
Check if information is included
Bank Credit Union
Checking Checking
Savings Savings
Certificate of
Deposit
Certificate of
Deposit
Money Market Money Market
Credit Cards Credit Cards
Loan Information Loan Information
Other Other
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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________________________
________________________
Credit Card(s)________________________
________________________
(Lost or stolen card call ________________________)
Credit Card(s)________________________
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________________________
(Lost or stolen card call ________________________)
Credit Card(s)________________________
________________________
(Lost or stolen card call ________________________)
Financial Institutions
(Continued)
Name of Financial
Institution______________________________________
Address
___________________________________________________________
Phone
_____________________________________________________________
Contact Person
___________________________________________________
Account Number(s) PIN Number
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Checking ________________________
________________________
Savings ________________________
________________________
Certificates ________________________________________________
of Deposit ________________________
_________________________
Money Market________________________
________________________
Credit Card(s)________________________
________________________
(Lost or stolen card call ________________________)
Credit Card(s)________________________
________________________
(Lost or stolen card call ________________________)
Credit Card(s)________________________
________________________
(Lost or stolen card call ________________________)
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Location of Safe Deposit Box(es)
Name of Bank ______________________________________________ Box No.
_______________
Address ____________________________________________ Phone
________________________
Contact Person
____________________________________________________________________
Location of Key
____________________________________________________________________
Contents/Inventory:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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Loan Information
Name of Bank/Credit Union
__________________________________________________________
Address ________________________________________________ Phone_____________________
Account Number
____________________________________________________________________
Contact Person
_____________________________________________________________________
Collateral
___________________________________________________________________________
Loan Term ______________________ Payoff Date
_____________________________________
Credit Life/Disability Insurance Yes No
Name of Bank/Credit Union
__________________________________________________________
Address ________________________________________________ Phone
_______________________
Account Number
_____________________________________________________________________
Contact Person
_____________________________________________________________________
Collateral
____________________________________________________________________________
Loan Term ______________________ Payoff Date
______________________________________
Credit Life/Disability Insurance Yes No
Name of Bank/Credit Union
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_________________________________________________________
Address ________________________________________________ Phone
______________________
Account Number
_____________________________________________________________________
Contact Person
_____________________________________________________________________
Collateral
_____________________________________________________________________________
Loan Term ______________________ Payoff Date
_______________________________________
Credit Life/Disability Insurance Yes No
Other Financial Information
_______________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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Insurance Checklist
Check if information is included
Medical
Dental
Vision
Life
Disability
Auto
Recreational Vehicles
Homeowners/Renters
Umbrella ( General Liability Policy)
Long-Term Care
Other Insurance Plans
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Health Insurance Medical, Dental and Vision
Medical Insurance Company
_______________________________________________________
Group Individual
Phone Number
_____________________________________________________________________
Policy or Certificate Number
______________________________________________________
Plan Name and Type
_______________________________________________________________
Hospitalization
Physician Visits
Prescriptions
Dental Insurance Company
_________________________________________________________
Group Individual
Phone Number
_____________________________________________________________________
Policy or Certificate Number
_______________________________________________________
Plan Name and
Type________________________________________________________________
Vision Insurance Company
_________________________________________________________
Group Individual
Phone Number
______________________________________________________________________
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Policy or Certificate Number
_______________________________________________________
Plan Name and Type
_______________________________________________________________
Other Insurance Company
_________________________________________________________
Group Individual
Phone Number
______________________________________________________________________
Policy or Certificate Number
________________________________________________________
Plan Name and Type
________________________________________________________________
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Prescription Information
Patient Name
Medication
Dosage/Frequenc
ies Doctor
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Life Insurance
Insurance Company
___________________________________________________________________
Group Individual
Phone Number
_______________________________________________________________________
Policy or Certificate Number
_________________________________________________________
Type of Coverage____________________________________________________________________
Amount of Coverage
_________________________________________________________________
Beneficiaries
________________________________________________________________________
Insurance Company
__________________________________________________________________
Group Individual
Phone Number
________________________________________________________________________
Policy or Certificate Number
_________________________________________________________
Type of Coverage
____________________________________________________________________
Beneficiaries
________________________________________________________________________
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Disability/Accident Insurance
Insurance Company
__________________________________________________________________ Group Individual
Phone Number
_________________________________________________________________________
Policy or Certificate Number
_________________________________________________________
Type of Coverage
_____________________________________________________________________
Beneficiaries
___________________________________________________________________________
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Auto Insurance
Insurance Company
____________________________________________________________________
Group Individual
Agent
_________________________________________________________________________________
Phone Number
_______________________________________________________________________
Policy or Certificate Number
________________________________________________________
Type of Coverage
____________________________________________________________________
Vehicle 1 _________________________________ VIN _________________________________
Vehicle 2 _________________________________ VIN _________________________________
Vehicle 3 _________________________________ VIN _________________________________
Vehicle 4 _________________________________ VIN _________________________________
Recreational Vehicle Insurance
Insurance Company
___________________________________________________________________
Group Individual
Agent
__________________________________________________________________________________
Phone Number
_______________________________________________________________________
Policy or Certificate Number
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________________________________________________________
Type of Coverage
_____________________________________________________________________
Vehicle 1 __________________________________ VIN _________________________________
Vehicle 2 __________________________________ VIN _________________________________
Vehicle 3 __________________________________ VIN _________________________________
Motorcycle ________________________________ VIN _________________________________
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Homeown ers/Renters Insurance
Insurance Company
____________________________________________________________________ Group Individual
Agent
_________________________________________________________________________________
Phone Number
_______________________________________________________________________
Policy or Certificate Number
________________________________________________________
Type of Coverage
____________________________________________________________________
Umbrella Policy (General Liability Policy)
Insurance Company
__________________________________________________________________
Group Individual
Agent
________________________________________________________________________________
Phone Number
______________________________________________________________________
Policy or Certificate Number
________________________________________________________
Type of Coverage
_____________________________________________________________________
Long-Term Care Insurance
Insurance Company
__________________________________________________________________
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Group Individual
Agent
_________________________________________________________________________________
Phone Number
______________________________________________________________________
Policy or Certificate Number
________________________________________________________
Type of Coverage
____________________________________________________________________
Other Insurance Information
___________________________________________________
___________________________________________________
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Pension & Investment Checklist
Check if information is included
UCRP Basic Retirement Plan & Other
Pension Plans
Savings Account (see financial institutions
section)
Certificates of Deposit (see financial
institutions section)
UC Savings Plans & Other Employer
Savings Plans
IRA
Mutual Funds U.S. Savings Bonds
Stocks & Bonds
Social Security Information
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UCRP Basic Retirement Plan
Contact: UC Riverside Benefits Office
Phone: (909) 787-4766 E-mail:
Retirement estimate can be obtained at:
www.ucop.edu/bencom
Retirement Estimate Enclosed: Yes No
Payout option
______________________________________________________
Beneficiary_________________________________________________________
Other Pension Plan(s)
Company
___________________________________________________________
Address
____________________________________________________________
Phone _____________________ Contact Person
________________________
Amount
_____________________________________________________________
Company
___________________________________________________________
Address
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____________________________________________________________
Phone _____________________ Contact Person
________________________
Amount
_____________________________________________________________
Other Pertinent Information:
________________________________________
____________________________________________________________________
__
____________________________________________________________________
__
____________________________________________________________________
_
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UC Savings Programs & Other Savings Plans
1. Tax Deferred 403(b) Plan Plan Balances can be found at:
www.ucop.edu/bencom or call (800)888-8267
Account Number (Social Security
Number)_________________________
Location of Semi-Annual
Statements________________________________
PIN Number
________________________________________________________
Outstanding loans against 403(b) plan
_____________________________
Date of Loan
________________________________________________________
Term of Loan________________________________________________________
Final Payment Due
__________________________________________________
2. After-Tax Plan 401(a) Plan Balances can be found at:
www.ucop.edu/bencom or call (800)888-8267
Account Number (Social Security
Number)_________________________
Location of Semi-Annual Statements
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________________________________
PIN Number
______________________________
__________________________
3. Defined Contribution Plan (DCP 401(a) plan) Plan
Balances can be found at : www.ucop.edu/bencom or call
(800)888-8267
Account Number (Social Security Number)
________________________
Location of Semi-Annual Statements
_______________________________
PIN Number
________________________________________________________
4. Capital Accumulation Plan (CAP account) Plan Balance can
be found at www.ucop.edu/bencom or call (800)888-8267
Account Number (Social Security Number)
_________________________
Location of Semi-Annual Statements
________________________________PIN Number
________________________________________________________
5. Other Employer Savings Plans Plan Balance can be found
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at:
____________________________________________________________________
_
Account Number (Social Security Number)
_________________________
Location of Semi-Annual Statements
________________________________
PIN Number________________________________________________________
6. Other Employer Savings Plan Plan Balance can be found
at:
____________________________________________________________________
_
Account Number (Social Security Number)
_________________________
Location of Semi-Annual Statements
________________________________
PIN Number________________________________________________________
7. Other Employer Savings Plan Plan Balance can be found at:
_____________________________________________________________________
Account Number (Social Security Number)
_________________________
Location of Semi-Annual Statements
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________________________________
PIN Number________________________________________________________
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IRA Accounts
Traditional
Rollov
er
ROTH
Educat
ion
Company
____________________________________________________________
Address ________________________________________Phone
______________
Contact Person
_____________________________________________________
Account Number & Type
____________________________________________
Company
____________________________________________________________
Address ________________________________________Phone
______________
Contact Person
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_____________________________________________________
Account Number &
Type_____________________________________________
Company
____________________________________________________________
Address ________________________________________Phone
_______________
Contact Person
_______________________________________________________
Account Number & Type
_____________________________________________
Company
_____________________________________________________________
Address ________________________________________Phone
_______________
Contact Person
_______________________________________________________
Account Number & Type____________________________________________
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Mutual Funds
Company
____________________________________________________________
Address ________________________________________Phone
_______________
Contact Person
______________________________________________________
Account Number____________________________________________________
Company
____________________________________________________________
Address ________________________________________Phone
______________Contact Person
_____________________________________________________
Account Number
____________________________________________________
Stocks and Bonds
Brokerage Firm
______________________________________________________
Address _______________________________________Phone
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_______________
Contact Person
______________________________________________________
Account Number
_____________________________________________________
Other Investment Information
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Social Security Information
Beginning in 2000 the Social Security Administration sends out annual
statements to all wage earners. This Personal Earnings and Benefit
Estimate Statement shows your Social Security earnings history and
estimates how much you have paid in Social Security taxes. It also
estimates your future benefits and tells you how you can qualify for
benefits. It is a good idea to review these statements for accuracy and it is
important to keep these statements in your records.
Local Social Security Office: Hours 9 am to 4 pm
1860 Chicago Ave.
Riverside, CA
(909) 276-6041
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General Information and Services: Hours 7am to 7pm
(800) 772-1213 http://www.ssa.gov
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Tangible Assets Checklist
Check if information is included
Primary Residence
Secondary Residence
Automobile(s)
Recreational Vehicle
Personal Property
Business Interests
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Residential Property
Primary Residence
__________________________________________________
Mortgage Holder
____________________________________________________
Address __________________________________________Phone
_____________
Location of papers (deed, insurance,
etc.)________________________________________________________________________________________________
_
Secondary Residence
________________________________________________
Mortgage Holder____________________________________________________
Address __________________________________________Phone
____________
Location of papers (deed, insurance,
etc.)____________________________
_____________________________________________________________________
__
Other Real Property
_______________________________________________
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_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Automobile(s)
Make/Model
__________________________________________________________
Lien holder__________________________________________________________
Address _____________________________________Phone
___________________
Insurance Company
_________________________________________________
Location of Title
_____________________________________________________
License Plate # ____________________ VIN
_____________________________
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Make/Model
_________________________________________________________
Lien holder
___________________________________________________________
Address _____________________________________Phone
_________________
Insurance Company
_________________________________________________
Location of Title
_____________________________________________________
License Plate # _____________________VIN
______________________________
Make/Model
__________________________________________________________
Lien holder
_________________________________________________________
Address _____________________________________Phone
_________________
Insurance Company
_________________________________________________Location of Title
_____________________________________________________
License Plate # _____________________VIN
______________________________
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Recreational Vehicle(s)
Make/Model
_________________________________________________________
Lien holder
___________________________________________________________
Address _____________________________________Phone
__________________
Insurance Company________________________________________________
Location of Title
_____________________________________________________
License Plate # _________________________ VIN
________________________
Make/Model
_________________________________________________________
Lien holder
___________________________________________________________
Address _____________________________________Phone
_________________
Insurance Company
__________________________________________________
Location of Title
_____________________________________________________
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License Plate # ________________________ VIN
________________________
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Personal Property
List all possessions that are valuable, tangible property.
Examples: Jewelry, Furniture, Collectibles/Antiques, HomeOffice Equipment, Electronics, Other Equipment, Books,CDs, Artwork, Musical Instruments, etc.
Item
1. ____________________
2. ____________________
3. ____________________
4. ____________________
5. ____________________
6. ____________________
7. ____________________
8. ____________________
9. ____________________
10. ____________________
11. ____________________
12. ____________________
13. ____________________
14. ____________________
15. ____________________
Location
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
______________________________________________
_______________________
_______________
Value
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
Insured
Y or N________
________
________
________
________
________
________
________
________
________
________
________
________________
________
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Tax Information
Check if information is included
Federal Tax Return
State Tax Return
Flexible Spending Account (FSA)
Charitable Contributions
Premium Only Plan (POP)
Tax Service Used Yes No
Name of Service
_______________________________________________________
Address ____________________________________ Phone
____________________
Contact Person _____________________________________________________
Location of Tax Records
_______________________________________________________________________
_______________________________________________________________________
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_______________________________________________________________________
___
Charitable Contributions
Name of Organization
________________________________________________
Annual Donation Amount
_____________________________________________
Instructions for FutureDonations_____________________________________
______________________________________________________________________
_
Name of Organization_________________________________________________
Annual Donation Amount
_____________________________________________
Instructions for Future
Donations_____________________________________
______________________________________________________________________
_
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Name of Organization
_________________________________________________
Annual Donation Amount
____________________________________________
Instructions for Future Donations
____________________________________
______________________________________________________________________
_
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Wills/Trusts/Estate Planning
Wills and living trusts are legal documents that determine how your estate wi
be distributed following your death. In the absence of such documents, you
property will be distributed among your heirs as prescribed by statut
Because this distribution is unlikely to match your own preferences, yo
should carefully consider creating a will, a trust or both. Because estat
planning is a complex issue, you should seek appropriate legal counsel t
determine how best to meet your individual estate planning requirements.
Attorney for Will ______________________________
Phone__________________
Date of Wi
___________________________________________________________
Location of Wi
_______________________________________________________
Location of Additional Copie
_________________________________________
Executor
_______________________________________________________________
Address ________________________________________ Phon
________________
Attorney for Trust ____________________________
Phone________________
Name of Trus
_________________________________________________________
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Date of Trus
__________________________________________________________
Trustees
_________________________________________________________________
Location of Trus
Documents__________________________________________
Location of Additional Copie
__________________________________________
Trustee Bank (
applicable)___________________________________________
Address _______________________________________ Phon
___________________
Contact Perso
________________________________________________________
Professional ContactsCheck if information is included
Accountant
Attorney
Insurance Agent
Physician(s)
Dentist
Clergy
Certified Financial Planner
Benefits Office
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Auto Mechanic
Plumber
Roofer
Other
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Important Papers
Check if records are included
Birth Certificate(s)
Citizenship Papers
Passport
Marriage Certificate
Military Service Papers
Divorce Papers
Death Certificate(s)
Living Will
Power of Attorney
Real Estate Papers
Prepaid Funeral Plan
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Location of Important Documents
Birth Certificate(s
____________________________________________________
Citizenship Paper
____________________________________________________
Military ServicPapers________________________________________________
Marriage Certificat
___________________________________________________
Divorce Paper_________________________________________________________
Power of Attorne
______________________________________________________
Real Estate Paper
____________________________________________________
Living Wi
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____________________________________________________________
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You can throw those papers out!
At least most of them. The table below indicates the
documents you need to keep and how long you should keep
them.
DOCUMENT
HOW LONG
Bank Statements 6 years*
Birth Certificates
Indefinitely
Canceled checks 6 years*
Contracts
Updated
Credit card account numbers Updated
Divorce papers
Indefinitely
Home purchase & improvement records As long as you own th
property
Household inventory Updated
Insurance, life
Indefinitely
Insurance, car, home, etc. Updated
Investment records 6 yearafter tax deadline forthe year of sale**
Investment certificates Until cashe
or sold
Loan agreements Until pai
in full
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Military service records Indefinitely
Real estate deeds Until
transfer
Receipts for large purchases Until sale odiscard
Service contracts & warranties Until expiration
Social Security number Indefinitely
Tax returns 6
years from filing date
Vehicle titles Unt
sale or disposal
Will
Updated
**The IRS audits returns up to three years after filing; however, large underpaymenmay be
investigated as far back as six years.
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Prepaid Funeral PlanYes
No
Funeral Home_________________________________________________________Address ______________________________________ Phone_________________Name of Contac______________________________________________________
Pre-Purchased Burial Plot Yes No
Location of Cemetery_________________________________________________Plot No. and Location_________________________________________________MonumentInformation____________________________________________________________
_________________________________________________________________________
Obituary Yes No
Photo Yes No Burial Instructions to My Family______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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_______________________________________________________________________
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People to be contacted at time of death
Name ________________________________________________________________
Phone # ________________________________________________________
Name ________________________________________________________________
Phone # ________________________________________________________
Name ________________________________________________________________
Phone # ________________________________________________________
Name ________________________________________________________________
Phone # ________________________________________________________
Name ________________________________________________________________
Phone # ________________________________________________________
Name ________________________________________________________________
Phone # ________________________________________________________