A Joint Project of theNational Center for Preventive Law, Inc.

Participant's Workbook

NEW HAMPSHIRE

andLegal Counsel for the Elderly,

a Department of the American Association of Retired Persons

Legal Counsel for the Elderly, Inc.

Legal Counsel for the Elderly (LCE) works to expand the availability of legal services to older people and to enhance the quality of existing services. Nationally, LCE supports the legal community with training, technical assistance, publications and volunteers, and provides direct legal and protective services to older persons. LCE also operates a full service law office for low-income older Washington, D.C. residents. LCE is a department of the nonprofit American Association of Retired Persons (AARP). LCE, Inc. publishes several publications for consumers. For a list of these publications, see the Resource Lists in the Appendices of the Participant’s Workbook.

Legal Counsel for the Elderly, Inc.601 E Street, N.W.Washington, D.C. 20049(202) 434-2120

The National Center for Preventive Law

The National Center for Preventive Law, Inc. (NCPL), is dedicated to advancing preventive law, in practice and in theory, in all of its places and forms. NCPL achieves its mission through education, research and development, information services, and by facilitating interaction among others interested in the field.

The National Center for Preventive Law, Inc.1900 Olive StreetDenver, Colorado 80220(313) 871-6306

©1996 LCE, Inc. and NCPL, Inc.All Rights Reserved.

TABLE OF CONTENTS

DISCLAIMERup to date, the law is constantly changing, and we do

not guarantee the accuracy of any information contained herein. If you should find any

inaccuracies, errors or omissions in this document, please e-mail suggested changes to

cjanicko@aarp.org or mpotter@aarp.org.

Are You Legally Healthy?.............................................................................. 1

Read Me First...........................................................................................................................5

Questions & Explanations ...........................................................................................................................7

Section I. Personal Data.............................................................................................................................................................8

Section II. Employment.............................................................................................................................................................11

Section III. Marital/Family Situation.............................................................................................................................................................14

Section IV. Are You Getting All The Income Due To You?18

Section V. Health.............................................................................................................................................................25

Section VI. Purchasing Goods and Services30

Section VII. Claims32

Section VIII. Home/Apartment34

Section IX. Household Employees.............................................................................................................................................................41

Section X. Vehicles.............................................................................................................................................................43

Section XI. Pets44

Section XII. Insurance.............................................................................................................................................................45

Section XIII. Bank Accounts47

Section XIV. Your Estate.............................................................................................................................................................48

Section XV. Securities51

Section XVI. Real Estate Other Than Home.............................................................................................................................................................52

Section XVII. Business Interests.............................................................................................................................................................53

Section XVIII. Military Service54

Section XIX. Taxes55

Section XX. Discrimination 56

Appendices

Checklists...........................................................................................................................

57

Resource Lists

New Hampshire Centers and Agencies .............................................................................................................................................................65

Self-Help Guides Order Form.............................................................................................................................................................66

Self-Help Resources from Legal Counsel for the Elderly, Inc..............................................................................................................................................................67

Glossary of Terms...........................................................................................................................68

First Steps to Good Legal Health...........................................................................................................................72

"Important Dates"...........................................................................................................................74

We're Getting Married........................................................................................57

I'm Buying a Home...............................................................................................58

I'm Selling My Home............................................................................................59

I'm in Debt............................................................................................................60

I'm Moving Out of New Hampshire.....................................................................61

I'm Reaching Retirement .....................................................................................61

I'm Entering a Nursing Home...............................................................................62

My Spouse has Passed Away................................................................................63

Personal Plan...........................................................................................................................75

Questions to the Lawyer...........................................................................................................................76

The Legal Checkup is a joint project developed by Legal Counsel for the Elderly (LCE), a department of the American Association of Retired Persons (AARP), and the National Center for Preventive Law (NCPL). The project is designed to:

Educate the public about the issue of "legal health"; Encourage individuals to make a detailed evaluation of the state of their own

legal health; Suggest resources available to provide self-help or professional assistance.

WHAT IS "LEGAL HEALTH"?

Everyone understands what physical health is all about. Every day we are exposed through the media to a frightening array of diseases and health hazards. We are told that regular medical checkups can lead to early detection of potential diseases, and that the chance of successful treatment of a disease is dramatically higher when diagnosed in the early stages. If we become seriously ill or suffer an injury, our bodies tell us (in no uncertain terms) that there is a problem. If it seems serious, we seek medical attention from a doctor. We are literally bombarded by information about prevention of illness by dieting, exercising, and giving up smoking.

In contrast, very few of us have a concept of "legal health", even though it is a matter which affects us all. Many in the public interest legal community are concerned about the number of people who have no idea that they have a potential legal problem until it emerges in a moment of crisis. Just as there are a variety of potential hazards that can cause health problems, there are also a variety of potential hazards that can cause legal problems. Some are very obvious--someone files a lawsuit against you, cheats you on a car repair, or injures you in a car accident. Most people know that they should seek a lawyer in these situations.

However, many legal "illnesses" lie hidden until they surface as a result of a crisis such as physical illness, injury or death. They can create very serious emotional and financial problems for you or your family. Unfortunately, very few people ever think of having a "Legal Health Checkup." Yet, a comprehensive review of your legal affairs can expose those hidden problems and allow you to correct them before they erupt into a crisis.

Correcting your "legal health" problems is normally a relatively easy, inexpensive, and effective process. And it's a lot easier than dieting, exercising, or quitting smoking!

1

ARE YOU “LEGALLY HEALTHY”?

WHAT IS THE LEGAL HEALTH CHECKUP?

AM I "LEGALLY HEALTHY"?

If you are legally healthy, you should be able to answer yes to all of the following questions.

Y __ N __ Do you have all of your important personal documents and records on hand, either in a secure place, such as a desk, file cabinet or safe deposit box? (birth, marriage, adoption, divorce, naturalization or immigration, military discharge papers, etc.)

Y __ N __ Do you have basic legal documents which direct what happens to your assets when you die? (such as a will or trust?)

Y __ N __ Do you have the basic legal documents to designate who will make personal decisions and handle your financial affairs in the event you are unable to do this for yourself? (such as a durable power of attorney and a health care power of attorney)

Y __ N __ Do you have all of your financial records on hand, in some order, and up to date? (tax returns, deeds, insurance policies, investment records, pension records, bank statements, etc.)

Y __ N __ Do you know how each of your assets are titled and why this is a crucial issue?

Y __ N __ Are your insurance needs met to the extent practical? Y __ N __ Are you comfortable that your investments are both safe and productive?

Y __ N __ Are you receiving all of the public or private benefits to which you are entitled? (Social Security, Medicare, private pensions, etc.) If not, do you know when and where to apply for them?

Y __ N __ Do you know which changes in your life will require a review of your "legal health" status?

Y __ N __ Do you have a resource, such as an attorney or accountant, in the event you require professional advice or assistance.

2

CONSIDER A LEGAL CHECKUP!!

HOW DO I CHECK MY "LEGAL HEALTH"?

The Legal Checkup Seminar Project has been specially designed to evaluate your legal health. It consists of:

The Workbook is lengthy and might take you some time to complete. We explain why each question is important. Some questions will not be applicable to your circumstances. Information about local resources is included. Your time will be well spent regardless of how long it takes to complete the Workbook. Once you have completed the Workbook, you will have a reasonable idea of the condition of your legal health.

At the seminar you, along with others pursuing a Legal Checkup, will meet with an attorney licensed to practice in your state with the AARP Legal Services Network from your community. The attorney will discuss some of the most common legal health problems in more detail. You will have some opportunity to ask questions about the issues being discussed. Please understand, however, that the attorney will limit questions to those where the answers are of general interest to all attendees. The attorney, in a seminar setting where other participants are present, may not be able to provide specific answers to personal concerns where private information is required for accurate advice.

WILL THE SEMINAR ATTORNEY REPRESENT ME?

The purpose of the seminar is to provide some general guidance and to answer questions raised by the Workbook. Attorneys conducting the seminar portion of the Checkup frequently will be available for individual questions after the program has ended. They are not required to do so. Seminar participants are free to make private arrangements for legal work with the attorney conducting the seminar.

3

this Workbook.Don't be intimidated – This is not a test!

a Seminar Program led by a Legal Services Network attorney.

WHAT BENEFITS WILL I GET OUT OF THIS LEGAL CHECKUP?

1. The first and most important step in fixing any problem is to discover it. The time and effort you spend on your Legal Checkup gives you the opportunity to spot potential legal problems before they cause you damage.

2. You will create a personal work plan identifying the next steps you need to take (see Personal Plan on page 75 of this workbook).

3. You will usually identify some legal problems you can easily resolve on your own. You will receive tips on how to take action on your own, where appropriate.

4. If you do need to see a professional, you will be better prepared. With information in hand and a sense of the issues involved, you are likely to save a lot of time, which also means lower fees. In addition, you are likely to get better service. It is a lot easier for a professional to provide effective advice, draft a document, or do almost anything, when the client can provide accurate and complete information at the initial visit.

5. Information regarding where to seek professional help is contained in the Workbook and will also be provided at the seminar.

WHY SHOULD I TAKE THE TIME TO COMPLETE THIS WORKBOOK?

Good legal health eliminates many of the most emotionally draining legal problems that commonly occur. Over and over again, these problems surface as a result of a crisis, often a sudden illness or a death. At the worst possible time it is discovered that no one has authority to act for their stricken loved one, or no one can find important information required to apply for a needed benefit or to begin helping a grieving widow to settle the affairs of a deceased spouse. Having your legal affairs in order won't prevent sickness, injury, or death. But it can make difficult situations easier to cope with, for you as well as your loved ones.

In the end, your legal health is a matter of concern primarily to you and your loved ones. Those who have participated in creating the Legal Checkup Project have had vast experience in dealing with the consequences of poor legal health. We are also aware of how many of these problems can be avoided with proper planning and preparation, in other words, good legal health practices. But, like the horse in the old proverb, we can only lead you to the water. Only you can decide to take the drink. We urge you to take this program seriously. Go to the trouble of filling out the Workbook, create your Personal Plan, attend the seminar, and finally do what needs to be done to correct the problems. In the end, you and your loved ones will be happy that you did.

4

_______________________________________Read Me First

HOW DO I START?

Before you start writing anything, take some time to read through the materials.Yes, all of them! We suggest you do this to gain some familiarity with how the Workbook is organized. You will have less leafing back and forth through the Workbook if you know what information we provided and where it is as you fill out the Workbook. If you feel that any of the self-help guides listed in the Resource Section would be useful to you, go online to the AARP Legal Solutions web site: http://www.aarp.org/legalsolutions/selfhelpindex.html.

Make yourself comfortable.Arrange yourself at a desk or table where you have enough room. Select a time when you can be free of distractions. Take your time and work at your own pace. Prior participants have reported requiring 2 hours to 2 weeks to complete the Workbook.

Start at the beginning and answer all of the questions relevant to you.

Read the explanations carefully. As you go along make notes.

Be as precise as you can with your answers.

Go through the explanations sections carefully.They are full of useful information. Compare them to your notes on page 7. Order any self-help materials that you think might help you.

Read Me First 5

_______________________________________Read Me First

Find the form entitled "Personal Plan" (p. 75)Any questions or concerns which you have not been able to resolve using the materials should be noted on the Personal Plan.

For example you might enter "need estate plan documents" and under action required, you will enter "find a lawyer to prepare documents."

Find the form "Questions to the Lawyer." (p. 76)This is your opportunity to submit questions for the lawyer conducting the seminar. If you have remaining questions that you would like to have addressed at the seminar, write down your questions on this form and send it to the co-sponsor whose contact information is provided on the form. The questions are given to the attorney at least TWO WEEKS before the date set for the seminar. You can always bring the questions to the seminar; however, the ability to respond to such questions is limited.

WHAT'S NEXT FOR YOU

Take action!Once you have a list of the items you need to resolve, the next step is, what else? Resolve them! Some matters will be just that simple. Organizing personal records and documents that are a mess may be difficult, but it is important, and something which does not usually require professional advice. Others might require more action, for example having an attorney prepare legal documents. Use the materials included in the Workbook to assist you.

Bring your Personal Plan to the Seminar!Bring your Personal Plan as well as the Workbook with your notes. You may wish to refer to them during the seminar. Your information will remain confidential. This is your prescription to achieve legal health. Mark off items on your personal plan with a check as you resolve them. When all of your items are checked, you should be in excellent legal health.

Now, you are ready to begin. Relax, take your time and avoid getting frustrated.

Read Me First 6

Questions and ExplanationsMake a list of things to do or questions to ask.Anytime you can't find a document that might apply to you, such as marriage certificate, military discharge record, etc., make a note to either search for it or obtain a copy. Make notes below of any items you do not understand, or which require clarification. TIP: Leave space to write the answer next to your question.

Questions and Explanations 7

__________________________________Personal Data

SECTION I: PERSONAL DATA

1. Name (print): _______________________________________________________

2. Normal signature: ____________________________________________________

Many people use names other than their given names such as “nicknames” or shortened versions or different spellings of their given names or other forms of aliases to identify themselves. If you are married, you may have used a different name or names before your marriage. There is nothing to prevent you from doing so. Additionally, in New Hampshire you can formally change your given name in a legal proceeding.

3. Residence address: ___________________________________________________

___________________________________________________

___________________________________________________

4. How long have you lived at this residence? _____ Date moved in? _____________

5. Telephone Number: Home ____________________ Work ___________________

6. Date of birth: _______________________________________________________

7. Place of birth: _______________________________________________________

8. Do you have a copy of your birth certificate? yes ___ no ___

Your date of birth may be important in establishing your eligibility for various state, federal and other benefits, such as Medicare, Social Security, pension plans, profit sharing plans and insurance policies. Your birth certificate is usually the best method to prove your age.

If you do not already have a birth certificate, you should get one. Contact the town where you were born or, if you were born in New Hampshire, send $12.00 with your request to the Bureau of Vital Record, New Hampshire Department of Health & Human Services at 6 Hazen Drive, Concord, NH 03301. You can call them at (800) 852-3345 (ext. 4651) or (603) 271-4650.

Otherwise, contact the Department of Health in the state where you were born. There is a self-help publication published by the U.S. Department of Health and Human Services called, "Where to Write for Vital Records" which lists who to call or write and the costs (state-by-state). You will receive information at the seminar on how to obtain this publication. You can prove your age by several other documents if you cannot get a birth certificate. For instance, the Social Security Administration (SSA) prefers a certified copy of a birth certificate but may allow other proof of age such as: public or religious

Personal Data 8

__________________________________Personal Data

records; family Bible or other family records; school records; or immigration and naturalization records.

9. Are you a U.S. citizen? yes ___ no ___

If no, are you a legally admitted resident alien? yes ___ no ___

Your citizenship status may affect your rights to vote, work, and receive certain public benefits.

10. Did you move to New Hampshire from another state or country? yes ___ no ___

If yes, indicate the following:

When did you move to New Hampshire: _________________________________

Where did you live prior to New Hampshire: ______________________________

If you are married, your previous state or country of residence may have laws regarding property acquired there during your marriage that differ from New Hampshire’s laws. If another state in which you lived has different laws or ways to hold title to property, those differences may affect your right to dispose of property and they may affect you if you separate from or divorce your spouse in the future.

11. Are you registered to vote? yes ___ no ___ if yes, where? ___________

All adult citizens age 18 or older have the right to vote. However, you cannot vote if you are not registered. In New Hampshire, you must register 30 days before an election to be eligible to vote. You can register at your town or city clerk's office up to ten days before election day and on election day itself, but not between those two dates.

12. Do you have a driver's license? yes ___ no ___

If yes, what state?________________________ Expiration date?_____________

If you now have a New Hampshire driver's license, effective with renewals after July 2001 you must renew your license every five years. If you are 75 years or older, you must take a road test. If you have an out-of-state license, you must get a New Hampshire license within 60 days of moving to New Hampshire. For more information, call the Department of Safety, Motor Vehicle Division at (603) 271-2371.

Personal Data 9

__________________________________Personal Data

SECTION 1A: PERSONAL DATA

Please use this section to record similar data for a second adult in the household. You can write “Same” where applicable:

1. Name (print): _______________________________________________________

2. Normal signature: ____________________________________________________

3. Residence address: ___________________________________________________

___________________________________________________

___________________________________________________

4. How long have you lived at this residence? _____ Date moved in? _____________

5. Telephone Number: Home ___________________ Work ___________________

6. Date of birth: _______________________________________________________

7. Place of birth: _______________________________________________________

8. Do you have a copy of your birth certificate? yes ___ no ___

9. Are you a U.S. citizen? yes ___ no ___

If no, are you a legally admitted resident alien? yes ___ no ___

10. Did you move to New Hampshire from another state or country? yes ___ no ___

If yes, indicate the following:When did you move to New Hampshire:

_________________________________Where did you live prior to New Hampshire:

______________________________

11. Are you registered to vote? yes ___ no ___ If yes, where? ___________ Personal Data 10

__________________________________Personal Data

12. Do you have a driver's license? yes ___ no ___

If yes, what state?___________________________ Expiration date?_________

Personal Data 11

___________________________________ Employment

SECTION II: EMPLOYMENT

1. Social Security number: _______ - _____ - __________

2. Are you currently employed? yes ___ no ___

If yes, list your current employer; if no, list your last employer:

Name of employer: ___________________________________________________

Address of employer: _________________________________________________

_________________________________________________

3. If you are currently working, when did you begin working for the employer listedabove?

_____________________________________________________________

4. If you are not currently working, when did you stop? _______________________

5. Why did you stop? (circle one)

Quit Retired Fired Laid-Off Other

If you circled other, please explain: _____________________________________

You may have certain legal rights depending on the circumstances under which you left your last place of employment. These rights may include: the right to receive severance pay; the right to compensation for accumulated vacation hours you did not take; the right to receive pension benefits; the right to continued health insurance coverage; the right to bring a discrimination claim based on age, race, sex, national origin, creed, color, marital status, sexual orientation, or physical or mental disability against your former employer.

6. Are you a member of a union? yes ___ no ___

If yes, what is the union's name?______________________________________Employment 12

___________________________________ Employment

7. If presently employed, are you covered by an individual employment contract, an agreement between your employer and your union, or a written personnel policy manual?

yes ___ no___

8. Have you ever had a problem collecting pay that you were entitled to receive from your employer? yes ___ no ___

If you have a pay dispute with your employer, contact the New Hampshire Department of Labor, Wage and Hour Division at (603) 271-6294, for assistance.

9. If you are not employed, were you covered by an individual employment contract, or an agreement between your employer and your union in your last job, or a written personnel policy manual? yes ___ no___

If you are or were covered by a union contract, a written personnel policy manual, or an employment agreement, the contract or agreement may have defined the terms of employment and benefits available to you. Contact your union, or an attorney, for more information.

10. Do you currently, or have you ever, participated in an employer’s: pension plan ____ profit sharing plan ____

Do you have a copy of the plan summary? yes ___ no ___If not, you should obtain one.

Your plan summary will explain any rights and entitlement you may have under the plan. If you cannot understand the plan, enter this as a problem to be resolved on your Personal Plan form.

11. Do you have any plans to work in the future? yes ___ no ___

If you are not working but plan to in the future, income from a job may affect your eligibility for certain benefits that are based on income or employment status. For example, in 2003, if you will reach your “Full Employment 13

___________________________________ Employment

Retirement Age (FRA) this year, $1 in benefits will be deducted for every $3 over $30,720 you earn from employment. Note: only counting the earnings before the month you reach your FRA. If you are over 62 but under full retirement age and receiving Social Security, every $2 over $11,520 you earn from employment in a year will result in a $1 reduction in your Social Security benefits. Starting with the month you have reached “Full Retirement Age” (FRA)*, you will get your benefits with NO limit on your earnings.*For persons born in 1938 or after, the age requirement increases and varies according to your year of birth. Go to the Social Security Administration web site: www.ssa.gov for more information about calculating Full Retirement Age. You must report the amount of earned income you make in a year to the Social Security Administration. Other income based benefits such as property tax relief, energy, and pharmaceutical assistance may be similarly affected. To find out how to apply, contact your local area agency on aging. For more information on Social Security benefits, you can call SSA’s toll-free numbers, (800) 772-1213 (24 hours a day – service representatives are available between 7 a.m. and 7 p.m., Monday through Friday) or (800) 325-0778 (TTY).

Employment 14

___________________________________ Employment

SECTION IIA: EMPLOYMENTPlease use this section if completing this workbook with a second adult in the household:1. Social Security Number: _______ - _____ - __________

2. Are you currently employed? yes ___ no ___

If yes, list your current employer; if no, list your last employer:Name of employer:

___________________________________________________Address of employer:

_________________________________________________

_________________________________________________

3. When did you begin working for the employer listed above? __________________

4. If you are not currently working, when did you stop? ________________________

5. Why did you stop? (circle one)Quit Retired Fired Laid-Off OtherIf you circled other, please explain:

_____________________________________

6. Are you a member of a union? yes ___ no ___If yes, what is the union's name?

______________________________________

7. If presently employed, are you covered by an individual employment contract, an agreement between your employer and your union, or a written personnel policy manual?

yes ___ no___

8. Have you ever had a problem collecting pay that you were entitled to receive from your employer? yes ___ no ___

Employment 15

___________________________________ Employment

9. If you are not employed, were you covered by an individual employment contract, or an agreement between your employer and your union in your last job, or a written personnel policy manual? yes ___ no___

10. Do you currently, or have you ever, participated in an employer’s: pension plan ____ profit sharing plan ____

Do you have a copy of the plan summary? yes ____ no ____ If no, you should obtain one.

11. Do you have any plans to work in the future? yes ____ no ____

Employment 16

______________________________ Marriage/Family Situation

SECTION III: MARITAL/FAMILY SITUATION

There are several differences in the legal rights of married couples compared with the legal rights of unmarried couples. Some differences are summarized here. Marriage is an agreement governed by state law.

Common law marriages – New Hampshire does not recognize common law marriages. If a couple contracted a common law marriage while living in a state that recognized common law marriage at that time, then the couple will be considered "married" when they move to New Hampshire.

Property - Without a specific agreement between the marriage partners to the contrary, state law determines what interest the husband and wife have in earnings and other property acquired during the marriage. Generally, in New Hampshire, all property acquired during the marriage by either spouse is marital property, and each spouse has a full and equal interest in it. If the marriage ends, a divorce proceeding determines the property division.

Unmarried couples - The rules for unmarried couples are different. As a result, if you are living with an individual to whom you are not legally married, you may wish to prepare a written agreement that will govern ownership disputes and perhaps provide for financial support of one partner by the other if the relationship ends. A surviving spouse is eligible for Social Security benefits based on the work record of the deceased spouse. Generally, the surviving partner in an unmarried relationship is not eligible for benefits. Married persons can file a joint income tax return. Individuals who live together, but are not married, cannot file a joint income tax return. There are other differences. If you are an unmarried couple, you may wish to seek the advice of a lawyer about the legal implications of your relationship.

1. Are you now married? yes ____ no ____ If yes, answer the following:

(a) Are you living with your spouse? yes ____ no ____ or separated? yes ____ no ____

(b) Name of spouse: _____________________________________________________Marital/Family Situation 17

______________________________ Marriage/Family Situation

(c) Date and place of marriage: ____________________________________________

(date) (place)

(d) Do you have a copy of your marriage certificate? yes ____ no ____

Separation or divorce may result in present or future problems for which the advice of an attorney may be helpful.

2. Do you and your spouse have a written agreement with one another concerning your property?

yes ____ no ____

It is possible under the law to have an agreement, entered into either before (prenuptial), during or after marriage (postnuptial) that affects the way you and your spouse will split property, assets, personal belongings, etc., if you separate or get a divorce. Nuptial agreements also may affect your power to dispose of property by will or to otherwise control the distribution of your property after death.

3. Do you have any previous marriages? yes ____ no ____

If yes, answer the following for each previous marriage:

(a) Name of previous spouse: ________________________________________

(b) Did your spouse die? yes ____ no ____ If yes, answer the following:

(i) What was the date and cause of death? _________________

_________________________________________________

(ii) Do you have a copy of the death certificate? yes____ no ____

Marital/Family Situation 18

______________________________ Marriage/Family Situation

(c) Were you divorced? yes ____ no ____ If yes, answer the following:

(i) When and where did you obtain your divorce? _________________________________________________________

(ii) Do you have a copy of your divorce decree? yes ___ no ___

(iii) Do you have a copy of your settlement agreement?yes ___ no ___

(iv) Are you required to pay alimony? yes ___ no ___

(v) Are you entitled to receive alimony? yes ___ no ___

(vi) Is there a provision for child support? yes ___ no ___

If yes, what is the monthly amount? $______________

Marital/Family Situation 19

_______________________Marriage/Family Situation

4. If you are not married:

(a) Are you contemplating marriage? yes ____ no ____Marriage will create certain legal rights and implications. It is possible to enter an agreement before you are married (prenuptial) that will determine how you and your future spouse will split property, assets, personal belongings, etc., if you separate. You may wish to consult an attorney about these agreements and the legal implications of marriage.

(b) Are you now living with someone? yes ____ no ____

If yes, answer the following:

(i) Name of person: ___________________________________

(ii) Length of time you have lived with person: _____________

(iii) Do you have a written agreement with one another concerning your property? yes ____ no ____

If you are living with someone other than a spouse, you may want to consider signing an agreement about how each of you will share the payment of bills, how you own common assets and property, etc.

5. List the name and birth date of all your children, including adopted children:

Name Birth date

Marital/Family Situation 20

_______________________Marriage/Family Situation

6. List anyone else not listed above who depends on you for support.

Name Relationship

7. If you are a grandparent, are you having any difficulty visiting your grandchildren?

yes ____ no ____

New Hampshire law provides for grandparent visitation rights in limited circumstances. To receive visitation rights from a court a grandparent has to prove that spending time with the grandparent would be in the child's best interest.

Marital/Family Situation 21

________________________________All Income Due

SECTION IV: ARE YOU GETTING ALL THE INCOMEDUE TO YOU?

Many individuals do not have a clear picture of their financial status. It is helpful to occasionally itemize your monthly income and your monthly expenses. This process gives you a better idea of how able you are to meet your obligations.

1. List the approximate amounts you receive or are entitled to receive each month for each item below. For each item you have not received all you were entitled to receive, show the amount that is owed to you.

RECEIVE OWED TO YOU

(a) Gross salary $ _________________(b) Net salary (take home pay) $ _________________(c) Social Security benefits $ _________________(d) Pension benefits $ _________________(e) Spousal support $ _________________(f) Child support $ _________________(g) Veterans benefits $ _________________(h) Workers compensation $ _________________(i) City/Town Assistance $ _________________

(Welfare/TANF)(j) Investment income $ _________________(k) Dividends $ _________________(l) Interest on bank accounts

and bonds $ _________________All Income Due 22

________________________________All Income Due

(m) Supplemental Security Income $ _________________

(n) Other (describe) $ ________________

$ ________________$ ________________

Total $ ________________

All Income Due 23

________________________________All Income Due

If your income is below certain levels, you may qualify for a variety of federal, state, or municipal financial assistance programs. Some of these programs are available regardless of age. Others require that you be over a certain age. The following is a list of some programs with income-based eligibility criteria: Supplemental Security Income (SSI); TANF; Transitional Assistance; property tax relief; rent assistance, energy assistance; and home weatherization. This list is not inclusive. There are other types of aid available. We discuss these programs in this section. Note: Many of the figures used to calculate public benefits change annually. There are also federal and state income-based health programs which are discussed in Section V: Health. You also may be entitled to receive benefits that are not based on your income, (for example, Social Security or pensions). These are discussed in the next section

A. You may be eligible for the following income-based benefits if you meet the conditions listed:

SUPPLEMENTAL SECURITY INCOME (SSI)

You should apply if you meet all four (4) of the following conditions:

65 or older or legally blind or totally disabled.

U.S. citizen or qualified non-citizen. (A law passed in 1996 made most non-citizens ineligible for SSI; there are a few exceptions.)

If you don’t work and total countable gross income is not more than $572/month for an individual or $849/month for a couple. Income can be higher if there are earnings from work. (February 2003, Pub. 05-11069).

Countable resources are not more than $2000 ($3000 for couple). If you live in your home, the value of your home is not counted. Usually your car is not counted nor is a burial plot or burial funds up to $1500 (2 burial accounts of $1500 each for a couple). Life insurance with a face of $1,500 or less is not counted. (2003 figures).

For additional information or updates go to “Questions About:” on the Social

Administration web site (www.ssa.gov).

All Income Due 24

________________________________All Income Due

FOOD STAMPSYou should apply for food stamps if you meet the following criteria:

Resources are below $2,000 (for households with no elderly member) or resources are below $3,000 (for households with an elderly member age 60 or older); and

Net food stamp income is defined as follows: For households containing an elderly or disabled member, in

2003, net monthly countable income, after certain allowable deductions, may not exceed $739for one person. For a couple, the limit is $995/month.

For households without an elderly or disabled member, net monthly countable gross income may not exceed $960 for one person, $1,294 for two people.

NOTE: Calculating your net income for food stamp eligibility purposes is a complex process. If you think you may be eligible, you should contact the New Hampshire Department of Health and Human Services at (603) 271-4238 or Toll Free at 1-800-852-3345 (X. 4238). For information on-line, go to the Programs & Services page of the DHHS web site: www.dhhs.state.nh.us.

OTHER FINANCIAL ASSISTANCE Financial assistance through state and federal programs is available to childless adults and families in several additional forms. Child care subsidies, tuition and transportation care, adult deposit loans, substance abuse and mental health services are all administered by the Division of Family Assistance within the N.H. Department of Health and Human Services (www.dhhs.state.nh.us).Eligibility standards for specific services and benefits may include age, degree of disability, family size, household income, and other factors.For more information, call the Division of Family Assistance at (603) 271-4238.Each city and town is obliged to offer direct relief in the form of vouchers paid directly to vendors for such needs as food, rent, heat and utilities. The general eligibility standard is, the applicant have no means of support.

All Income Due 25

________________________________All Income Due

State law authorizes municipalities to require capable recipients to participate in a work program as a condition of continued eligibility. Municipalities can also require reimbursement from the recipient's spouse, parent or child if they are financially able to do so. For more information, call your city or town clerk's office.

All Income Due 26

________________________________All Income Due

PROPERTY TAX REDUCTIONS Eligibility and Application. New Hampshire residents are eligible for a real estate tax exemption, deferral, or credit, if they meet the specific requirements as blind, disabled, elderly, or military veteran property owners. To see if you qualify, call your town or city clerk, or the New Hampshire Department of Revenue Administration at (603) 271-2191.

ENERGY ASSISTANCEIndividuals may be eligible for fuel assistance to help with home heating costs, electric or rent (if heat is included in the rent). Eligibility is based on family size and income. If you are having difficulty paying home energy expenses contact your local Community Action Program or, for more information, call the Office of State Planning and Energy Programs at (603) 271-2155. Large families, the elderly, and the disabled receive priority.

B. You may be eligible for the following benefits (not based on income) if you meet the conditions listed:

SOCIAL SECURITYOld Age, Survivors and Disability Insurance (OASDI)

You should apply if you meet one of these conditions:

worked in jobs covered by OASDI and (FICA taxes withheld) 62 or older.

disabled and have worked in jobs covered by OASDI for 5 years of 10 years immediately before becoming disabled.

spouse of worker who receives OASDI and 62 or older or cares for worker's minor or disabled child.

divorced spouse (after at least 10 years of marriage) of worker who receives OASDI and 62 or older or cares for worker's minor or disabled child. If you have been divorced for at least two years and former spouse worker is 62 years old or older, former spouse worker does not have to be receiving benefits.

All Income Due 27

________________________________All Income Due

widow(er) or divorced (if married 10 years from a deceased worker), and 60 or older or cares for deceased worker's minor or disabled child.

parent of deceased worker and 62 or older and supported by worker at time worker died.

VETERANS BENEFITSYou should apply for a veteran's pension if you meet all of the following conditions:

You or your spouse: had at least 90 days of wartime service. did not have dishonorable discharge. is 65 or older or disabled After subtracting unreimbursed medical expenses, total family gross income

(not counting welfare) is less than $9,690/year if living alone; $12,692/year if living with spouse or child; (add $1,653 per year for each additional dependent) (2002 figures).

NOTE: The surviving spouse of an eligible veteran should apply if married at least one year (if married and natural parent of veteran's child, the one-year marriage requirement does not apply) and living with veteran at time of death, or separated (but not divorced) through no fault of spouse. The surviving spouse can't be remarried and income must be less than $6,497/year (for surviving spouse with no children) (2002 figure).

Surviving spouses or spouses with one or more children also may be eligible for service related death benefits.

For more information call 1-800-827-1000 or visit web site www.va.gov .

FEDERAL CIVIL SERVICE RETIREMENTYou should apply for a pension if either you or your spouse is: 62 or older and was employed by the federal government for at least 5 years and did not withdraw retirement funds upon separation from

government service,

All Income Due 28

________________________________All Income Due

or you should apply if you are disabled, currently employed by the federal government, and have at least 5 years of federal government service.

NOTE: Widow(er) of a person who worked for the federal government for 5 years will receive a survivor annuity only if the deceased annuitant had elected an Annuity With Survivor Benefit to Widow(er). Divorced spouses should consult an attorney about the 1984 Civil Service Spouse Equity Act.

STATE/LOCAL CIVIL SERVICE RETIREMENTYou should apply if you participated in a state or local government retirement plan. Contact the local or state agency for specific criteria and benefits. The New Hampshire Retirement System can be found online at www.state.nh.us/retirement or call toll free 1-877-917-6477 (Local # 271-3351).

RAILROAD RETIREMENT BENEFITS (RRB)

You should apply if you meet one of these conditions:

Retired, 62 or older, and worked in railroad industry at least 10 years. Or spouse, widow(er) or parent of retired worker (if railroad was worker's last employment). Worker with 30 years railroad service can retire at 60.

If spouse of railroad worker: married at least one year to retired worker, retired, and 62 or older (60 if worker retired at 60).

If widow(er) of railroad worker: married at least 9 months, not remarried, and 60 or older.

If unmarried parent of deceased railroad worker: at least 60, no surviving spouse or minor child of worker, and was dependent on worker for at least half of support at time of worker's death.

If divorced spouse: eligible for Tier I benefits only, if married to railroad worker at least 10 years and 62 or older or cares for worker's minor or disabled child.

If disabled for work in his/her regular occupation or for work in any regular occupation and has worked for the railroad for twelve months of the 30 months before the disability began and

All Income Due 29

________________________________All Income Due

has worked a total of 20 years for railroad, or has attained the age of 60.For more information, contact U.S. Railroad Retirement Board using web site www.rrb.gov or call the Boston District Office at (617) 223-8550.

All Income Due 30

________________________________All Income Due

UNION/PENSION PLANYou should apply if you or your spouse meet all the following conditions:

was ever a member of a union or ever worked for an employer who provided a private pension plan; and

didn't withdraw pension funds; and have never applied for pension funds.

NOTE: You may wish to contact the Pension Action Center’s New England Pension Assistance Project at (888) 425-6067 for assistance or go online to www.pensionaction.org/nepap.htm.

All Income Due 31

____________________________________________Health

SECTION V: HEALTH

1. Are you having difficulty paying for doctor's visits or hospital care? yes ____ no ____

2. Do you foresee that you or someone close to you will require long-term nursing home care? yes ____ no ____

The following federal and state programs are available to help pay for medical bills, hospital and long-term care, if you meet the conditions listed below. (Note, many of the figures used to calculate benefits change annually.)

MEDICARE

You should apply if you meet one of the following conditions:

65 or older and eligible for Social Security or Railroad Retirement benefits (RRB)

Eligible to receive Civil Service Retirement check and FICA deductions for Medicare were withheld from pay check when working

Disabled and qualified for Social Security or Railroad Retirement Benefits for past 24 months

Kidney patient

Turned 65 before 1968 and U.S. citizen or legal alien

Turned 65 before 1975 and have worked some jobs covered by Social Security or Railroad Retirement Benefit U.S. citizen or legal alien

65 or older and U.S. citizen or legal alien and willing to pay $316/mo. (Part A); $58.70/mo. (Part B) (2003 figures)

Additional information is available from the Social Security Administration www.ssa.gov; from www.medicare.gov .

Health 32

____________________________________________Health

MEDICAID

You should apply if you meet the following conditions:

U.S. citizen or qualified non-citizen (certain non-citizens are still eligible for Medical Assistance, including permanent resident aliens); and

Meet financial need criteria under the “categorically needy," “medically needy,” “Qualified Medicare Beneficiary,” “Specified Low-Income Medicare Beneficiary,” or other Medicaid program; and

Meet other requirements to fit into one of the above-named programs (for example, age, disability, receipt of other public benefits).

NOTE: Older adults must generally fit into one of the following categories to be eligible for a Medicaid program:

• age 65 or older, blind or disabled;

• members of families with minor children without financial support of one or both parents; or

• TANF recipients.

Categorically Needy MedicaidTo receive Medicaid as an aged, blind or disabled person, a person must meet financial and non-financial eligibility requirements for the receipt of financial grants under the Old Age Assistance (OAA), Aid to the Needy Blind (ANB), or Aid to the Permanently and Totally Disabled (APTD) programs.

Medically Needy MedicaidPeople who do not qualify as “categorically needy” may be eligible for Medicaid if “medically needy.” The “medically needy” are those individuals who do not qualify as categorically needy because they have too much income and/or resources to meet the financial criteria, but yet have too little income and too few resources to afford necessary medical care.

Health 33

____________________________________________Health

QUALIFIED MEDICARE BENEFICIARY, AND SPECIFIEDLOW INCOME MEDICARE BENEFICIARY PROGRAMS

Lower income elderly or disabled people who are eligible for Medicare can get assistance in paying medical premiums. The Medicare Beneficiaries Savings Program is also referred to as the Buy-In program. Depending on their resources, “Qualified Medicare Beneficiaries” (QMBs) may qualify to have their Medicare Parts A and B premiums and all Medicare co-insurance and deductibles paid for through the Qualified Medicare Beneficiaries (QMB) program. Eligible individuals may also receive full Medical Assistance coverage for other services. Individuals with somewhat higher incomes may qualify to have all or a portion of Medicare Part B premiums paid for through the Specified Low-Income Beneficiaries (SLMB) programs. There are 3 different levels of benefits available through these programs, based on income. The Qualified Disabled and Working Individuals (QDWI) program provides payment of Medicare Part A premiums for eligible working individuals with disabilities who are entitled to enroll in Medicare Part A, but who have lost Medicare Part A coverage due to earnings.

You should apply for QMB benefits if you: are a Medicare Part A beneficiary; have income of no more than $749 per month for an

individual and $1,010/month for a couple in 2003; and meet the requirement for limited other resources.

You should apply for SLMB benefits if you: are a Medicare Part B beneficiary; have net income of no more than $898 per month for an

individual, and $1,212 for a couple in 2003. You should apply for SLMB 135 benefits if you:

are a Medicare Part B beneficiary; have net income of no more than $1,031 per month for an

individual, and $1,384 for a couple (six months ending March 2004) .

Health 34

____________________________________________Health

Note: Individuals eligible for SLMB may also be eligible for Medicaid, but individuals eligible for SLMB135 and SLMB175 may not otherwise be eligible for Medicaid.

You should apply for QDWI benefits if you: are a working individual with disabilities

entitled to enroll in Medicare Part A, but have lost Medicare Part A coverage due to earnings; and

have net income of no more than $1,497 per month for an individual, and $2,020 for a couple in 2003) .

Note: Individuals eligible for QDWI may not otherwise be eligible for Medicaid.

To apply for any medical assistance program, visit your DHHS District Office.

NOTE: Older adults and individuals with disabilities, their families and caregivers have access to trained and certified HICEAS volunteers who provide free and confidential health insurance information and counseling through the NH Health Insurance Counseling, Education and Assistance Service (HICEAS). HICEAS educates Medicare Beneficiaries on: Medicare, Appeals, Fraud/Abuse, Supplemental Insurance, Medicare Savings Programs, Medicaid, Long Term Care Insurance, and Prescription Drug Assistance, empowering them to make informed decisions on their own. HICEAS has 25 sites located throughout the state, and over 200 volunteers. For more information or to get in touch with a local health insurance counselor please call the intake office, NH Help Line, 24 hours a day at: 1-800-852-3388 (in-state) or (603) 225-9000 (out-of-state).

Health 35

____________________________________________Health

HOSPITAL FREE CARE OBLIGATIONSYou should apply for benefits if you:

have had or need hospital or nursing home care, are unable to pay for it, and are ineligible for Medicaid.

Some hospitals are obligated to provide free care under the Hill-Burton Act. The federal income limitation guidelines for free care are $8,980/year for an individual; and $12,120/year for a couple (2003 figures). Some hospitals raise the income level.

People with higher incomes may qualify for reduced cost care. Income figures are tied to the federal poverty guidelines and typically change in March of each year. For more information, contact Health Resources & Services Administration – Hill-Burton Act Hotline at (800) 638-0742.

1. Have you entered into, or are you considering entering into, a life care contract?

yes ____ no ____

2. Do you require intensive, daily, at-home care by another? yes ____ no ____

If yes, is that care provided by: A nurse, therapist or other health care professional?

_____________________________________________________________ A friend or family member?

______________________________________ Other? If so, who:

_____________________________________________________________

Both Medicare and Medicaid pay for certain home care services.Health 36

____________________________________________Health

3. Do you personally provide intensive, daily, at-home care to a family member or friend? yes ____ no

____

Health 37

______________________Purchasing Goods and Services

SECTION VI: PURCHASING GOODS AND SERVICES

1. Are your credit cards in your name only, in your spouse's name only, or in your name and your spouse's name?Cardholder(s) Card Type (Visa,

MC, etc)Account Number

If credit cards are in your spouse's name only, you may have difficulty establishing a credit record if your spouse dies. Note, however, if credit cards are in your spouse's name only, as a general rule, you cannot be held personally responsible for charges on the credit card.

2. Is anyone other than your spouse authorized to use a credit card issued in your name?

yes ____ no ____

Remember that you are ultimately responsible for charges made by others whom you have authorized to use your card.

3. Do you have a list of all of your credit cards, including the card number and the name and telephone number of the card issuer?

yes ____ no ____

It is advisable to keep a list of all your credit cards, including the name and the telephone number of the issuer of the card, and the card number. This is important, because if your credit cards are lost or stolen, you can quickly cancel the cards, before anyone has the opportunity to make unauthorized purchases. (To the extent a thief does make charges on your credit card, the maximum amount you can be responsible for is $50 per card.) Most credit card issuers also offer, for a nominal fee, a credit card protection plan. You give the issuer a list of all your credit cards and numbers. If the cards are lost or stolen, you make one telephone call to the credit card protection plan provider. The provider then takes care of immediately canceling all your cards, and having new cards with new numbers issued.

4. Have you had errors on your credit card bill that you have had difficulty getting corrected?

yes ____ no ____Purchasing Goods & Services 38

______________________Purchasing Goods and Services

Federal law gives you some protection if your credit card bill has an error. It applies to bills for credit cards, bank cards, department store charge accounts, and other types of credit.

5. Have you ever purchased merchandise (or services) using a credit card, and the merchandise (or services) turn out to be defective?

yes ____ no ____

Special federal laws give you some protection when you use a third-party credit card to buy goods or services. These rules were created because of the widespread use of credit cards, and the growing number of cases in which people were stuck with poor goods or services but still had to pay for them.

6. Have you ever had a problem with goods you purchased after you got them home, and the seller was not willing to correct the problem? yes ____ no ____

If the seller can't or won't fix the problem, you have several options, including filing a complaint with the Division of the New Hampshire Attorney General’s Consumer Protection Bureau or filing a lawsuit.

7. Have you ever been confused by the terms of a warranty on an item you purchased?

yes ____ no ____

Before you buy, find out if the goods come with a warranty. If so, find out if the warranty is "full" or "limited."

8. Have you ever ordered goods through the mail and been unhappy with either the quality of the goods, or the length of time it took to receive them? yes ___ no ___

There are Federal Trade Commission regulations and New Hampshire laws that apply to mail order sales to protect consumers.

9. Have you ever purchased goods on credit (but not by credit card), then later had problems with the goods?

yes ____ no ____

Purchasing Goods & Services 39

______________________Purchasing Goods and Services

Both federal and New Hampshire law give you some protection in different credit situations.

Purchasing Goods & Services 40

________________________________________Claims___

SECTION VII: CLAIMS

1. Has anyone, in the past year or so, made a legal claim against you, or given you reason to believe that they intend to make a claim of any kind against you in the future?

yes ____ no ____

If yes, please explain briefly: __________________________________________

__________________________________________________________________

__________________________________________________________________

2. Have you, in the past year or so, made a claim against anyone, or given anyone reason to believe that you intend to do so in the future? yes ____ no ____

If yes, please explain briefly: __________________________________________

___________________________________________________________________

___________________________________________________________________

In this Section VII, when we use the word “claims” we do not intend to mean only lawsuits or similar legal matters. Please also include any significant problems that you have had difficulty resolving (e.g., the constant barking of a neighborhood dog that disturbs you, neighbors regularly blocking your driveway, loud music late at night, difficulty with bill collectors, annoyances by door-to-door salespersons, etc.) If the answer to Question 1 or 2 above is “yes,” consulting an attorney or other professional at an early stage may enable you to find a relatively easy solution before the problem gets larger and more difficult to correct or control. If you are reluctant to contact an attorney, consider seeking the help of an alternative dispute resolution center or an agency. The following telephone numbers may be useful:

Better Business Bureau of New Hampshire...............(603) 224-1991Consumer Protection Division, Attorney General's Office (603) 271-3641U.S. Food & Drug Administration.................................(781) 596-7700Claims 41

________________________________________Claims___

U.S. Consumer Product Safety Commission.................(800) 638-2772

Claims 42

________________________________________Claims___

3. Have you been denied credit based on what you feel is an incorrect credit report?

yes ____ no ____

If you have received a notice from a company from which you have applied for credit, stating you have been denied credit based on your credit report, you can request the name of the credit reporting agency that issued the report. You may request a copy of the report from the credit agency and the credit agency must supply you with a copy. The credit agency must supply the credit report for free if you request the report within 60 days after you are notified that you have been denied credit. Even if you have not been denied credit based on your credit report, it is a good idea to check your credit report periodically for accuracy. Under federal law, a consumer has the right to be sent a copy of his or her credit report. If you have not been denied credit based on the report, the reporting agency may charge you a reasonable fee to send you your credit report.. You can look in the yellow pages of your telephone directory under such headings as "Credit" or "Credit Rating and Reporting Services," or call Equifax (800) 685-1111; Experian (888)397-3742; or Trans Union (800) 916-8800. For further assistance contact the Federal Trade Commission toll free at (877) 382-4357 or at (216) 263-3410.

4. Do you feel that you have ever been harassed or improperly treated by any of your creditors attempting to collect on their bills?

yes ____ no ____

State and federal laws regulate the method that creditors may and may not use in attempting to collect debts. Creditors are prohibited from communicating with a debtor before 8:00 AM or after 9:00 PM, at an inconvenient place, or while the debt is being verified. The laws also prohibit threats, swearing, false statements, repetitive phone calls and making more that one visit to a debtor's home in a 30 day period. Additional activities are prohibited. You may have legal recourse if any of these tactics have been used against you.

5. If you are a party in a lawsuit, briefly describe the circumstances of the lawsuit:

___________________________________________________________________

___________________________________________________________________

Claims 43

________________________________________Claims___

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Claims 44

____________________________________Home/Apartment

SECTION VIII: HOME/APARTMENT

How you hold title to your home is important for various legal purposes. It may determine who gets the proceeds if you sell your home. It may affect the rights of your spouse, other individuals who share title, or your heirs if you die or get a divorce. The legal terms determining title on a deed are sometimes difficult to understand.

The common ways for individuals to hold title to real property in New Hampshire are as joint tenants, or as tenants in common

Another way to hold title is as “joint tenants.” There may be two or more persons holding a parcel of property as joint tenants, and each tenant has an individual interest in the whole property and has an equal right to its use during his or her lifetime. Each joint tenant has a right of survivorship, which means that when one joint tenant dies, the property passes to the remaining joint tenants, not to the deceased's beneficiaries or heirs. The words “as joint tenants with right of survivorship” usually appear on the deed when title is held in this manner.

Title also may be held by persons as “tenants in common.” There may be two or more persons holding property as tenants in common. Each has a separate and distinct share of the property, but each also has a right to use of the whole property. When one of the tenants in common dies, the deceased tenant's share of the property passes by will or intestacy. It does not go to the surviving tenants in common unless the will (or intestacy laws if there is no will) so provides. An example of the words that would appear on the deed when A and B own property as tenants in common, with A having 1/5th ownership and B having 4/5ths ownership is “in the undivided portions of shares of one fifth to A, his heirs and assigns, and four fifths to B, his heirs and assigns.”

Please note, this section is a brief explanation of some ways you can own property. The word “tenant” as used to indicate the form of ownership does not mean necessarily that the owners are occupying the property. This is one of those legalisms that can be confusing. You can think of the word “tenant” as being the same as the word “owner” or ownership when we use it here. For example, tenancy by the entirety means ownership by the entirety.

If you own your residence, answer only the Owner Section (below). If you rent your residence, answer only the Renter Section (which follows the Owner Section).Home/Apartment 45

____________________________________Home/Apartment

OWNER SECTION:

1. Do you own a: house? condominium? townhouse? mobile home?

2. My home is owned by: (circle the one that applies)Just Me My Spouse and Me Another Person

and MeOther (please explain)

_________________________________________________If possible, please check your deed for the wording indicating how title is held and write the language here: ________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________Be sure you understand the language in your deed. If you do not understand the language in your deed, make a note to have it explained to you by an attorney.

3. Date of purchase: ____________________________________________________

4. Purchase price: _____________________________________________________

5. Mortgage amount: ___________________________________________________

6. Total current principal balance outstanding on mortgage: ____________________

7. Are your payments up to date? yes ____no ____

Home/Apartment 46

____________________________________Home/Apartment

If you are behind in your payments, it may affect your credit rating and could result in the lender beginning foreclosure proceedings against you. Many lenders are willing to work with you if you tell them ahead of time that you will have trouble meeting a monthly payment. You should take immediate action if you are behind in your payments. In New Hampshire, before a lender can start foreclosure proceedings, the lender must send you a notice of default at least 30 days prior to filing a mortgage foreclosure action. You can telephone Consumer Credit Counseling Services of NH/VT directly at (800) 327-6778 or get information on line from the National Foundation For Consumer Credit web site: http://www.debtadvice.org/takethefirststep/locator.html.

Persons whose mortgages are insured by FHA/HUD may have additional rights in foreclosure situations. There are federal regulations setting requirements for notice, partial payment options and foreclosure procedures. Under the Home Mortgage Assignment program, you may be able to delay repayment by having HUD accept assignment of the mortgage from the lender. HUD will require that: 1) the mortgage default was beyond your control; 2) your inability to pay is temporary; and 3) there is a reasonable prospect that, after not more than 36 months, you will be able to resume payment of the mortgage, with the maturity date extended. Rationales for eligibility include illness or death, or expenses related to them, unemployment and loss of income maintenance benefits. You can contact HUD at (800) 767-7468; (800) 877-8339 (TTY).

8. Have you made major improvements to your home since buying it (note, general repairs and maintenance are not considered to be improvements)?

yes ____ no ____If yes, please list each improvement, the year made and the cost.

IMPROVEMENT YEAR MADE COST

You may add the cost of improvements to the cost of the house when determining gain for income tax purposes if you sell your house.

Under one provision of the Internal Revenue Code (IRC), up to $250,000 of gain ($500,000 for spouses filing jointly) from the sale or exchange of a principal residence is not taxable if the taxpayer owned and used the home as a principal residence for at least 2 years during the 5 year period ending on the sale date. This provision may be used once every two years.Home/Apartment 47

____________________________________Home/Apartment

Please note that the tax laws are complex and always changing. It is advisable to consult an attorney if you are selling your home.

9. Have you taken out loans to finance the cost of any improvements to your home?

yes ____ no ____

10. Are you thinking about signing a contract to have someone do work on your home?

yes ____ no ____

New Hampshire law gives you a short "cooling off" period. The reason for this law is to help you avoid being stuck with "impulse" or "high pressure" sales.

11. Do you believe your home needs repair or maintenance work that you cannot afford to have done?

yes ____ no ____

The federal government authorizes local agencies to make low interest home improvement loans to homeowners who could not otherwise afford such repairs. If you are interested in this type of loan, contact ServiceLink (866) 634-9412 or the local area agency on aging.

Home/Apartment 48

____________________________________Home/Apartment

12. Property tax annual amount for current year: ______________________________Paid to: Government taxing authority

__________________________________Lending institution

__________________________________________Other (please describe)

_______________________________________

13. Does your financial situation make it difficult or impossible to make your property tax payment?

yes ____ no ____

In New Hampshire, you may qualify for certain types of property tax relief if you are over age 65, a veteran, blind, disabled, have a low or moderate income or have seen a sharp increase in your school tax rate. To get more information or get an application, contact your city or town clerk. For additional information you could call the New Hampshire Taxpayer Assistance Line at (603) 271-2186.

14. Are you planning to move and sell your home? yes ____ no ____

If you are planning to sell your home, see the Checklist titled "I'm Selling My Home" (in the Appendices Section, page 59).

15. Are you planning to purchase a new home? yes ____ no ____

If you are planning to purchase a new home, see the Checklist titled "I'm Buying a Home," (in the Appendices Section, page 58). Remember, the agreement of sale on a home is the most important document. An attorney should review it before you sign it. Remember also, that in most states, the realtor actually works for the seller, and may not always have the buyer's best interest in mind.

16. Are you planning to move and lease your home to tenants? yes ____ no ____

Selling or renting your home may result in both legal rights and legal obligations. It is advisable for you to consult an attorney if you plan to sell or lease your home.

Home/Apartment 49

____________________________________Home/Apartment

17. Do you have adequate homeowners insurance? yes ____ no ____

You should be sure you have the types of insurance you need considering the location of your home (for example, earthquake, heavy winds/hurricane, flood). Have your homeowners insurance reviewed annually to be sure you have adequate insurance for your home and personal possessions. Ask yourself if the amount of insurance is sufficient at today's prices to replace your home and personal property, if they were destroyed. Your policy probably provides that if the coverage on your home does not equal at least 80% of the value of the property (less the value of the land and foundation), and if you have a loss, your recovery will be only a percentage of your loss, even if your coverage exceeded your total loss. Depending on your financial situation, it may be advisable to have an umbrella liability policy.

18. Do you keep a current household inventory (a list of all your valuable personal property with its original cost and serial number (if any)? yes ____ no ____

A current household inventory will speed the process of filing a claim with the insurance company if all, or a portion, of your personal property is stolen or destroyed. It is also a good idea to take photographs or make a videotape of major household items, and to keep a record of serial numbers (when available).

19. Have you considered getting a reverse mortgage on your home? yes ____ no ____

Reverse mortgages are mortgages that are secured by a homeowner's equity in his or her home. Repayment of the loan is generally not required until the homeowner dies or moves from the home. Older homeowners can use reverse mortgages to improve their income and standard of living.

Reverse mortgages can be structured in several different ways. The homeowner can: (1) borrow a lump-sum amount; (2) receive monthly payments for life (commonly referred to as a "tenure loan" because it is for the tenure of the homeowner's life); (3) receive monthly payments for a set term (commonly called a "term loan"); (4) establish a home equity line of credit on which a homeowner can draw at will; or (5) any combination of the above. The homeowner can use the proceeds for any purpose desired. Many elderly individuals use the Home/Apartment 50

____________________________________Home/Apartment

increased income to pay for long-term care. As in traditional mortgages, the homeowner retains title to the home and is responsible for all taxes and home maintenance.

In a traditional (forward) mortgage, as the borrower makes periodic payments, the principal balance of the loan declines. In a reverse mortgage situation, the borrower does not make payments during the life of the loan, and, therefore, the principal balance rises. The interest that accrues is added to the principal, and the lender then charges interest on interest. Generally, reverse mortgages do not have to be repaid until one of the loan maturity triggers specified in the mortgage documents is activated (in a term loan when the term expires, in a tenure loan when the borrower dies, homeowner sells property or fails to pay taxes or insurance premiums). At the end of the loan term, the homeowner (or his or her estate) owes the lender the loan balance or the value of the home, whichever is less. Most reverse mortgages are non-recourse loans. This means the homeowner (or his or her estate) is not personally liable for any amount due on the debt after the house is sold. The lender cannot get a deficiency judgment against the homeowner if the home-owner receives more in loan payments than the home is worth when the loan matures.

Home/Apartment 51

____________________________________Home/Apartment

In 1988 Congress enacted the Home Equity Conversion Mortgage (HECM) Demonstration, authorizing HUD to insure certain lenders offering reverse mortgage loans. To qualify for a HUD-insured reverse mortgage, the borrowers must: (1) be at least 62 years old, (2) own their homes free and clear, (3) be free of any other debt (including any other mortgage), and (4) occupy the home as a principal residence. Homeowners with a small mortgage or other debt may qualify if the preexisting mortgage or debt can be paid off with the proceeds from the reverse mortgage at the closing. Also, a borrower in the HUD program must receive "adequate counseling by a third party (other than the lender)" before receiving a reverse mortgage loan. The counseling is to explain other options available to the borrower including public benefits.

In many states the laws written to regulate mortgages prohibit reverse mortgages. Several states have enacted specific laws authorizing reverse mortgages. Some states have enacted laws that require counseling before entering into a reverse mortgage, while other states allow the borrower to waive it. New Hampshire permits reverse mortgages. For details, call HUD at (603) 666-7510, or the New Hampshire Banking Department at (603) 271-3561. Homeowners must always be cautious and research the lender involved to avoid scam refinancing deals and scrutinize closing costs to ensure that they are reasonable.

20. Have you considered refinancing your home? yes ____ no ____

If the rate of interest on home loans drops significantly from the rate on your current loan, it may be a good idea to refinance your current loan. Closing costs are usually involved in refinancing. Therefore, you need to determine (possibly with the help of an accountant) whether you will save money by refinancing. This determination depends upon your particular circumstances and goals. Homeowners must be cautious when refinancing a home and avoid scam refinancing deals.

RENTER SECTION:

1. Do you have a written lease or rental agreement? yes ____ no ____If no, please explain: _________________________________________________

Home/Apartment 52

____________________________________Home/Apartment

A written lease or rental agreement outlines your rights and obligations about your rental residence. Written leases are not uniform. Read your lease agreement. Seek advice or explanation if anything is not clear. If you do not have a written document, you may have more difficulty protecting yourself if you are involved in a dispute.

2. Do you rent a: house? condominium? townhouse? mobile home?

If you rent space in a mobile home park in New Hampshire, a special law protects your rights. The law requires mobile home parks to give you a copy of a notice discussing both your rights and obligations and the law, as well as, a copy of the park's rules. If you believe your park manager is not following the law, you may wish to consult a lawyer or call the Consumer Protection & Antitrust Bureau of the New Hampshire Attorney General's Office at (603) 271-3641.

3. Amount of rent paid monthly: __________________________________________

4. Landlord's Name: ____________________________________________________

Address: ___________________________________________________________

5. Did you pay the rent in advance for the last month of the term of the lease?

yes ____ no ____

6. Did you pay a security deposit? yes ____ no ____

If yes, how much? ___________________________________________________

7. How long have you rented the premises? _________________________________

8. On what date does your lease/rental agreement end? ________________________

Home/Apartment 53

____________________________________Home/Apartment

Payment in advance of the rent for the last month of the term of the lease is to protect the landlord from a tenant's leaving the premises without paying the last month of rent. A security deposit is to protect the landlord from the possibility of the tenant physically damaging the premises or not living up to the terms of the lease. Under certain circumstances, however, a landlord may apply the security deposit towards unpaid delinquent rent. Under New Hampshire law, the landlord must send to the tenant within 30 days of the date that the tenant has moved out, an itemization of damages that the tenant has caused to the premises, along with the estimated or actual costs of repair or replacement and any paid receipts for the repair or replacement. If the landlord does not send any such statement of damages the landlord must return the security deposit in full within 30 days of the date that the tenant vacates the premises. New Hampshire law gives your landlord certain obligations about paying interest on your security deposit.

9. Do you have adequate renter's insurance? yes ____ no ____

If you are renting, it is important to have renter's insurance covering your personal possessions in an adequate amount (enough to replace). If you do not have renter's insurance, you will not be able to recover your losses if you lose your personal possessions because of fire or theft. You should review your renter's insurance annually.

10. Does your financial situation make it difficult or impossible to pay your rent?

yes ____ no ____

Home/Apartment 54

_____________________________Household Employees

SECTION IX: HOUSEHOLD EMPLOYEES

1. Do you employ a housekeeper, home care provider, chauffeur, nanny or other household help?

yes ____ no ____

If yes, please describe the nature of the services provided: ___________________

___________________________________________________________________

___________________________________________________________________

You may have various legal obligations if you are the employer of a home care provider or household helper. You can treat a home employee as either an independent contractor or an employee. The tests for determining a worker's classification are different for tax, liability and labor law issues. The type of service provided also helps determine whether the home care worker is an employee or an independent contractor.

Tax Issues - Every employer must withhold Federal Insurance Contributions Act (FICA) taxes for each employee. An employee for FICA purposes includes individuals who would have the status of employee under the usual common law rules applicable to determining employer-employee relationships. If the employer fails to withhold the required amounts, the employer is liable for the full amount required to be withheld. The employer also must pay an excise tax of 7.65% of the employee's wages. This is the same rate that applies to the tax the employer is required to withhold from the employee's pay. The result is that the employer has a matching obligation to the employee for FICA and Medicare taxes.

The compensation of independent contractors is not subject to FICA withholding requirements. The employer of an independent contractor has no matching obligation. Under the Self Employment Contributions Act (SECA), the independent contractor is responsible for paying his or her own Social Security taxes. The independent contractor pays an amount equal to 15.3% of his or her compensation, the equivalent of the employee obligation plus the employer obligation under FICA. Employers are also required to pay federal unemployment tax (FUTA) equal to 7.65% of the total wages paid by the employer during the calendar year. The FUTA is only imposed on employers for services provided by an employee as defined under the FICA provisions; therefore, the employer does not have to pay FUTA taxes for an Household Employees 55

_____________________________Household Employees

independent contractor. An employer is also required to withhold income taxes from the wages paid to an employee.

In determining the classification of the home worker for tax purposes, the following factors are considered: (i) the nature of the services provided, (ii) the amount of control exercised, (iii) the home worker's professional licensing status, if any, and (iv) any other evidence showing whether the services were performed in the conduct of an independent trade, business or profession. However, if the home service being provided consists

Household Employees 56

_____________________________Household Employees

largely of household-type services, the employment relationship is generally characterized as an employer/employee arrangement regardless of the other factors.

There are some exceptions to the withholding rules for domestics. You need to pay Social Security tax only for household helpers who earn $1,400 or more during the year. In the past, employers and employees were required to report and pay social security taxes on all earnings of at least $50 in a three-month calendar quarter. No Social Security tax is due if the household helper is under age 18 during any part of the year. Therefore, an occasional babysitter who is under the age of 18 is now exempt from the tax, unless babysitting is his or her main job. The $1,400 threshold may be increased in the future to reflect rising wages. (2003 figures: Publication 926) Go to web site: www.irs.gov for more information.

Liability Issues - The employment relationship also affects issues concerning liability for injuries sustained by the home worker or caused by the home worker to a third party. Generally, employers are liable only for those injuries suffered by an employee in the discharge of his or her employment duties that result from the negligence of the employer or the employer's failure to perform a duty owed to the employee. However, most jurisdictions have enacted some form of worker's compensation act that requires employers to provide coverage for injuries an employee gets while performing his or her duties as an employee. In many jurisdictions, the workers' compensation laws do not cover independent contractors. The test for determining whether an employer/employee relationship exists for worker's compensation statutes are different from the test for federal employment tax purposes. There also are special rules for "domestics" in some jurisdictions. The type of services a home worker provides may be very important in determining whether the workers' compensation statutes apply to a particular situation. Under the doctrine of respondeat superior, an employer may be liable for injuries to third parties caused by his employees while carrying out their duties for the employer. The critical factor in imposing liability on an employer is the amount of control he or she has over the performance of the worker's duties.

Labor Law Issues - The federal Fair Labor Standards Act (FLSA) applies to employers who have employees engaged in commerce, or in the production of goods for commerce or employed in an enterprise engaged in commerce or the production of goods for commerce. The FLSA expressly applies to domestic workers and to home care workers Household Employees 57

_____________________________Household Employees

who are not independent contractors. Therefore, individuals who employ home care workers as employees should follow the minimum wage and overtime obligations imposed on employers under the FLSA (unless an exemption applies). To determine whether a person is an employee or independent contractor for FLSA, such factors as control, skill required, duration of the work, whether the worker has a distinct occupation or business, the availability or furnishing of equipment and the right to fire the employee, will be considered. Contact an attorney for help.

Household Employees 58

__________________________________VehiclesSECTION X: VEHICLES

1. For each vehicle you own, indicate the year and make of the vehicle and how title to the vehicle is held:

OWNERSHIP

DESCRIPTION ME SPOUSE & ME

ANOTHER & ME

2. Is each vehicle insured? yes ____ no ____ If no, why not?

New Hampshire law requires owners/operators of motor vehicles to prove “financial responsibility,” either through purchase of insurance, or through proof of adequate self-insurance. Financial responsibility is the ability to pay for damages in a vehicle accident of $25,000 for injury to one person, $50,000 for injury to two or more persons and $25,000 for property damage of others.

3. Name of automobile insurance company: _________________________________

4. Insurance agent's name: _______________________________________________

Address: ___________________________________________________________

5. Amount of insurance coverage:Bodily injury:

________________________________________Property damage:

________________________________________Uninsured motorist:

________________________________________Underinsured motorist:

________________________________________Collision:

________________________________________

Vehicles 59

__________________________________VehiclesComprehensive (fire/theft):

________________________________________Deductible: ________________________________________

6. Who, beside yourself, drives your motor vehicles? ________________________

7. Do you own, by yourself, or with another person, any of the following:

Motorcycle Boat Trailer Recreational Vehicle

Vehicles 60

__________________________________________Pets

SECTION XI: PETS

1. Complete the following information for each pet you own or possess:

a. Type of pet ____________________________________________________

b. Is the pet licensed? yes ____ no ____

If yes, date license expires: ________________________________________

c. Types of immunizations: _________________________________________

d. Has your pet bitten or injured anyone? yes ____ no ____

The State of New Hampshire requires you to license your dog when it reaches the age of four months and every year thereafter. Dogs must be vaccinated against rabies. Your city or town may also require that cats be licensed.

Pets 61

_____________________________________Insurance

SECTION XII: INSURANCE

Insurance coverage gives you certain rights and benefits. Benefits do not come to you automatically, however. You must claim your right to benefits when those rights become available to you. As a result, you should periodically review your policies and their terms. You may wish to consult your insurance agent or insurance company for help with a review.

1. Indicate with a yes or no which of the following types of insurance coverage there is on you, your spouse, and your dependent(s):

Coverage Type You Spouse Dependenta. Life

The type and amount of life insurance you should carry is specific to your personal situation. You should consult an insurance professional to be sure you have the appropriate coverage.

Coverage Type You Spouse Dependentb. Medical/Health

If you are, or become, eligible for Medicare coverage, you also can purchase Medicare supplemental health insurance (commonly known as a Medigap policy), to add to your Medicare coverage. By law, insurance carriers cannot deny Medigap coverage for health reasons if you apply within the first six months after you become eligible for Medicare Part B. If you have any questions as to eligibility, or feel a company has improperly denied you Medigap coverage, contact the Department of Insurance at (603) 271-2261 or (800) 735-2964 (TDD).

You also should call either of these numbers if you have any questions or problems with any of your insurance policies, such as your policy is improperly cancelled or denied, or you have a dispute about premiums or claims.

Coverage Type You Spouse Dependentc. Dentald. Disabilitye. Long Term Caref. Visiona. Life

Insurance 62

_____________________________________Insurance

Insurance 63

_____________________________________Insurance

2. If there is life insurance coverage for you and/or your spouse, indicate:

Coverage Type You Spousea. Amount of Term Insurance

$ $

*Term insurance covers you for a specified time. When that time is up, you no longer have any coverage.

Coverage Type You Spouseb. Amount of Whole Life Ins

$ $

*Whole life insurance provides you with coverage for your entire life.

Cash Surrender Value You Spousec. Total Amount of Policies

$ $

*Cash surrender value is the amount of money you would receive from the insurer if you cancel or “cash in” the policy before your death. Most term insurance does not have a cash surrender value.

3. If there is life insurance coverage for you and/or your spouse, indicate the named beneficiary(ies) for each policy:______________________________________________________________________________________________________________________________________

4. Is any of the insurance coverage shown above provided by your employer or through your employment?

yes ____ no ____

5. Medicare number (if you have one): _____________________________________

6. Do you have insurance on all your automobiles? yes ____ no ____

See the discussion of automobile insurance under Section X: Vehicles, Question 2, page 43.

Insurance 64

_____________________________________Insurance

7. Do you have adequate homeowner's insurance? yes ____ no ____

See the discussion of homeowner's insurance under Section VIII: Home/Apartment, Owner Section, Question 17, page 37.

8. Do you have adequate renter's insurance? yes ____ no ____

See the discussion of renter's insurance under Section VIII: Home/Apartment, Renter Section, Question 9, page 40.

Insurance 65

__________________________________Bank Accounts

SECTION XIII: BANK ACCOUNTS

List all Individual Retirement Accounts (IRAs), Certificates of Deposit (CDs), accounts with banks, savings and loan associations, credit unions, money market funds, where you have funds. For each, indicate if it is in your name alone, the names of you and your spouse, or the names of you and another person.

For each account list the names of anyone, beside yourself, who has the authority to withdraw funds from the account.

Bank Account #

Names Listed Others Authorized to Withdraw

Also list any accounts you do not own, but on which you have the authority to withdraw funds, such as an account on which someone has added your name to the account for convenience, or an account to which you have access as an attorney-in-fact.

Bank Account Names Listed

The three basic types of ownership of bank accounts are sole accounts, joint accounts, and trust accounts. There are others, but they mostly involve business, not personal, relationships. You should consider several important issues about bank accounts: legal ownership of the funds in the account; access to the account; and what happens to the account when the owner(s) die.

Bank Accounts 66

_____________________________________Your Estate

SECTION XIV. YOUR ESTATE

1. Do you have a will? yes ____ no ____

2. Does your spouse have a will? yes ____ no ____

Your Estate 67

_____________________________________Your Estate

A will or a trust allows you to distribute your property, belongings and assets the way you wish. If you do not have a will or trust, when you die, the state will distribute your property, belongings and assets according to the state's law of intestate succession. New Hampshire also provides for a marital elective share. This means a surviving spouse, if dissatisfied with the share under a will, may instead renounce the will and take his or her statutory share. If the spouse renounces the will, his or her statutory share is one-third of the entire estate if the testator leaves a descendant or approximately one-half of the entire estate if there is no descendant (according to a statutory formula). There is New Hampshire Legacy and Succession tax on assets inherited by most recipients who are not direct descendants, or ascendants, or non-profit organizations.

Only estates larger than $1,000,000 (2003 figure) pay federal estate taxes. This figure rises gradually to $2,000,000 by 2006. Estates involving a family farm or a family-owned business, should seek tax advice as special rules may apply. These figures are changes from the old law. These changes were part of a major tax law passed in 1997. Estate planning may sometimes enable you to reduce the amount of estate taxes due. For update on limits, go to www.irs.gov and search on “Unified Credit”.

3. Have you ever inherited any money or property? yes ____ no ____

If yes, from whom: ___________________________________________________

When: _____________________________________________________________

What was the value of the property at the time you inherited it? _______________

4. Do you expect to inherit any money or property? yes ____ no ____

If yes, please explain:_________________________________________________

Any substantial increase in your property or net worth is a signal to review your will and estate planning documents.

Your Estate 68

_____________________________________Your Estate

5. Are you the beneficiary of any property held in trust? yes ____ no ____If yes, answer the following:

a. Please describe: _____________________________________________________b. Have you ever received benefits from the trust? yes ____ no____c. If you have not received any benefits, do you know when you

might expect to? yes ____ no ____

Please explain: ______________________________________________________

______________________________________________________________________________________________________________________________________

*A trust involves a situation where one person holds money or property “in trust” for another. The person who creates the trust is called the "settlor." The person holding the money or property is called the “trustee.” The trustee manages the trust. The person for whom the trust is intended to benefit is called the “beneficiary.” The beneficiary receives income or rights to the assets of the trust. The trust document states the terms of the trust and describes the beneficiary's interest. A common type of trust is one created in your will for the benefit of your children.

6. Do you have a living trust? yes ____ no ____

*A living trust (also called an inter vivos trust) is a trust that you create while still living. This differs from a testamentary trust, a trust you create in a will. The handling of a living trust is not usually a matter of public record. Probate of a will usually is a matter of public record. If confidentiality is important to you, you may wish to consider a living trust. In some circumstances, a living trust may save probate costs. It is also possible to set up a living trust because you want someone else to manage your property when you lack the expertise, capacity or desire to do so. If you fear becoming incapacitated and unable to Your Estate 69

_____________________________________Your Estate

manage your affairs, a living trust may be a way for you to keep control over your affairs while competent, while still providing for management if you become incompetent. Living trusts may be either revocable or irrevocable. In a revocable trust, the settler keeps the right to revoke, destroy or amend the trust or take back or add to the trust property. In an irrevocable trust, the settler gives up his or her right to revoke or amend the trust. As a result, property placed in an irrevocable trust for someone is like a gift. Once you give it, you cannot take it back. While revocable living trusts may save probate costs, they do not have income tax advantages. For federal income tax purposes, the settler of a revocable living trust usually must pay tax on the income from property in the trust. By contrast, an irrevocable trust is a separate taxpayer. Whether or not a trust is a good idea for you depends upon your particular needs and circumstances. You should consult an attorney if you are interested in a living trust.

7. Do you have a safe deposit box? yes ___ no ___ If yes, answer the following:

a. Name of institution: ______________________________________________b. Address: ______________________________________________________

______________________________________________________c. Does anyone else have access to the safe deposit box? yes ____ no ____

If yes, whom? ____________________________________________________

8. Do you have a living will? yes ____ no ____

*A living will (also called an advance directive) is a legal paper in which you explain your desire for care if you have a terminal medical condition or are in a state of permanent unconsciousness. New Hampshire has a living will law. For more information on living wills and health care powers of attorney, see the LCE publication “Planning for Incapacity: A Self-Help Guide to Advance Directives” (page 66).

9. Do you have a durable power of attorney for health care decisions?

yes ____ no ____

Your Estate 70

_____________________________________Your Estate

*A durable power of attorney for health care decisions allows you to say who can make decisions about your health care if you cannot make such decisions yourself. The person you authorize to make decisions is called your “agent” or “proxy.”

10. Have you purchased a prepaid cemetery plot? yes ____ no ____If yes, at which cemetery have you purchased the plot?

_____________________

Be sure to keep all the paperwork verifying your purchase of the cemetery plot with your will and other important documents.

11. Do you have a prepaid funeral plan? yes ____ no ____

Prepaid funeral plans involve the advance selection and payment of funeral and cemetery merchandise and services such as casket, burial plot, funeral director services. The plans fall into two groups: insurance-funded plans, and pre-need trusts. In an insurance-funded plan, the customer chooses the merchandise and services and buys an increasing benefit life insurance policy from the funeral director or the cemetery who is the named beneficiary of the policy. The price of the funeral is usually guaranteed. In a pre-need trust, the customer pays the seller an amount to cover future merchandise and funeral services. The seller agrees to hold the money received in a trust fund. The price of the merchandise is frequently guaranteed as of the time of death. If you decide to purchase a prepaid funeral plan, be sure you are dealing with a reputable company. Carefully read and keep all the paperwork you have proving your purchase of the funeral plan with your will and other important documents.

Your Estate 71

__________________________________Securities

SECTION XV: SECURITIES

If you own any stocks, bonds or other securities, list the name and address of your broker. Please also list for each security the record owner (i.e., do you own the security alone or with one or more others), original cost, date of acquisition, and current market value. Your broker may be able to give you this information.

Broker Name: __________________________________________________________Broker Address: __________________________________________________________Broker Telephone Number:_________________________________________________

Type ofSecurity

RecordOwner

DateAcquired

Value whenAcquired

CurrentMarket Value

Securities 72

________________Real Estate Other Than Home

XVI: REAL ESTATE OTHER THAN HOME

If you own any interests in real estate other than your home, describe the nature of the property, note the date you acquired it, and estimate its current market value and cost basis. "Cost basis" is the amount you paid for the property, plus the costs of major improvements. (Note, for inherited property, the “cost basis,” commonly referred to as the “stepped up basis,” is the value of the property as of the date of death.) Also note if the property is owned by you alone, you and your spouse, or you and some other person.

Property Date Acquired

Value Cost Basis Ownership Shared?

If you jointly own property with someone other than your spouse, you may wish to enter into a co-ownership agreement with the co-owner. This type of agreement, outlining each party's rights and obligations, may help minimize disputes about the management and ownership of the property. (Also, review the ways to hold title to property discussed in Section VIII: Home/Apartment, page 34).

Real Estate Other than Home 73

____________________________________Business Interests

XVII: BUSINESS INTERESTS

1. Do you have an ownership interest in any business? yes ____ no ____

2. If yes, please list any such ownership interests and identify the nature of your ownership such as entrepreneur, shareholder in a close corporation, partner in a business partnership.

Business Name and Description Type of Ownership Interest

The details of business ownership, manner of operation, and other aspects of business ownership are beyond the scope of this workbook. However, please answer the brief questions above if you have any business interests because it is important to list all your assets. Note also, that however you structure your business, it is very important to keep all formation documents and accurate records. For example, for a corporation, be sure you have a copy of articles of incorporation and bylaws, and keep accurate minutes of all meetings.

Business Interests 74

__________________________________Military Service

XVIII: MILITARY SERVICE

1. Are you, or were you, in the military? yes ____ no ____

If yes, answer the following:

a. Year started: ________________________________________________________

b. Year terminated: _____________________________________________________

c. Branch of service: ____________________________________________________

d. Type of discharge: ____________________________________________________

e. Department of Veterans Affairs (VA) file number: __________________________

f. Did you receive (or are you now receiving) veteran's benefits? yes ____ no ____

If yes, what types of benefits are you receiving (e.g., disability)?

What amounts of benefits do you receive?

Military Service 75

__________________________________Military Service

If you are a veteran, you may be eligible for a variety of benefits including pensions, medical care, prescription drugs, vocational rehabilitation, education and home loans. If you would like additional information about possible benefits, you may contact the following VA office: 275 Chestnut St., Manchester, NH or (800) 827-1000 or go to: www.va.gov.

Military Service 76

_______________________________________________Taxes

XIX: TAXES

1. Did you file a U.S. income tax return last year? yes ____ no ____

2. Did you file a state income tax return last year? yes ____ no ____

If yes, which state(s): _______________________________________________

4. Are you eligible to receive an Earned Income Tax Credit (EITC) yes ____ no ____

Beginning in tax year 1994, individuals and couples without children can qualify for the Earned Income Tax Credit. Wage earners at least age 25 and under 65, without children, earning less than $11,230 per year, will qualify for a credit of up to $382.There are two credits available to families with children. There is a maximum credit of $2,547 for a family with a single child, earning less than $29,666. The EITC for families with two or more children earning less than $33,692 will qualify for a credit of up to $4,204.

For taxpayers who are “married filing jointly”, add $1,000 to the maximum adjusted gross income limit provided for the other filing statuses. (Source: Income/Credit Limits for 2003 Tax Year from www.irs.gov Publication 596).

4. Do you have an accountant? yes ____ no ____

If yes, Name: ________________________________________________________

Address: ___________________________________________________________

5. Has the IRS ever audited or questioned you about any of your income tax returns?

yes ____ no ____

Taxes 77

_______________________________________________Taxes

If yes, please explain: _________________________________________________

Taxes 78

_________________________________Discrimination

SECTION XX: DISCRIMINATION

1. Do you feel that you have ever been discriminated against because of your age, race, sex, religion, color, marital status, sexual orientation, or national origin?

yes ____ no ____

Federal and/or state laws prohibits discrimination based on those factors. You may have legal recourse if you believe you have been discriminated against based on one of these factors. For example, you may have been discriminated against in trying to rent housing, get a mortgage, find employment, or receive government services or credit cards.

2. Are you physically or mentally disabled or handicapped? yes ____ no ____

Federal and/or state laws prohibits discrimination based on physical disabilities. You may have legal recourse if you believe you have been discriminated against on that basis. For example, if you are considered to be disabled under the Americans with Disabilities Act, your employer or potential employer may be required to make “reasonable accommodation” to the work environment to aid you in performing your job. Reasonable accommodation could include actual physical changes to facilities, job restructuring, modified work schedules, or acquiring or modifying equipment or devices.

2. Is anyone in your family physically disabled or handicapped?yes ____ no ____

Discrimination 79

______________________________________Checklists

WE'RE GETTING MARRIED

We must arrange for a: blood test marriage license

If one of us makes a last name change, we should notify: credit card companies and charge accounts banks and other financial institutions other organizations where we have investments insurance companies Social Security Administration (get new Social Security card) Employer New Hampshire Division of Motor Vehicles (change driver’s license

& auto registration)

We should review the beneficiaries listed in our: wills life insurance policies bank accounts annuities pension plans testamentary or living trusts

We should review and agree upon the funds and possessions that will be considered to be our: joint property (things we own together) separate property (things we own apart from one another)

We should determine the best way (separately or together) to: sign income tax returns (for tax savings) sign leases (in terms of liability) own property (real and personal)

We should consult a lawyer about a pre-nuptial agreement.

Checklists 80

______________________________________Checklists

I'M BUYING A HOME

I may need to budget these costs:

appraisal inspection down payment monthly mortgage payments escrow service loan application fee title insurance mortgage insurance monthly utility bills property taxes maintenance costs "fixer-upper" improvements insurance costs homeowner assoc. fees

( some cases) possible assessments (e.g.

lights, sewers)

I should consider these inspections: general structural inspection pest control (termites and dry

rot) asbestos soil stability (e.g. hillside

property) hazardous materials lead paint water quality radon gas

My offer on the house should cover allImportant terms: complete description of the

property (full street address and legal description, if available)

I can shop for a loan at: banks savings and loan

associations insurance companies credit unions mortgage brokers mortgage bankers

Among other things, my loan may:

have a fixed or adjustable interest rate be seller financed be assumed (taken over

from seller) be due in full if I sell the

house

I should consider the advantages/ disadvantages of a:

standard down payment larger down payment and

smaller monthly payments

My taxes and heirs are affected by whether I own the house:

by myself as a joint tenant with one

or more people

as a tenant-in-common with one or more people

If I fail to pay the mortgage, the lender can begin

Checklists 81

______________________________________Checklists

description of anything else included in the sale (appliances, etc.)

exact purchase price (broken down into deposit, down payment, amount of loan)

my rights if inspections uncover a problem

whether my deposit will be returned if I cancel

foreclosure proceedings and:

must notify me that my property will be sold

must give me a chance to make the missed payments

collect late fees and costs of foreclosure from me

I'M SELLING MY HOME

I should collect the following documents: document showing my ownership (deed) mortgage obligation on my home insurance policies current receipts for property and school taxes current receipts for water and sewer payments

I should consider whether to: sell my home myself use a broker

If I use a broker, I should select a broker by interviewing available brokers. The broker will ask me to sign a “listing agreement” that I should carefully review. Remember, the contract with the broker is negotiable (including the commission amount). It is a legally binding contract. I should consider, among other things, the following: Does it set forth the duties of the broker? When does it terminate? When am I obligated to pay a commission? How much? Are all sales included or might we agree that sales, for example, to

a relative, be excluded?

I should determine (with the help of a broker if so desired) the following: the expected sales price

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______________________________________Checklists

the amount of down payment whether the present mortgage can be pre-paid without penalty the probable amount and terms of a new loan on my home whether I am willing to accept partial down payment and take back

a purchase money mortgage on the property or other security

I should determine: the tax consequences of the sale what I will do with the proceeds I hope to receive my living

accommodations when I sell my home

I'M IN DEBT

I can consider: getting professional assistance in budgeting and paying off bills

(contact your local consumer credit counseling service) asking my creditors for more time to pay my bills filing a Chapter 13 debt repayment plan in bankruptcy court filing for bankruptcy if I can't find a way to pay my debts

I can repay part or all of my debts through a Chapter 13 plan if I: have a steady income owe less than $750,000 in debts for which I put up security owe less than $250,000 in other debts

If I file for bankruptcy, I still have to pay: any debt for which I put up security debts to anyone I didn't list on the bankruptcy forms most of my unpaid income taxes and penalties for the last three

years most student loans child support spousal support (alimony) any money I owe from a drunk-driving lawsuit the bill for any luxury item I bought shortly before filing all my debts, if I hide or lie about my assets

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______________________________________Checklists

my bankruptcy attorney, if any

I'M MOVING OUT OF NEW HAMPSHIRE

I will have a new residence and mailing address, so I should: notify the Post Office notify subscriptions to magazines, newspapers, etc. notify insurance carriers to send premium notices to my new

address notify credit card companies notify utility companies, including cable TV consider notifying Internal Revenue Service (perhaps after

consulting my accountant or lawyer) move all my essential legal documents establish a new banking account notify clubs and associations

In my new state, I should: obtain a new driver's license and auto registration review my will and other estate planning documents register to vote find a new local bank

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______________________________________Checklists

I'M REACHING RETIREMENT

I should: determine any amounts I am entitled to receive (including Social

Security benefits) review pension benefits review health and medical insurance carried by my employer, and

determine my eligibility for Medicare determine whether I have the option, if I so desire, to continue

insurance (health, life) carried by my employer (If my employer asks me to sign a release

of any type, I am entitled to consult my lawyer before signing.) review my personal estate and property because this is a good time

to consider or reconsider estate planning, durable power of attorney, my will,

and health care decisions consider or reconsider my investments

I'M ENTERING A NURSING HOME

I should consider the following factors when choosing a nursing home: how I will finance the cost of nursing home care (e.g., Medicare,

Medicaid, savings/personal assets, health insurance, pension plan) is the home approved for participation in Medicare or Medicaid does the home provide the type of care I will require what costs are included in the basic monthly charge is the nursing home licensed by the state is there a written statement which specifically describes the rights

of residents is a physician available at all times for emergencies

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______________________________________Checklists

is 24-hour-a-day nursing care provided are other specialists available what recreational services are available are there common areas for group activities are there adequate outside areas are there private rooms

I should visit the home and: determine if I will be comfortable there see if the home is kept clean talk to other residents to see if they have any complaints taste the food and inquire as to whether a dietician is available for

consultation ask to see a meal schedule; are there at least 3 meals-a-day served are portions limited are staff members courteous

I should: carefully review the admission contract before signing (preferably

with the assistance of an attorney) to be sure that it encompasses the complete agreement between the parties as to costs, services included, and other issues relating to patient rights and nursing home responsibilities.

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______________________________________Checklists

MY SPOUSE HAS PASSED AWAY

I should collect the following papers: copies of all insurance policies social security numbers of my spouse, myself, and my children certified copies of the death certificate (you will be required to give

certified copies of the death certificate to many of the offices or agencies you contact)

copy of certificate of honorable discharge (if the deceased was a veteran)

copies of marriage certificate copies of birth certificates for dependent children a copy of the will a complete list of all property, including real estate, stocks, bonds,

savings accounts, and personal property of the deceased.

I should also:

Contact the Social Security officeRemember, you will not be entitled to keep the check representing benefits for the month in which your spouse died. To be entitled to the benefits, the worker must have been alive at the end of the month in question. Social Security checks are always one month behind. As a surviving spouse, you are entitled to the amount your spouse was receiving each month, or the amount based on your own work record, whichever is greater. If you were receiving your benefits based on your spouse's work record, then following his or her death, you will receive a monthly check equal to what he or she was receiving during his lifetime. As a surviving spouse, you may also be entitled to a lump-sum death benefit. To be entitled to this benefit, you must have been living in the same household with the worker (your spouse) at the time of death. If you were not entitled to benefits based on his or her work record for the month in which he died, then you must apply for this benefit within two years of his or her death. You need not apply again if you were entitled to your spouse's benefits based on his or her work record at the time of death.

Contact the local Department of Veterans Affairs OfficeIf your spouse was receiving veteran's benefits during his lifetime, you may be eligible to receive survivor's benefits. If your spouse

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______________________________________Checklists

was not receiving benefits during his lifetime, but was not dishonorably discharged, you may be entitled to certain lump-sum payments following his death, including, a funeral allowance, an allowance for the purchase of a burial plot, or an allowance to purchase a grave marker. You can obtain a certificate of honorable discharge by writing to: Department of Defense, National Personnel Record Center, 9700 Page Boulevard, St. Louis, MO 63132.

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______________________________________Checklists

Notify all insurance companies which have issued life insurance policies

on my spouse (I should follow the notification instructions contained in the policy.)The proceeds which you, as a named beneficiary, receive under an insurance policy do not pass through your spouse's estate. Therefore, they are not subject to the creditors of his estate. These proceeds can be spent by you as you see fit. If there is no named beneficiary on the policy, the insurance company will pay the proceeds to your spouse's estate. If this should happen, these proceeds are subject to all creditors of your spouse's estate. You will not receive any of this money until all the expenses of the estate have been paid. If your spouse had certain rights regarding the policy, such as the right to change the beneficiary or the right to surrender or cancel the policy, the proceeds will be subject to the Federal Estate Tax. The money received from a life insurance policy is not considered “income” for Federal tax purposes. Therefore, the ultimate beneficiary will receive the proceeds free from income taxes. It may also be beneficial to notify disability insurance companies as some policies have a death benefit.

Contact my spouse’s employer, and union, regarding any benefits for survivors

The employer may have provided life, health or accident insurance which will yield payments. The deceased may be due a final paycheck for vacation or sick leave. If the death was work-related, there may be worker's compensation benefits. You should contact all past employers, including federal, state or local government, to determine if the survivors of the deceased are entitled to any payments from a pension plan. Also check with the employer to see if the deceased belonged to a union or professional organization. These groups may offer death benefits for their members. If the deceased was already retired and received a pension, you should check with the employer to determine if survivors will continue to receive a pension payment and whether the payment will be reduced.

Checklists 89

New Hampshire_____________________Resources on Aging

New Hampshire HELP LINE79 Sheep Davis RoadPembroke, NH 03275(603) 225-9000(800) 852-3388 (NH only)(800) 735-2964 (TDD)Serves as Hotline for various agencies.

Senior Citizens Law ProjectNew Hampshire Legal Assistance1361 Elm Street, Suite 307Manchester, NH 03101(603) 624-6000(888) 353-9944 (NH only)

Social Security Administration(800) 772-1213 www.ssa.gov

Veteran's Administration275 Chestnut St.Manchester, NH (800) 827-1000www.va.gov

New Hampshire State GovernmentWebsite www.state.nh.us

Governor's Office of Energy andCommunity Services(603) 271-2611

New Hampshire Attorney General's OfficeConsumer Protection & Antitrust Bureau (603) 271-3641

NH Dept. of Health & Human ServicesOffice of the CommissionerPublic Information Office 129 Pleasant StreetConcord, NH 03301-3857(603) 271-4957(800) 852-3345 (x.4957)www.dhhs.state.nh.us

ServiceLink(866) 852-3388

New Hampshire Division of Elderly & Adult ServicesMain Office:State Office Park South129 Pleasant St.Brown Building #1Concord, NH 03301(603) 271-4680(800) 351-1888District Offices:Berlin(603) 752-7800(800) 972-6111

Claremont(603) 542-9544(800) 982-1001

Concord(603) 271-3610(800) 322-9191

Conway(603) 447-3841(800) 552-4628

Keene(603) 357-3510(800) 624-9700

Laconia(603) 524-4485(800) 322-2121

Health Insurance Counseling Education & Assistance Service(800) 852-3388 (NH Only)

New Hampshire Rural Development

Area Agencies on Aging 90

Littleton(603) 444-6786(800) 552-8959

Manchester(603) 668-2330(800) 852-7493

Nashua(603) 883-7726(800) 852-0632

Portsmouth(603) 433-8318(800) 821-0326

New Hampshire_____________________Resources on Aging

www.rurdev.usda.gov/nh/

Area Agencies on Aging 91

Self-Help Resources from _____________________Legal Counsel for the Elderly Inc.

Self-Help Guide Available from Legal Services Network

The following self-help guides are available on line at the AARP Legal Solutions web page. To download a copy of a guide or for more information, go to: www. aarp.org/legalsolutions/selfhelpindex.html

CONSUMER:

Buying a Home Selling A Home Home Modification

ESTATES:

Financial Powers of Attorney What is a Will?

HEALTH CARE: Health Insurance Portability & Accountability Act of 1996 (Group

Plans) Hiring a Home Health Care Worker

Self-Help Resources 92

Self-Help Resources from _____________________Legal Counsel for the Elderly Inc.

Organizing Your Future: A Guide to Decision-making Cost:

in Your Later Years (102 pages, softbound, 1994, 8½" x 11")$10.00If you became incapacitated, who would handle your money? decide what type of medical treatment you will or will not have? decide if you should move to a nursing home or receive care at

home?With proper advance planning, the answer should be YOU!The Q and A format clearly describes the legal tools available to you to exercise control over major life decisions should you become incapacitated. Topics include joint ownership, powers of attorney, trusts, wills, living wills, elder abuse, representative payee, guardianships, conservatorships, and financing long-term care under Medicare, Medicaid and long-term care insurance.

Planning for Incapacity: A Self-Help Guide to Advance Cost:Directives (Specify state, 48 pages, softbound, 8½" x 11")$10.00 Question & Answer discussion of commonly expressed concerns

about advance directives Living will and health care power of attorney forms that comply with

your state's laws and practices Easy to follow instructions on preparing and individualizing the

formsSample wording to insert in the advance directive forms, how to talk to your doctor and family about your medical wishes, a glossary of medical and legal terms, local and national resources and much more make Planning for Incapacity a useful and complete guide to medical decision-making.

Finding Legal Help: An Older Person's GuideCost: (20 pages, 1995, 8½" x 11")$6.00This new consumer publication illuminates the way through the maze of knowing when you need a lawyer, and how to find a good one. The book also spells out alternatives to hiring a lawyer, including the

Self-Help Resources 93

Self-Help Resources from _____________________Legal Counsel for the Elderly Inc.options of representing yourself or locating free or low-cost legal representation. Tips cover how to select the right lawyer for your problem, how to negotiate a fee, and what to expect after you have hired your lawyer. With advice useful to legal consumers of all ages, the book also explains what is "elder law" and how to find an attorney who specializes in the legal issues of concern to older persons.

Self-Help Resources 94

Send check or money AARP Foundation/National Legal Training Projectorder payable to: P.O. Box 96474

Washington, D.C. 20090-6474

_____________________________Glossary of Terms

GLOSSARY OF TERMS

acknowledgment: A sworn statement before a public official, usually a notary public. The statement declares that the legal document is signed freely and that any statements in the document are accurate. Advance directives such as living wills and durable powers of attorney may require acknowledgment.

attorney-in-fact: The person or organization designated in a power of attorney to act for the principal. This person or organization is also referred to as an agent. The agent has whatever power the principal authorizes, and can act to benefit or bind the principal to the extent of that authority. The agent owes a fiduciary duty to the principal and could be liable to the principal or a third party for a breach of that duty.

beneficiary: Person is entitled to receive the benefits of a device such as a will or a trust.

common-law marriage: A marriage by mutual consent without the formality of application for a license or issuance of a certificate. A common-law marriage requires that both parties agree to the marriage and that they agree to assume the same marital duties and obligations as formal marriages. Some states do not recognize common-law marriages, including New Hampshire.

conservator: A court-appointed surrogate decision-maker with the authority to make decisions about property only. In some jurisdictions the term is used synonymously with the term guardian.

declaration: A written document required by living will statutes which sets forth the wishes of a person with respect to artificial life-support systems.

durable power of attorney: A written instrument authorizing another to act as one’s agent or attorney-in-fact that survives the subsequent incapacity or disability of the principal.

encumber: To place a claim, lien, charge or liability on property (e.g., mortgage, judgment lien, mechanic's lien, security interest).

Glossary of Terms 95

_____________________________Glossary of Terms

fiduciary (V.A.) A person or organization designated by the Department of Veteran Affairs to receive benefit payments on behalf of the veteran. The VA recognizes two types of fiduciaries; the court-appointed fiduciary, which is the equivalent of a court-appointed guardian; and the federal fiduciary, which is comparable to a representative payee.

general power of attorney: An unlimited agency. The agent is authorized to act in whatever capacity the principal actually has. In some jurisdictions, such an agency would be ineffective for some transactions such as land conveyances.

guardian: A court-appointed surrogate decision-maker for personal decisions and/or property decisions. (This term is sometimes used synonymously with the term conservator.)

health-care proxy: A durable power of attorney by which the principal may choose an agent to make health-care decisions after the principal has become incapacitated and is unable to make those decisions.

incapacitated: A term used to describe a person lacking the ability to make decisions concerning health care or, more generally, personal matters. The incapacity may be mental (i.e., Alzheimer's disease) or physical (i.e., the effects of a stroke).

incapacity: A legal term describing someone lacking the capacity to make his/her own decisions. When a person has a guardian appointed, the subject is often referred to as "incapacitated." Incapacity also describes a legal disability to perform a specific act or acts.

inter vivos: "Between the living." This term is used in a transfer of property, or other transaction, which occurs between living persons.

intestacy: The state or condition of dying without having made a valid will, or without having disposed by will of a part of your property.

Glossary of Terms 96

_____________________________Glossary of Terms

irrevocable trust: When the settlor (the person creating a trust) transfers title of the trust proceeds to the trustee and reserves no right to cancel, alter or abolish the trust.

joint account: An account with two or more parties named on it. The account may provide equal or unrestricted access to the funds by all parties, or may impose certain conditions on access to the funds.

living will: A declaration that states an individual's decisions about artificial-life-support.

long-term care facility: Generally synonymous with a nursing home, but could also describe any residential facility which is considered a permanent home (such as board and care home), and in which some degree of medical attention is provided.

NCPL: The National Center for Preventive Law, Inc.

notary public: An official authorized by the state to certify documents. A justice of the peace has the same authority.

personal property: Generally refers to movable property--anything other than land or houses.

post-nuptial agreement: Post-nuptial agreements are made after marriage between couples still married; they take the form of separation agreements, property settlements in contemplation of a separation or divorce, or property settlements where there is no intention of the parties to separate.

power of attorney: A written document in which a mentally competent adult (called the "principal") appoints another mentally competent adult or a corporation (called the "agent" or "attorney-in-fact") to act on the principal's behalf. The attorney-in-fact may perform any legal function or task which the principal has a legal right to do for him or herself.

pre-nuptial agreement: An agreement entered into by prospective spouses prior to marriage but in contemplation and consideration

Glossary of Terms 97

_____________________________Glossary of Terms

thereof; by it, the property rights of one or both of the prospective spouses are determined or are secured to one or both of them or their children.

principal: The individual authorizing another individual or organization to act in his or her place in a power of attorney.

probate: The court process in which a will is determined to be valid and a deceased person'sestate is distributed in accordance with the terms of the will or the state's law of intestate succession.

real property: Land and anything growing or fixed on it.

revocable trust: A trust in which the settlor retains the power to cancel, alter, or change the terms.

right of survivorship: A method of joint ownership where the surviving joint owner(s) gets title to the deceased's interest.

settlor: The person who establishes and funds a trust. Also known as trustor or grantor.

SSA: Social Security Administration which administers Social Security retirement, disability, and survivors benefits, as well as the SSI program.

SSI: Supplemental Security Income, a federal cash payment program which provides monthly payments on the basis of need to poor persons who are aged, blind, or disabled.

testamentary: Providing for the disposition of property after death by a will and therefore in accordance with the personal desires of decedent. Formalities in the state statute must be complied with in order for the disposition to be approved and not subject to challenge.

testator: One who makes or has made a will.

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_____________________________Glossary of Terms

Glossary of Terms 99

_____________________________________________ First Steps

First Steps To Good Legal Health

When entering into agreements or transactions, or when dealing with important documents:• Read documents carefully before signing.• Ask for an explanation of anything you do not understand before

signing.• Consider writing down the explanation you receive on the document

you are signing.• Keep copies of everything you sign.• Put any agreement you consider important in writing.• Use certified mail when sending important documents to verify

receipt.• Keep documents, like wills, up-to-date by reviewing them after

major events like birth, death, marriage, or divorce.• Keep notes of conversations you have that you consider to be

important, especially if the conversation concerns money or property.

Keep the following documents for at least six years:• Agreements, loan papers, and similar documents• Bank statements and canceled checks• Copies of income tax returns• Real estate records• Child care payments• Tax payment receipts (should be kept indefinitely)

Consider keeping the following documents in a safe deposit box or other safe place for safekeeping (Note: Someone else should be made aware of the safe deposit box or other safe place, in the event you are somehow incapacitated.):• Adoption papers• Automobile ownership certificate • Birth certificate• Marriage license• Will• Deed to your home and title insurance policy for your home• Life insurance policies• Stock certificates and bonds

First Steps 100

_____________________________________________ First Steps

• Passport• A current list of personal property, including descriptions of major items along with

identification numbers, purchase receipts for the items, and photographs of the items.

This may help verify your loss to the police and your insurance company in case of

theft or fire.

Keep your canceled checks or get and keep receipts when paying cash for the following:• Mortgage or rent payments• Insurance payments• Automobile payments• Credit card payments• Consumer loan payments• Tax payments

I should also:• Have adequate insurance coverage on my auto and home• Keep all warranties on merchandise I purchase in a safe place

where I can find them• Inform at least one other person in whom I have confidence of my

legal affairs and where I keep information

• Review my legal affairs annually• Have a family lawyer whom I can call on in emergency situations

and at other timesfor advice and help

• Inform the beneficiaries of all my life insurance policies of the following: the fact that

I have named them beneficiary, the insurance company with whom I have the insurance, and the physical location of the policy, but consider family consequences if you change beneficiaries.

First Steps 101

_ ________________________________Important Dates

EVENT TRIGGER DATEFederal income tax return and payment April 15Estimated tax and payment April 15

June 15 Sept 15 Jan 15

New Hampshire income tax return and payment

April 15

Auto insurance premium dueAuto insurance policy expiration dateAuto loan maturity dateAuto loan monthly payment dueHome insurance premium dueHome insurance expiration dateLife insurance premium dueLife insurance option dateLease or rental agreement termination dateMortgage payment due dateReal estate tax dueRent payment due dateAutomobile registration expiration dateDrivers license expiration datePassport expiration dateConvertible securities – conversion dateBank loan maturity dateBank loan monthly payment dueCredit union loan maturity dateCredit union loan payment dueCertificate of Deposit Expiration Date

Important Dates 102

Personal Plan

During the next 3 months, I plan to do the following:

Draft/revise my health care Durable Power-of-Attorney Draft/revise my living will Draft/revise my financial Durable Power-of-Attorney Draft/review my will Change the names on my bank accounts or property Apply for benefits Write for copies of important documents Talk to my doctor/clergyman/lawyer

about:__________________

______________________________________________________

Review my insurance policies: ____________________________

______________________________________________________________

______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Personal Plan 103

??? QUESTIONS TO THE LAWYER ???Legal Checkup Seminar –

Write down any questions you want to ask a lawyer. Send this form to the UNH Cooperative Extension Office listed on your confirmation letter at least TWO WEEKS AHEAD OF TIME. This will help us to prepare. You can also bring it with you, although it may be more difficult to include your question at the last minute.

1. Use this page to list the comments and questions you want to see answered at the Seminar:

________________________________________________________________________________________________________________________________________________________________________________________________________

_____________________________

Name (optional)

Personal Plan 104

Two weeks before the Seminar, mail this sheet to the address on the back or contact UNHCE via fax number or email listed on your confirmation letter.

Come to the Seminar and hear the answers!

Personal Plan 105