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Personal Information OrganizerYour source to record all personal information in one convenient place.

Table of Contents

Personal Information.............................................................................................................3Important Contacts................................................................................................................4Important Document Directory............................................................................................6Family Documents..................................................................................................................6Financial Documents.............................................................................................................6Legal Documents...................................................................................................................6Other Documents...................................................................................................................6Financial Information.............................................................................................................7Insurance................................................................................................................10Legal...............................................................................................................................12Supplemental Information..................................................................................................14Pre-Planning of Funeral and Burial Arrangements...........................................................17

HELPFUL HINT: While this document seems long, few people will need to complete every field on every page. You may also be able to attach documents, or indicate where information is located, to save time in completing all fields.

Once completed, keep in a secure location and make sure your estate executor or other responsible party knows this document exists.

Family

Personal/Family Information

Spouse/Partner

First Child

Second Child

NAME

ADDRESS

CITY EDOC PIZETATS

DATE OF BIRTH (use MM/DD/YY format) NO DETADPU TSAL SAW TNEMUCOD SIHTREBMUN YTIRUCES LAICOS

NAME (including maiden name)

DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER

CITY EDOC PIZETATS

HTRIB FO ETADREBMUN ENOHP (use MM/DD/YY format) SOCIAL SECURITY NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS


NAME

ADDRESS

Other Dependent - Relationship:

CITY EDOC PIZETATS


NAME

ADDRESS

3

Important Contacts

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

Attorney Information

Landlord Information

Financial Planner Information

Accountant Information

Tax Preparer

4

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

Important Contacts, cont’d.Primary Care Physician Information

Specialist Physician Information - Specialty:

Specialist Physician Information - Specialty:

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

Other Contact:

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

Other Contact:

5

Important Document DirectoryFAMILY DOCUMENTS LOCATIONSocial Security CardDriver’s License NumberBirth CertificatePassport/VisaMarriage CertificatePre-Nuptial AgreementDivorce DecreeAdoption Document(s)Military Discharge/Military IDGreen Card/Naturalization Papers

FINANCIAL DOCUMENTS LOCATIONDeeds/Titles to PropertyLife Insurance Document(s)Auto Insurance Document(s)Home Insurance Document(s)Health Insurance Document(s)Loan DocumentRetirement Benefit Statement(s)Investments and Savings Document(s)State & Federal Income Tax ReturnsEmployer/Union Benefits Information

ESTATE PLANNING LOCATIONWillLiving WillPower of AttorneyHIPAA Document(s)Trust Name ChangeLetter of Instruction

OTHER DOCUMENTS LOCATION

6

BANK PHONE LOCATION OF STATEMENTS

REDLOH TNUOCCAREBMUN TNUOCCA

SDROWSSAP/ETISBEWNOITACOL/EMAN KNAB

ADDRESS PHONE

LOCATION OF SAFETY DEPOSIT BOX KEYS SAFETY DEPOSIT BOX NUMBER

NAME OF INSTITUTION

Financial InformationSafety Deposit Box

Savings Account




Savings Account (additonal)

Checking Account




Checking Account (additional)




Checking Account (additional)




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Social Security Account Information

AMOUNT OF LOAN MONTHLY PAYMENT OF QUARTERLY PAYMENT OFI NTEREST RATE

LENDER DEBTOR

NAOL FO ETADSDROWSSAP/ETISBEW/REBMUN TNUOCCA (use MM/DD/YY format) DUE DATE

LARETALLOCSTNEMETATS FO NOITACOL

Loan Information

AMOUNT OF LOAN MONTHLY PAYMENT OF QUARTERLY PAYMENT OFI NTEREST RATE

LENDER DEBTOR

NAOL FO ETADSDROWSSAP/ETISBEW/REBMUN TNUOCCA (use MM/DD/YY format) DUE DATE

LARETALLOCSTNEMETATS FO NOITACOL

Loan Information (additional)

MORTGAGE OWNER ADDRESS

MORTGAGE OWNER PHONE

PROPERTY ADDRESS

LEGAL DESCRIPTION

LOCATION OF PROPERTY DOCUMENTS TYPE OF PROPERTY

PROPERTY OWNER PROPERTY VALUE

Real Estate Information

LOCATION OF STATEMENTS/WEBSITE/PASSWORDS

EULAVRENWO TNUOCCAREBMUN TNUOCCA

Retirement Fund



Investment Account

Financial Information, cont’d.

I

I

AS OF

AS OF

8

Financial Information, cont’d.LOCATION OF STATEMENTS/WEBSITE/PASSWORDS


Investment Account

PURCHASE DATE (use MM/DD/YY format) MATURITY DATE (use MM/DD/YY format) BOND VALUE FACE VALUE

LOCATION OF DOCUMENTS

BOND OWNER BOND TYPE

Bond Information

PURCHASE DATE (use MM/DD/YY format) MATURITY DATE (use MM/DD/YY format) BOND VALUE FACE VALUE


BOND OWNER BOND TYPE

Bond Information (additional)

STOCK NAME

NUMBER OF SHARES PURCHASE DATE (use MM/DD/YY format) PURCHASE PRICE CURRENT PRICE VALUE


STOCK OWNER STOCK PRICE

Stock Information

STOCK NAME

NUMBER OF SHARES PURCHASE DATE (use MM/DD/YY format) PURCHASE PRICE CURRENT PRICE VALUE


STOCK OWNER STOCK PRICE

Stock Information (additional)

9

InsuranceAuto Insurance Policy

DERUSNI SELCIHEVSELBITCUDED MUIMERP LAUNNA

DEUSSI ETADREBMUN YCILOPREBMUN ENOHP S’TNEGA (use MM/DD/YY format)


INSURANCE COMPANY AGENT’S NAME

Auto Insurance Policy (additional)

DERUSNI SELCIHEVSELBITCUDED MUIMERP LAUNNA

DEUSSI ETADREBMUN YCILOPREBMUN ENOHP S’TNEGA (use MM/DD/YY format)


INSURANCE COMPANY AGENT’S NAME

POLICY NUMBER DATE ISSUED (use MM/DD/YY format)


COMPANY

Homeowner’s Insurance Policy

DEATH BENEFITC ASH SURRENDER VALUE TYPE

PRIMARY BENEFICIARY CONTINGENT BENEFICIARY

POLICY OWNER INSURED

POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM


COMPANY

Life Insurance Policy

C

CDEATH BENEFITC ASH SURRENDER VALUE TYPE

PRIMARY BENEFICIARY CONTINGENT BENEFICIARY




COMPANY

Life Insurance Policy

10

Insurance, cont’d.





COMPANY

DEATH BENEFIT CASH SURRENDER VALUE TYPE




COMPANY





COMPANY

Final Needs Insurance

Long-Term Care Insurance

Disability Insurance

C

C

11

LegalENOHP YNAPMOCREDIVORP LAGEL

COMPANY URL MEMBER ID

ATTORNEY NAME ATTORNEY’S PHONE


ENOHPROTAVRESNOC/NAIDRAUG

CITY EDOC PIZETATS

PHONE NUMBER

ADDRESS

GUARDIAN/CONSERVATOR (additional) PHONE

CITY EDOC PIZETATS

PHONE NUMBER

ADDRESS

AGENT PHONE


AGENT PHONE

AGENT PHONE


AGENT PHONE

LOCATION OF STATEMENTS

Legal Services Provider

Power of Attorney Information

SERVICES

Living Trust Information

Guardianship/Conervatorship Information

Living Will Information

WEBSITE

12

Legal, cont’d.

CITY EDOC PIZETATS

PHONE NUMBER

LOCATION

CO-EXECUTOR PHONE


EXECUTOR PHONE

CITY EDOC PIZETATS

PHONE NUMBER

BENEFICIARY NAME

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

BENEFICIARY NAME (additional)

ADDRESS

CITY EDOC PIZETATS

PHONE NUMBER

BENEFICIARY NAME (additional)

ADDRESS

Will Information

NAME

ADDRESS

Executor Information

13

Supplemental Information

CITY EDOC PIZETATS


ADDRESS

FORMER SPOUSE’S NAME (including maiden name)

DIVORCE DOCUMENTS

DECREE LOCATION

OTHER LOCATION

OTHER LOCATION

OTHER LOCATION

CITY REBMUN ENOHPEDOC PIZETATS

ADDRESS

DIVORCE ATTORNEY’S NAME

REBMUN ECIVRESKNARHCNARB

STNEMUCOD FO NOITACOL/EGRAHCSID FO ETADECIVRES FO SETAD

Divorce Information

Military

Social MediaFACEBOOK

TWITTER

LINKEDIN

GOOGLE+

OTHER:

OTHER:

USERNAME

USERNAME

USERNAME

USERNAME

USERNAME

USERNAME

PASSWORD

PASSWORD

PASSWORD

PASSWORD

PASSWORD

PASSWORD

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Supplemental Information, cont’d.


ADDRESS

TNEMYOLPME FO SETADREYOLPME TNESERP

REBMUN ENOHPTCATNOC ROSIVREPUS TCERID

REBMUN ENOHPTCATNOC RH

DENTAL LOCATION/POLICY OR ACCOUNT NUMBER

EMPLOYMENT BENEFITS

MEDICAL LOCATION/POLICY OR ACCOUNT NUMBER

LIFE LOCATION/POLICY OR ACCOUNT NUMBER

401K LOCATION/POLICY OR ACCOUNT NUMBER

STOCK LOCATION/POLICY OR ACCOUNT NUMBER

PENSION LOCATION/POLICY OR ACCOUNT NUMBER

PROFIT SHARING LOCATION/POLICY OR ACCOUNT NUMBER

VISION LOCATION/POLICY OR ACCOUNT NUMBER

LEGAL LOCATION/POLICY OR ACCOUNT NUMBER

OTHER LOCATION/POLICY OR ACCOUNT NUMBER

RAEYLEDOMEKAM ELIBOMOTUA

TITLE LOCATION

RAEYLEDOMEKAM )lanoitidda( ELIBOMOTUA

LOAN LOCATION

TITLE LOCATION

LOAN LOCATION

Employment

Assets

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BOAT LOAN/TITLE/LOCATION

RV LOAN/TITLE/LOCATION

TRAILER LOAN/TITLE/LOCATION

OTHER LOAN/TITLE/LOCATION



EULAV DETAMITSEPIHSRENWO FO TNUOMAPIHSRENWO FO EPYTSSENISUB FO EPYT

REBMUN ENOHP1 TCATNOC SSENISUB

REBMUN ENOHP2 TCATNOC SSENISUB

ASSETS (additional)

Supplemental Information, cont’d.

Business

Additional Business Documents

DOCUMENT NAME LOCATION

LOCATION

LOCATION

LOCATION

LOCATION

LOCATION

DOCUMENT NAME

DOCUMENT NAME

DOCUMENT NAME

DOCUMENT NAME

DOCUMENT NAME

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ADDRESS

REBMUN TOLEMAN EHCIN/MUIRABMULOC/YRATEMEC

IMPORTANT DOCUMENTS

INSTRUCTIONS FOR BURIAL, CREMATION, ETC LOCATION

SPECIAL WISHES FOR CEREMONYL OCATION

PREPAID FUNERAL POLICYL OCATION

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS

PERSONAL FRIENDS TO CONTACT

CITY EDOC PIZETATS

PHONE NUMBER

NAME

ADDRESS


ADDRESS

EMAN ROTCERID LARENUFEMAN EMOH LARENUF

ORGAN DONOR RECORDS LOCATION


ADDRESS

TCATNOCEMAN REHTO/EUGOGANYS/HCRUHC

Pre-Planning of Funeral and Burial ArrangementsFuneral and Burial Arrangements

L

L

(OR ATTACH LIST)

17

MILITARY SERVICE

AWARDS AND ACHIEVEMENTS

CLUBS, ORGANIZATIONS, CHURCH AFFILIATION AND ACTIVITIES

HOBBIES AND/OR PERSONAL INTERESTS

ETATSYTICPIHSNOITALER1 EMAN ROVIVRUS

OTHER INFORMATION

OBITUARY INFORMATION




HTAED FO RAEYPIHSNOITALER1 DESAECED-ERP



PHONE NUMBER

NAME

ADDRESS

WHO CAN MEMORIAL DONATIONS BE MADE TO

PHONE NUMBER

NAME

ADDRESS

ADDRESSHOUSE OF WORSHIP

FUNERAL CEREMONY

PHONE NUMBERNAME OF CLERGYMAN

PREFERRED FUNERAL CEREMONY (select all that apply)

HELD AT FUNERAL HOME

HELD AT CHURCH (specify)

GRAVESIDE CEREMONY ONLY

GRAVESIDE CEREMONY ONLY AT:

OPEN CASKET

VIEWING ONLY AT FUNERAL HOME PRIOR TO CEREMONY

FAMILY AND FRIENDS ONLY

IMMEDIATE FAMILY ONLY

NO VIEWING/NO OPEN CASKET

PERSONAL EFFECTS THAT SHOULD STAY WITH THE REMAINS AFTER THE MEMORIAL SERVICE (select all that apply)

EYEGLASSES

WATCH

RINGS/JEWELRY

SMART PHONE/CELL PHONE

OTHER (please specify)

NONE

NO PERSONAL EFFECTS ARE TO BE WITH THE REMAINS DURING THE MEMORIAL SERVICE

Pre-Planning of Funeral and Burial Arrangements, cont’d.

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Pre-Planning of Funeral and Burial Arrangements, cont’d.VETERANS FUNERAL ARRANGEMENTS

DRAPED FLAG FOLDED FLAG FLAG PRESENTED TO:

TYPE OF EULOGY

RELIGIOUS SERVICE ONLY

RELIGIOUS SERVICE AND EULOGY

EULOGY ONLY

NONE

REBMUN ENOHPEDOC PIZETATSYTIC

NAME OF INDIVIDUAL TO PROVIDE EULOGY

ADDRESS

RELIGIOUS PASSAGES (to be read at service)

FLORAL PREFERENCES

MUSIC SELECTION

ORGANIST

SOLOIST

OTHER MUSIC SELECTION:

NONE

CLOTHING PREFERENCE

EXISTING CLOTHING

NEW CLOTHING

DESCRIPTION OF CLOTHING (type and color):

NONE

FLORAL TYPE: FLORAL COLOR: NO FLORAL

PREFERENCE FOR DISPOSAL OF THE REMAINS

BURIAL

CREMATION

OTHER (please explain):

OTHER INSTRUCTIONS (e.g. dispersal of cremains):

MAUSOLEUM INTERMENT

TYPE OF CASKET

HARDWOOD (type):

METAL (type):

OTHER (please explain):

NOT APPLICABLE

CREMATION COFFIN

CASKET SPECIFICS

MANUFACTURER

MODEL:

OTHER INFORMATION (please specify):

NOT APPLICABLE

CASKET PRESENTATION DURING CEREMONY

OPEN (if possible)

CLOSED

NOT APPLICABLE

TYPE OF HEADSTONE

STONE

FLAT MARKER

UPRIGHT

HEADSTONE SAYING:

HEADSTONE PHRASE:

POST-MEMORIAL GATHERING DESIRED

QUIET GATHERING AT FAMILY MEMBER’S HOUSE

LIFE CELEBRATION EVENT:

OTHER (please specify):

NONE

PROTECT YOUR IDENTITY - Keep this document in a secure location and only allow access to necessary parties.

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