*Can include a generic calendar showing due dates, etc.

I. Personal information

a. Name – full

b. Date of birth

c. Place of birth

d. Social Security number

e. ?

II. List of Immediate Contacts – name, phone number, email

a. Spouse (or Significant Other)

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

b. Children

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

c. Parents

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

d. Close friends/neighbors

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

e. Employer – supervisor or HR

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

f. Pet and/or House sitter

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

III. Burial

a. Obituary – if you don’t write it, list the following for someone else to prepare

          i. Date of birth

          ii. Place of birth

          iii. Parents’ names

          iv. Surviving family member names (that you want listed)

          v. Education

          vi. Employment

          vii. Interesting note about self, or something you want folks to remember you for/by

b. Funeral Home Information

c. Pallbearers

d. Minister/Priest

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

e. Music to be played

f. Service Readings (religious or otherwise)

IV. Professionals – name, address, and phone numbers for each applicable

a. Doctor – Primary physician

          i. Name

          ii. Practice name

          iii. Address

          iv. Phone number

b. Lawyer

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

c. Insurance agents

          i. Life

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          ii. Home

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          iii. Automobile

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          iv. Other

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

d. Accountant

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

e. Banker

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

f. Financial Advisor(s) / Securities Broker(s)

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

g. Dentist

          i. Name

          ii. Practice name

          iii. Address

          iv. Phone number

V. Assets

a. Directions – include the following information for each, as applicable, plus any other data that will help

          i. Account type – ex: Savings, Checking

          ii. Bank, brokerage firm, credit card provider name

          iii. Account holder name – if joint with spouse or child/parent, state who

          iv. Account ownership type – single, joint, joint with survivor, etc

          v. Account number

          vi. Corporate Address

          vii. Corporate Phone number

          viii. Personal representative full contact information

          ix. Online account URL and login (user name, password, security question answers)

b. Personal

          i. Life and burial insurance – (include credit life for home and credit cards?)

          ii. Checking accounts

          iii. Savings accounts

          iv. Brokerage accounts

          v. Stocks and bonds (not in brokerage account)

          vi. Mutual funds and money market accounts

          vii. Certificates of deposit

          viii. Retirement Accounts

1. Individual Retirement Accounts (IRAs)

2. ROTH account

3. Employer 401-k account

4. Pension or employer profit-sharing plan

5. Retirement Plans – not already considered, ex: Annuities

          ix. Safe deposit box

1. Bank name

2. Box number

3. Key location

          x. Household safe or lock box

1. Location

2. Contents list

3. Combination or location of key

          xi. Jewelry – include descriptions, receipts, photographs, history

          xii. Vehicles – automobiles, campers/RVs, snowmobiles, boats

1. Listing of make/model

2. Location of titles

3. Automobile insurance company and representative

          xiii. Real Estate – by location

1. Location

2. Ownership information – who else is on title/loan

3. Bills

a. Regularly occurring – TV, internet, water/sewage, electric

          i. Type

          ii. Company

1. Name

2. Mailing address

3. Phone number

          iii. Account number

          iv. Due date

          v. Amount

b. Periodic or special – heating oil, insurance, snow plow, etc

          i. Type

          ii. Company

1. Name

2. Mailing address

3. Phone number

          iii. Account number

          iv. Due date

          v. Amount

          xiv. Household Inventory

1. Standard items – suggest basic itemized list by Room

2. Special Item (repeat for each specialty item as needed – ex: “Great-gramma’s sideboard”, family silver, etc)

a. Description

b. Location

c. Disposition – special wishes not included in Will

d. History/provenance

e. Estimated/insured value

          xv. Valuable collections (artwork, stamps, coins, etc)

          xvi. Other assets not covered –

1. Promissory notes owed to you,

2. Joint ownership in items (real estate, vehicles, etc) other than with your spouse, etc

VI. Liabilities

a. Mortgage information

          i. Mortgage holder

          ii. Home Owner’s Insurance

          iii. Taxes

1. Type – school, property, automobile

2. Due dates

3. Mailing address and phone number

4. Amounts

b. Credit cards

          i. Card/bank/store name

          ii. Card number

          iii. Number of cards on account – and in whose name(s)

          iv. Billing

1. Mailing address

2. Phone number

3. Due date (if balance)

c. Outstanding payable by you

          i. Estimated Federal and/or State Income taxes

1. Amount

2. Due date

3. Mailing address

          ii. Home equity loan

1. Amount

2. Due date

3. Mailing address

          iii. Loan against retirement account

VII. Documents – include a copy and/or location where each can be located

a. Will

b. Trust

c. Advance Directives: (http://www.medicinenet.com/advance_medical_directives/article.htm)

          i. Living Will

          ii. Health Proxy – including DNR if desired

          iii. Durable Power of Attorney (DPOA)

1. Medical DPOW

2. Legal DPOA

d. Tax returns for the last 3 years

VIII. Other

a. Pets

          i. Veterinarian –

1. Name

2. Address

3. Phone number

          ii. Daily feeding/care instructions

          iii. Pet future caregivers/guardians –

1. Name

2. Address

3. Phone number

4. Email

          iv. Funds set aside for pet care

b. ??

IX. Business

a. Sole owner

          i. Directions for immediate and short term continuation of business

          ii. Disposition of business and/or business assets

          iii. Checking accounts

          iv. Savings accounts

          v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

          vi. Assets

          vii. Liabilities

b. Joint ownership or partnership

          i. Business Buy-Sell agreements

          ii. Partnership certificates

          iii. Checking accounts

          iv. Savings accounts

          v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

          vi. Assets

          vii. Liabilities

*Can include a generic calendar showing due dates, etc.

X. Personal information

a. Name – full

b. Date of birth

c. Place of birth

d. Social Security number

e. ?

XI. List of Immediate Contacts – name, phone number, email

a. Spouse (or Significant Other)

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

b. Children

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

c. Parents

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

d. Close friends/neighbors

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

e. Employer – supervisor or HR

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

f. Pet and/or House sitter

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

XII. Burial

a. Obituary – if you don’t write it, list the following for someone else to prepare

          i. Date of birth

          ii. Place of birth

          iii. Parents’ names

          iv. Surviving family member names (that you want listed)

          v. Education

          vi. Employment

          vii. Interesting note about self, or something you want folks to remember you for/by

b. Funeral Home Information

c. Pallbearers

d. Minister/Priest

          i. Name

          ii. Phone number(s) – work, cellular

          iii. Email

e. Music to be played

f. Service Readings (religious or otherwise)

XIII. Professionals – name, address, and phone numbers for each applicable

a. Doctor – Primary physician

          i. Name

          ii. Practice name

          iii. Address

          iv. Phone number

b. Lawyer

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

c. Insurance agents

          i. Life

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          ii. Home

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          iii. Automobile

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

          iv. Other?

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

d. Accountant

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

e. Banker

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

f. Financial Advisor(s) / Securities Broker(s)

          i. Name

          ii. Firm name

          iii. Address

          iv. Phone number

          v. Email address

g. Dentist

          i. Name

          ii. Practice name

          iii. Address

          iv. Phone number

XIV. Assets

a. Directions – include the following information for each, as applicable, plus any other data that will help

          i. Account type – ex: Savings, Checking

          ii. Bank, brokerage firm, credit card provider name

          iii. Account holder name – if joint with spouse or child/parent, state

          iv. Account ownership type – single, joint, joint with survivor, etc

          v. Account number

          vi. Corporate Address

          vii. Corporate Phone number

          viii. Personal representative full contact information

          ix. Online account URL and login (user name, password, security question answers)

b. Personal

          i. Life and burial insurance – (include credit life for home and credit cards?)

          ii. Checking accounts

          iii. Savings accounts

          iv. Brokerage accounts

          v. Stocks and bonds (not in brokerage account)

          vi. Mutual funds and money market accounts

          vii. Certificates of deposit

          viii. Retirement Accounts

1. Individual Retirement Accounts (IRAs)

2. ROTH account

3. Employer 401-k account

4. Pension or employer profit-sharing plan

5. Retirement Plans – not already considered, ex: Annuities

          ix. Safe deposit box

1. Bank name

2. Box number

3. Key location

          x. Household safe or lock box

1. Location

2. Contents list

3. Combination or location of key

          xi. Jewelry – include descriptions, receipts, photographs, history

          xii. Vehicles – automobiles, campers/RVs, snowmobiles, boats

1. Listing of make/model

2. Location of titles

3. Automobile insurance company and representative

          xiii. Real Estate – by location

1. Location

2. Ownership information – who else is on title/loan

3. Bills

a. Regularly occurring – TV, internet, water/sewage, electric

          i. Type

          ii. Company

1. Name

2. Mailing address

3. Phone number

          iii. Account number

          iv. Due date

          v. Amount

b. Periodic or special – heating oil, insurance, snow plow, etc

          i. Type

          ii. Company

1. Name

2. Mailing address

3. Phone number

          iii. Account number

          iv. Due date

          v. Amount

          xiv. Household Inventory

1. Standard items – suggest basic itemized list by Room

2. Special Item (repeat for each specialty item as needed – ex: “Great-gramma’s sideboard”, family silver, etc)

a. Description

b. Location

c. Disposition – special wishes not included in Will

d. History/provenance

e. Estimated/insured value

          xv. Valuable collections (artwork, stamps, coins, etc)

          xvi. Other assets not covered –

1. Promissory notes owed to you,

2. Joint ownership in items (real estate, vehicles, etc) other than with your spouse, etc

XV. Liabilities

a. Mortgage information

          i. Mortgage holder

          ii. Home Owner’s Insurance

          iii. Taxes

1. Type – school, property, automobile

2. Due dates

3. Mailing address and phone number

4. Amounts

b. Credit cards

          i. Card/bank/store name

          ii. Card number

          iii. Number of cards on account – and in whose name(s)

          iv. Billing

1. Mailing address

2. Phone number

3. Due date (if balance)

c. Outstanding payable by you

          i. Estimated Federal and/or State Income taxes

1. Amount

2. Due date

3. Mailing address

          ii. Home equity loan

1. Amount

2. Due date

3. Mailing address

          iii. Loan against retirement account

XVI. Documents – include a copy and/or location where each can be located

a. Will

b. Trust

c. Advance Directives: (http://www.medicinenet.com/advance_medical_directives/article.htm)

          i. Living Will

          ii. Health Proxy – including DNR if desired

          iii. Durable Power of Attorney (DPOA)

1. Medical DPOW

2. Legal DPOA

d. Tax returns for the last 3 years

XVII. Other

a. Pets

          i. Veterinarian –

1. Name

2. Address

3. Phone number

          ii. Daily feeding/care instructions

          iii. Pet future caregivers/guardians –

1. Name

2. Address

3. Phone number

4. Email

          iv. Funds set aside for pet care

b. ??

XVIII. Business

a. Sole owner

          i. Directions for immediate and short term continuation of business

          ii. Disposition of business and/or business assets

          iii. Checking accounts

          iv. Savings accounts

          v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

          vi. Assets

          vii. Liabilities

b. Joint ownership or partnership

          i. Business Buy-Sell agreements

          ii. Partnership certificates

          iii. Checking accounts

          iv. Savings accounts

          v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

          vi. Assets

          vii. Liabilities