Personal Inventory. Public Employees Retirement Association of Minnesota

Transcription

1 Personal Inventory Public Employees Retirement Association of Minnesota

2 Personal Inventory of Family Members Birth date/ Name Relationship Address Phone # Place S.S. # 2 11

3 Personal Inventory The following checklist is designed to help organize your records and can serve as a guide for your family and the personal representative of your estate in the event of your death. It can also help should you be injured or otherwise incapacitated and no longer able to handle your own affairs, or if you should suffer a catastrophic loss, such as a fire. Make several copies, keeping one at home and another in your safe deposit box. Personal Contact List Accountant - Telephone: Address: Attorney - Telephone: Address: Banker - Telephone: Address: Broker - Telephone: Address: Clergy - Telephone: Address: Doctor - Telephone: Address: Employer (Human Resources)- Telephone: Address: Financial Planner - Telephone : Address: Insurance Agent - Telephone: Address:

4 Will The original executed copy of my will is located: Date will signed: Named as personal representative: Named as alternate: Named as guardians of my children: Named as trustees: Attorney who drew up will: Telephone number: Durable Power of Attorney The original executed copy of my Durable Power of Attorney is located: Date POA signed: Named as Attorney-in- Fact: Successor Attorney-in Fact: Health Care Directive The original executed copy of my Health Care Directive is located: Date HCD signed: Health Care Agent: Alternate Health Care Agent:

5 Personal Information My birth certificate is located: Place of birth: Date of birth: My marriage certificate is located: Place of marriage: Date of marriage: Documents for divorce or legal separation are located: Personal Employment Record Name of employer: H.R. representative: Benefit plans I participate in: Name of employer: H.R. representative Benefit plans I participate in: Social Security Social Security Number: Location of Social Security card:

6 Tax Records Copies of my income tax returns are located: Documents for current year s taxes are located: My tax preparer is: Prior years tax records are located: Real Estate The deed to my home is located: Title to residence is held in my name only: Yes No (If No, names of joint holders) Papers related to my home are located: (Check each item which applies and give location) Deed Copy of mortgage Closing statement Title abstract Surveys Building cost Title insurance Insurance policies Tax records Leases

7 Other real estate I own is located: Papers related to this property are located: (complete check list as for home) Deed Copy of mortgage Closing statement Title abstract Surveys Building cost Title insurance Insurance policies Tax records Leases My homeowners insurance agent is: Policy Number: Location of policy: Safe Deposit Box My safe deposit box is located: People with access to the box: Addresses:

8 Banking I have a checking account at: Account number: I have an additional checking account at: Account number: I have a savings account at: Account number: I have an additional savings account at: Account number: My checking and savings books are located: Name of holder of joint accounts with me: Account numbers: Person who has power to sign my checks: I have custodial accounts for: They are located at:

9 Outstanding Debts/Credits The following people/companies owe me money: Name: Amount: Name: Amount: Name: Amount: Name: Amount: I owe the following people/companies money: Name: Amount: Name: Amount: Name: Amount: Investments Name of financial planner/broker: Stock, Bonds, Mutual Funds My stocks and bonds are located: Records of my transactions are located:

10 Mutual Fund Registrations are located: Records of mutual fund transactions are located: Records of securities I received as a gift or inheritance are located: Securities which are held as security on loans: Institutions holding securities: Person or persons holding securities jointly with me: Security: Security: Security: 0

11 Government Bonds Government bonds I own are located: Serial numbers: Person or persons holding bonds jointly with me: Bond name and number: Bond name and number: Retirement Investments Retirement/Pension Plans Type: Defined Benefit IRA 401(k) 403(b) 457 (Deferred Comp.) Other Agency Administering Plan: Member No. or Account No.: Location of documents:

12 Type: Defined Benefit IRA 401(k) 403(b) 457 (Deferred Comp.) Other Agency Administering Plan: Member No. or Account No.: Location of documents: Type: Defined Benefit IRA 401(k) 403(b) 457 (Deferred Comp.) Other Agency Administering Plan: Member No. or Account No.: Location of documents: Tax-Deferred Annuities Type: Fixed Variable Member No. or Account No.: Location of documents: 2

13 Type: Fixed Variable Member No. or Account No.: Location of documents: Space for smaller personal property items is located at the back of this inventory. Personal Property Vehicles Make: Model: VIN: Located: Insurance: Yes No Make: Model: VIN: Located: Insurance: Yes No Household furnishings Location: Insurance: Yes No

14 Jewelry Item/Location: Insurance: Yes No Other Item/Location: Insurance: Yes No Evidence of ownership for these items is located: Insurance policies for the above items are located: Policy Number: Policy Number: Agent's Name:

15 Jointly owned personal property: Article: Person: Article: Person: Insurance I own the following life insurance policies: Policy Number: Location of policy: Policy Number: Location of policy: Names of beneficiaries on these policies: Policies held by others on my life: Policy Number: Holder: Policy Number: Holder:

16 The following policies have been borrowed against: Policy: Borrowed amount: Policy: Borrowed amount: Taxable Annuity contracts I own: Annuity Number: Location of documents: Annuity Number: Location of documents: I have the following disability insurance: Policy Number: Location of policy: Policy Number: Location of policy: Life insurance policies containing disability provisions: Insurance agents for these policies are: Policies: Agent:

17 Policies: Agent: Trust Funds I have prepared a living trust fund for: Names of beneficiaries: Date established: Names of trustees: Attorney who drew up document: Location of document: I am a beneficiary under the following trust fund: Name of benefactor: Location of document: Upon my death, the following heirs are beneficiaries under the fund: Location of document:

18 Funeral Arrangements I would like a traditional burial I would like to be cremated I own a cemetery plot at: Deed to the plot is located: Funeral instructions are located in my: Will Letter of instruction Other Location of instructions: Other Important Information:

19 Personal Property Item Model # Serial # Description 11 19