My personal beneficiary planner

[Pages:10]My personal beneficiary planner

compliments of

Using your personal beneficiary planner

How to use this planning tool to keep everything your loved ones will need in one place:

This unique beneficiary planner has been designed to help you keep the right information available for a family member or friend. It organizes:

? Important Contacts ? Important Documents

? Insurance Policies ? Financial Information

FIRST NAME __________________________________________ MIDDLE NAME_________________________________ LAST NAME____________________________________________________________________________________________ CURRENT Address____________________________________________________________________________________ City________________________________________ State _______ Zip_________________________________________ DRIVER'S LIC. NO. _________________________________ Social Security No._____________________________ Where are your License and SSN Card? ___________________________________________________________ Date of Birth _____________________________________ Place of Birth_________________________________ WHERE IS YOUR BIRTH CERTIFICATE? __________________________________________________________________ HOME PHONE # ________________________________________CELL PHONE # ________________________________ EMAIL ____________________________________________________ PASSWORD ________________________________

MARITAL and Family status

m Single m Married m Widow/Widower m Divorced Where is your Marriage Certificate? _____________________________ Maiden Name_____________________________________________________

Spouse'S NAME________________________________________________________________________________

PHONE # __________________________________ EMAIL______________________________________________

Number of Children _________________________________________________________________________

Children's Names: ________________________________Phone #___________________________________

___________________________________________________ Phone #__________________________________

___________________________________________________ Phone #__________________________________

___________________________________________________ Phone #__________________________________

EMPLOYMENT Current Employment Status:

m Actively Working m Retired

Current or Last Employer's Name:____________________________________________

Address______________________________________________________________________________

City________________________________________ State _______ Zip__________________________

PHONE #__________________________________________ FAX #______________________________

EMAIL_________________________________________________________________________________

MILITARY SERVICE

Are you a Veteran?

m Veteran

m Non-Veteran

If you are a Veteran, provide Serial #__________________________________________________

Branch of Service____________________________________________________________________

Rank at Discharge____________________________________________________________________

Discharge Date ______________________________________________________________________

Discharge Place______________________________________________________________________

Where are your Military Discharge Papers?____________________________________________

PETS

Pet's Name______________________________________________________________ Type of Animal/Breed _____________________________________________________

Medication___________________________________________________________________________

Pet's Name__________________________ Type of Animal/Breed________________________

Medication___________________________________________________________________________

Other Important Information AND COMMENTS:

Animal Hospital ______________________________________________________________________

Where are your Pet's Medical Records?_______________________________________________

Veterinarian's Name__________________________________________________________________

Address______________________________________________________________________________

City________________________________________ State _______ Zip__________________________

PHONE #__________________________________________ FAX #______________________________

EMAIL_________________________________________________________________________________

ATTORNEY Where are your Legal Documents?__________________________________

Attorney's Name____________________________________________________

Address______________________________________________________________________________

City________________________________________ State _______ Zip__________________________

PHONE #__________________________________________ FAX #______________________________

EMAIL_________________________________________________________________________________

Did this Attorney handle your will?

m Yes m No

Primary Care Physician

Where are your Medical Records?______________________________ DOCTOR's Name________________________________________________

Address________________________________________________________

City________________________________________ State _______ Zip__________________________

PHONE #__________________________________________ FAX #______________________________

EMAIL_________________________________________________________________________________

ACCOUNTANT Where are your TAX FORMS?_____________________________________

ACCOUNTANT's Name___________________________________________ Address______________________________________________________________________________ City________________________________________ State _______ Zip__________________________ PHONE #__________________________________________ FAX #______________________________

EMAIL_________________________________________________________________________________

IMPORTANT DOCUMENTS

Do you have a will?

m Yes m No

Where IS YOUR WILL?_________________________________________

_____________________________________________________________

m m DO you have a safe deposit box?

Yes

No

BOX #_______________________

Where is your Safe Deposit Box? ______________________________________________________

Address______________________________________________________________________________

City________________________________________ State _______ Zip__________________________

Where is your Box Key?________________________________________________________________

INSURANCE

List all Life, Health, Disability, Homeowner's and Auto Policies

Where are your policies?__________________________________________

Insurance Co. ____________________________________ Contact_______________________________

Type of Policy__________________Policy # ___________________ Amount $_______________________

Address______________________________________________________________________________________

City________________________________________ State _______ Zip__________________________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

Insurance Co. ____________________________________ Contact_______________________________

Type of Policy__________________Policy # ___________________ Amount $_______________________

Address______________________________________________________________________________________

City________________________________________ State _______ Zip__________________________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

Insurance Co. ____________________________________ Contact_______________________________

Type of Policy__________________Policy # ___________________ Amount $_______________________

Address______________________________________________________________________________________

City________________________________________ State _______ Zip__________________________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

BANK ACCOUNTS

List all Checking, Savings, Money Market and CDs

Where are your Statements and Account Information?______________________________

Bank/Credit Union ____________________________________ Contact________________________

Type of account________________________ account #_________________________________________

Address______________________________________________________________________________________

City________________________________________ State _______ Zip__________________________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

Bank/Credit Union ____________________________________ Contact________________________

Type of account________________________ account #_________________________________________

Address______________________________________________________________________________________

City________________________________________ State _______ Zip__________________________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

CREDIT CARDS

List All Major and Department Store Credit Cards

Where are your Credit Cards and Statements?_______________________________________________ company ______________________________ account #________________________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ company ______________________________ account #________________________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ company ______________________________ account #________________________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________

Receivables

Where are your Statements and Account Information?______________________________________ ______________________________________________________________________________________________ type ______________________________ account #______________________________________________ company ____________________________________ Contact_____________________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ type ______________________________ account #______________________________________________ company ____________________________________ Contact_____________________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________

DEBTS

Where are your Statements and Account Information?_________________________

debt type ______________________________ account #_______________________________________

company ____________________________________ Contact_____________________________________

Address______________________________________________________________________________________

City_____________________________________________________ State _______ Zip_____________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

debt type ______________________________ account #_______________________________________

company ____________________________________ Contact_____________________________________

Address______________________________________________________________________________________

City_____________________________________________________ State _______ Zip_____________________

PHONE #__________________________________________ User id_____________________________________

website _________________________________________ Password___________________________________

INVESTMENTS -- Stocks, Bonds & Mutual Funds

Where are your Statements and Account Information?______________________________________ Investment Type ______________________________ account #_______________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ Investment Type ______________________________ account #_______________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ Investment Type ______________________________ account #_______________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________

RETIREMENT PLANS, INVESTMENTS & Pension PLANS

Where are your Statements and Account Information?______________________________________ plan Type ______________________________ account #_______________________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ plan Type ______________________________ account #_______________________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________ plan Type ______________________________ account #_______________________________________ company/broker ____________________________________ Contact___________________________ Address______________________________________________________________________________________ City_____________________________________________________ State _______ Zip_____________________ PHONE #__________________________________________ User id_____________________________________ website _________________________________________ Password___________________________________

REal estate

Where is your Mortgage/Lease Agreement/Deed?______________________________________________

m Primary Residence

Rent

m Own

m select one:

Landlord

m Bank or Mortgage Co.

company ____________________________________ Contact_____________________________________

Address______________________________________________________________________________________

City_____________________________________________________ State _______ Zip_____________________

PHONE #__________________________________________ fax #______________________________________

website ______________________________________________________________________________________

USER ID ______________________________________ Password______________________________________

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