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1 Personal Information Organizer Your source to record all personal information in one convenient place.

2 Table of Contents Personal Information...3 Important Contacts...4 Important Document Directory...6 Family Documents...6 Financial Documents...6 Legal Documents...6 Other Documents...6 Financial Information...7 Insurance...10 Legal...12 Supplemental Information...14 Pre-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.

3 Personal/Family Information DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER THIS DOCUMENT WAS LAST UPDATED ON Family Spouse/Partner (including maiden name) DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER First Child P HONE NUMBER DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER Second Child P HONE NUMBER DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER Other Dependent - Relationship: P HONE NUMBER DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER 3

4 Important Contacts Attorney Information Landlord Information Financial Planner Information Accountant Information Tax Preparer 4

5 Important Contacts, cont d. Primary Care Physician Information Specialist Physician Information - Specialty: Specialist Physician Information - Specialty: Other Contact: Other Contact: 5

6 Important Document Directory FAMILY DOCUMENTS Social Security Card Driver s License Number Birth Certificate Passport/Visa Marriage Certificate Pre-Nuptial Agreement Divorce Decree Adoption Document(s) Military Discharge/Military ID Green Card/Naturalization Papers FINANCIAL DOCUMENTS Deeds/Titles to Property Life Insurance Document(s) Auto Insurance Document(s) Home Insurance Document(s) Health Insurance Document(s) Loan Document Retirement Benefit Statement(s) Investments and Savings Document(s) State & Federal Income Tax Returns Employer/Union Benefits Information E PLANNING Will Living Will Power of Attorney HIPAA Document(s) Trust Name Change Letter of Instruction OTHER DOCUMENTS 6

7 Financial Information Safety Deposit Box OF SAFETY DEPOSIT BOX KEYS SAFETY DEPOSIT BOX NUMBER OF INSTITUTION Savings Account ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS Savings Account (additonal) ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS Checking Account ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS Checking Account (additional) ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS Checking Account (additional) ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS 7

8 Financial Information, cont d. Social Security Account Information ACCOUNT NUMBER ACCOUNT HOLDER BANK / WEBSITE/PASSWORDS BANK OF MENTS Loan Information LENDER DEBTOR ACCOUNT NUMBER/WEBSITE/PASSWORDS DATE OF LOAN (use MM/DD/YY format) DUE DATE AMOUNT OF LOAN MONTHLY PAYMENT OF QUARTERLY PAYMENT OFI INTEREST RATE OF MENTS COLLATERAL Loan Information (additional) LENDER DEBTOR ACCOUNT NUMBER/WEBSITE/PASSWORDS DATE OF LOAN (use MM/DD/YY format) DUE DATE AMOUNT OF LOAN MONTHLY PAYMENT OF QUARTERLY PAYMENT OFI INTEREST RATE OF MENTS COLLATERAL Real Estate Information OF PROPERTY DOCUMENTS TYPE OF PROPERTY PROPERTY OWNER PROPERTY VALUE LEGAL DESCRIPTION PROPERTY MORTGAGE OWNER MORTGAGE OWNER Retirement Fund OF MENTS/WEBSITE/PASSWORDS ACCOUNT NUMBER ACCOUNT OWNER VALUE AS OF Investment Account OF MENTS/WEBSITE/PASSWORDS ACCOUNT NUMBER ACCOUNT OWNER VALUE AS OF 8

9 Financial Information, cont d. Investment Account OF MENTS/WEBSITE/PASSWORDS ACCOUNT NUMBER ACCOUNT OWNER VALUE Bond Information OF DOCUMENTS BOND OWNER BOND TYPE PURCHASE DATE (use MM/DD/YY format) MATURITY DATE (use MM/DD/YY format) BOND VALUE FACE VALUE Bond Information (additional) OF DOCUMENTS BOND OWNER BOND TYPE PURCHASE DATE (use MM/DD/YY format) MATURITY DATE (use MM/DD/YY format) BOND VALUE FACE VALUE Stock Information OF MENTS/WEBSITE/PASSWORDS STOCK OWNER STOCK PRICE STOCK NUMBER OF SHARES PURCHASE DATE (use MM/DD/YY format) PURCHASE PRICE CURRENT PRICE VALUE Stock Information (additional) OF MENTS/WEBSITE/PASSWORDS STOCK OWNER STOCK PRICE STOCK NUMBER OF SHARES PURCHASE DATE (use MM/DD/YY format) PURCHASE PRICE CURRENT PRICE VALUE 9

10 Insurance Auto Insurance Policy OF DOCUMENTS INSURANCE COMPANY AGENT S AGENT S POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM DEDUCTIBLES VEHICLES INSURED Auto Insurance Policy (additional) OF DOCUMENTS INSURANCE COMPANY AGENT S AGENT S POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM DEDUCTIBLES VEHICLES INSURED Homeowner s Insurance Policy OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) Life Insurance Policy OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM POLICY OWNER INSURED PRIMARY BENEFICIARY CONTINGENT BENEFICIARY DEATH BENEFITC CASH SURRENDER VALUE TYPE Life Insurance Policy OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM POLICY OWNER INSURED PRIMARY BENEFICIARY CONTINGENT BENEFICIARY DEATH BENEFITC C ASH SURRENDER VALUE TYPE 10

11 Insurance, cont d. Final Needs Insurance OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM POLICY OWNER INSURED DEATH BENEFITC CASH SURRENDER VALUE TYPE Long-Term Care Insurance OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM POLICY OWNER INSURED DEATH BENEFITC CASH SURRENDER VALUE TYPE Disability Insurance OF DOCUMENTS COMPANY POLICY NUMBER DATE ISSUED (use MM/DD/YY format) ANNUAL PREMIUM POLICY OWNER INSURED DEATH BENEFIT CASH SURRENDER VALUE TYPE 11

12 Legal Legal Services Provider LEGAL SERVICES PROVIDER COMPANY COMPANY URL WEBSITE MEMBER ID ATTORNEY ATTORNEY S Power of Attorney Information OF DOCUMENTS AGENT AGENT Living Trust Information OF DOCUMENTS AGENT AGENT Guardianship/Conervatorship Information OF DOCUMENTS GUARDIAN/CONSERVATOR GUARDIAN/CONSERVATOR (additional) Living Will Information OF MENTS 12

13 Legal, cont d. Will Information OF DOCUMENTS EXECUTOR CO-EXECUTOR BENEFICIARY BENEFICIARY (additional) BENEFICIARY (additional) Executor Information 13

14 Supplemental Information Divorce Information FORMER SPOUSE S (including maiden name) P HONE NUMBER DATE OF BIRTH (use MM/DD/YY format) SOCIAL SECURITY NUMBER DIVORCE DOCUMENTS DECREE OTHER OTHER OTHER DIVORCE ATTORNEY S Military BRANCH RANK SERVICE NUMBER DATES OF SERVICE DATE OF DISCHARGE/ OF DOCUMENTS Social Media FACEBOOK USER PASSWORD TWITTER LINKEDIN USER USER PASSWORD PASSWORD GOOGLE+ USER PASSWORD OTHER: USER PASSWORD OTHER: USER PASSWORD 14

15 Supplemental Information, cont d. Employment PRESENT EMPLOYER DATES OF EMPLOYMENT DIRECT SUPERVISOR CONTACT HR CONTACT EMPLOYMENT BENEFITS MEDICAL /POLICY OR ACCOUNT NUMBER LIFE /POLICY OR ACCOUNT NUMBER 401K /POLICY OR ACCOUNT NUMBER STOCK /POLICY OR ACCOUNT NUMBER PENSION /POLICY OR ACCOUNT NUMBER PROFIT SHARING /POLICY OR ACCOUNT NUMBER DENTAL /POLICY OR ACCOUNT NUMBER VISION /POLICY OR ACCOUNT NUMBER LEGAL /POLICY OR ACCOUNT NUMBER OTHER /POLICY OR ACCOUNT NUMBER Assets AUTOMOBILE MAKE MODEL YEAR TITLE LOAN AUTOMOBILE (additional) MAKE MODEL YEAR TITLE LOAN 15

16 Supplemental Information, cont d. ASSETS (additional) BOAT LOAN/TITLE/ RV LOAN/TITLE/ TRAILER LOAN/TITLE/ OTHER LOAN/TITLE/ OTHER LOAN/TITLE/ OTHER LOAN/TITLE/ Business TYPE OF BUSINESS TYPE OF OWNERSHIP AMOUNT OF OWNERSHIP ESTIMATED VALUE BUSINESS CONTACT 1 BUSINESS CONTACT 2 Additional Business Documents DOCUMENT DOCUMENT DOCUMENT DOCUMENT DOCUMENT DOCUMENT 16

17 Pre-Planning of Funeral and Burial Arrangements Funeral and Burial Arrangements CEMETARY/COLUMBARIUM/NICHE LOT NUMBER FUNERAL HOME FUNERAL DIRECTOR CHURCH/SYNAGOGUE/OTHER CONTACT IMPORTANT DOCUMENTS ORGAN DONOR RECORDS INSTRUCTIONS FOR BURIAL, CREMATION, ETC SPECIAL WISHES FOR CEREMONYL PREPAID FUNERAL POLICYL PERSONAL FRIENDS TO CONTACT (OR ATTACH LIST) 17

18 Pre-Planning of Funeral and Burial Arrangements, cont d. OBITUARY INFORMATION HOBBIES AND/OR PERSONAL INTERESTS CLUBS, ORGANIZATIONS, CHURCH AFFILIATION AND ACTIVITIES MILITARY SERVICE AWARDS AND ACHIEVEMENTS OTHER INFORMATION SURVIVOR 1 RELATIONSHIP SURVIVOR 2 RELATIONSHIP SURVIVOR 3 RELATIONSHIP SURVIVOR 4 RELATIONSHIP PRE-DECEASED 1 RELATIONSHIP YEAR OF DEATH PRE-DECEASED 2 RELATIONSHIP YEAR OF DEATH PRE-DECEASED 3 RELATIONSHIP YEAR OF DEATH WHO CAN MEMORIAL DONATIONS BE MADE TO FUNERAL CEREMONY HOUSE OF WORSHIP OF CLERGYMAN PREFERRED FUNERAL CEREMONY (select all that apply) HELD AT FUNERAL HOME VIEWING ONLY AT FUNERAL HOME PRIOR TO CEREMONY HELD AT CHURCH (specify) FAMILY AND FRIENDS ONLY GRAVESIDE CEREMONY ONLY IMMEDIATE FAMILY ONLY GRAVESIDE CEREMONY ONLY AT: NO VIEWING/NO OPEN CASKET OPEN CASKET PERSONAL EFFECTS THAT SHOULD STAY WITH THE REMAINS AFTER THE MEMORIAL SERVICE (select all that apply) EYEGLASSES WATCH RINGS/JEWELRY SMART /CELL OTHER (please specify) NONE NO PERSONAL EFFECTS ARE TO BE WITH THE REMAINS DURING THE MEMORIAL SERVICE 18

19 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 OF INDIVIDUAL TO PROVIDE EULOGY RELIGIOUS PASSAGES (to be read at service) FLORAL PREFERENCES FLORAL TYPE: FLORAL COLOR: NO FLORAL MUSIC SELECTION ORGANIST SOLOIST OTHER MUSIC SELECTION: NONE CLOTHING PREFERENCE EXISTING CLOTHING NEW CLOTHING DESCRIPTION OF CLOTHING (type and color): NONE PREFERENCE FOR DISPOSAL OF THE REMAINS BURIAL CREMATION MAUSOLEUM INTERMENT TYPE OF CASKET HARDWOOD (type): METAL (type): CREMATION COFFIN CASKET SPECIFICS MANUFACTURER MODEL: CASKET PRESENTATION DURING CEREMONY OPEN (if possible) CLOSED TYPE OF HEADSTONE STONE FLAT MARKER UPRIGHT POST-MEMORIAL GATHERING DESIRED QUIET GATHERING AT FAMILY MEMBER S HOUSE LIFE CELEBRATION EVENT: OTHER (please explain): OTHER INSTRUCTIONS (e.g. dispersal of cremains): OTHER (please explain): NOT APPLICABLE OTHER INFORMATION (please specify): NOT APPLICABLE NOT APPLICABLE HEADSTONE SAYING: HEADSTONE PHRASE: OTHER (please specify): NONE PROTECT YOUR IDENTITY - Keep this document in a secure location and only allow access to necessary parties. 19

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