NC Office of State Personnel Life Planning Program. Your Financial Account: Insurance/Risk Management

Size: px
Start display at page:

Download "NC Office of State Personnel Life Planning Program. Your Financial Account: Insurance/Risk Management"

Transcription

1 NC Office of State Personnel Life Planning Program Your Financial Account: Insurance/Risk Management

2 PROTECTION COVERAGE INSURANCE RECORD TYPE (1) COVERAGE NOW ** (2) COVERAGE NEEDED (3) COST Life Insurance (Life Insurance Calculator) Disability Insurance (Disability Calculator) Medical Insurance Liability Insurance (Total of Assets) Property: Personal (Current Value) Real Estate (Replacement Value) Automobile (Current Value)

3 LIFE INSURANCE CALCULATOR To determine the amount of Life Insurance you need, complete the information in each section of this form. Be as accurate as possible. A. Debts: Enter the amount you owe on your home: (1) Enter the total amount of your other debts: (2) Add (1) and (2) and enter here: (A) B. Final Bills: Average cost of final medical bills, burial expenses, and administration expenses is: (B) C. Income Needs: The total monthly income your family would need if you died tomorrow: (3) The total monthly income your family (spouse) would receive from your retirement plan if you died after you retired: (4) Subtract (4) from (3) and enter here: (5) Total monthly income from Social Security: (6) Subtract (6) from (5) and enter here: (7) Multiply (7) by 200 and enter here: Add (A), (B), & (C) and enter here: (C) (D) D. Deductions: Enter the total amount in savings: (8) Enter amount of other investments you would want sold at your death: (9) Add (8) and (9) and enter here: (E) Subtract (E) from (D) and enter here: (F) ** ** This is the amount of Life Insurance you should own**

4 DISABILITY CALCULATOR To determine the amount of Disability Coverage you need to protect your family, record the requested information on this form. The Cash Flow Analysis Income and Expense forms are useful tools in completing this form. TOTAL A. Annual Family Expenses Source of Income: Your Income Spouse's Income Social Security Disability Disability Benefits (Work) Income from Investments Other Income B. TOTAL INCOME C. Additional Income Needed (Subtract B from A) D. Amount of Money Needed to Make up Shortage: 1. Assumed Rate of Interest = 6% multiply line C by 6 10% multiply line C by 10 12% multiply line C by Enter TOTAL in line D

5 UNDERSTANDING YOUR BENEFITS/ LINKS TO PROTECTION COVERAGE TYPE LINKS Life Insurance Employee Death Benefit Plan Retiree Death Benefit Plan efits_handbook.htm Filling the Life Insurance Gap Resources and Options NCFlex o Term life BenefitHL.html Employee Disability Benefit Plan Disability Insurance Disability Income Plan Office of State Personnel: Employee Handbook Retirement System: Teachers and State Employees Retirement Handbook rm%20care 1

6 TYPE LINKS Filling the Disability Income Gap Options NCFlex Social Security Administration Disability Income Plan State Employee Health Insurance Medical Insurance Options Filling the Medical Insurance Gaps NCFlex (Active Employees Only) o Supplemental Medical o Healthcare Flexible Spending Account o Vision o Dental Medicare and Medicaid o Social Security Administration o Seniors Health Insurance Information Program o Centers for Medicare and Medicaid Services o State Children s Health Insurance (SCHIP) Long Term Careo State Sponsored Plan o Department of Insurance Shiip Program: Long Term Care Guide ion.pdf

7 TYPE LINKS Personal Insurance Needs Although the state does not offer insurance to meet these areas, the following are options you should consider as you evaluate your insurance needs: o Liability o Property Real Estate Homeowners Mobile Home Renters Flood Vehicle Automobile Other Risk Management Resources/Options Department of Insurance State Employees Credit Union WeSave, Inc North Carolina Retired Governmental Employees Association State Employee s Association of North Carolina Agency Specific Benefit Plans (visit your agency Human Resources office) Boat and Watercraft o Other North Carolina Department of Insurance, Consumer Services 3

8 Inventory of Personal Papers Use this form to: 1. Record and monitor all insurance policies and important contracts, pension accounts, etc. 2. Record the status and location of important documents and personal property. TYPE OF DOCUMENT LOCATION NOTES PERSONAL DOCUMENTS: Certificate of Birth Certificate of Marriage Certificate of Divorce Social Security Cards Military Discharge Passports Spouse Birth Certificate Children's Birth Certificates Death Certificates Cemetery Plots/Burial Arrangements FINANCIAL DOCUMENTS: Bank Account Information Loan Agreements Stocks and Bonds Government Securities Notes Due to Others Notes Due to You Passbooks Stock/Bond Transfer Receipts Pension Plan Information IRA/Keogh/Tax Deferred Annuities Other Items TAXES: Past Returns Canceled Checks Interest/Dividend Receipts 1

9 TYPE OF DOCUMENT LOCATION NOTES INSURANCE: Life Insurance Policies Homeowners Policies Car Insurance Policies Major Medical Insurance Supplementary Health Insurance Disability Insurance REAL ESTATE: Deeds Real Estate Notes Title Insurance Policy Mortgage Documents/Deeds of Trust Tax Assessments Rental Agreements Rental Receipts Repair Receipts Improvement Receipts Other MEDICAL: Records Receipts Insurance Payments CARS: Registration Ownership/Title Documents Loan Agreements Loan Payments Records Lease Agreement Repair Records 2

10 TYPE OF DOCUMENT LOCATION NOTES SAFE DEPOSIT INFORMATION: Location Box Number Location of Keys Persons Authorized WILLS: Location Codicil(s) Executor(s) Guardian(s) Trusts Trustee(s) General Power of Attorney Health Care Power of Attorney Medical Declaration/Living Will ADVISORS: Attorney Financial Advisor Banker Doctor Other MISCELLANEOUS ITEMS: Jewelry Other Personal Property 3

11 4

Your Personal Financial Inventory. For documenting your family s important financial information

Your Personal Financial Inventory. For documenting your family s important financial information Your Personal Financial Inventory For documenting your family s important financial information Table of contents Use this document to record your family s important financial information. Store it in

More information

A form that will help you identify, locate, and organize the important documents your will need as a primary caregiver.

A form that will help you identify, locate, and organize the important documents your will need as a primary caregiver. Caregiver s Document Organizer A form that will help you identify, locate, and organize the important documents your will need as a primary caregiver. Check yes or no to indicate whether or not you can

More information

INFORMATION FOR MY EXECUTOR. The information in this booklet will be helpful in settling my estate.

INFORMATION FOR MY EXECUTOR. The information in this booklet will be helpful in settling my estate. INFORMATION FOR MY EXECUTOR The information in this booklet will be helpful in settling my estate. Cowan & Kelly 402 Middletown Blvd. Suite 202 Langhorne, PA 19047 215-741-1100 FAX 215-741-4029 My Full

More information

Valuable Papers INVENTORY AND RECORD OF

Valuable Papers INVENTORY AND RECORD OF INVENTORY AND RECORD OF Valuable Papers Every person has important papers relating to personal records, property ownership, insurance, finances, and other business affairs. Good management dictates that

More information

YOUR ESTATE PLANNING RECORD

YOUR ESTATE PLANNING RECORD YOUR ESTATE PLANNING RECORD Metropolitan Community Church Putting Your House in Order One of the most valuable gifts you can leave to your heirs is a well-organized estate and accurate records of your

More information

Family Records Organizer

Family Records Organizer Family Records Organizer Family Records Organizer: Creating A Well-Ordered Life Keeping important documents and financial records organized and readily available is one of the best gifts you can give those

More information

How To Know Your Assets And Liabilities

How To Know Your Assets And Liabilities COOPERATIVE EXTENSION SERVICE UNIVERSITY OF KENTUCKY COLLEGE OF AGRICULTURE, LEXINGTON, KY, 40546 FCS5-422 Estate Planning: Your Records and Personal Information Jennifer Hunter, Ph.D., Family Finance

More information

ESTATE PLANNING WORKSHEET

ESTATE PLANNING WORKSHEET ESTATE PLANNING WORKSHEET Please complete the following worksheet and mail it to my office prior to our initial meeting, or e-mail it, or bring it with you. At the end of the worksheet is a list of documents

More information

FINANCIAL & ESTATE PLANNING ORGANIZER. R.W. Rogé & Company, Inc.

FINANCIAL & ESTATE PLANNING ORGANIZER. R.W. Rogé & Company, Inc. FINANCIAL & ESTATE PLANNING ORGANIZER Blank FINANCIAL & ESTATE PLANNING ORGANIZER In order to simplify matters, the following pages of financial and estate planning information serve to aid my family in

More information

PUT YOUR HOUSE IN ORDER

PUT YOUR HOUSE IN ORDER PUT YOUR HOUSE IN ORDER Cetera Investment Services Susan J. Cavell, Investment Executive 200 E. Main St. Harbor Springs, MI 49740 Tel: (231) 526-3997 Fax: (231) 526-9575 Securities and insurance products

More information

Caring for an Aging Parent Checklist

Caring for an Aging Parent Checklist Caring for an Aging Parent Checklist Page 1 of 5, see disclaimer on final page Caring for an Aging Parent Checklist General information Yes No N/A 1. Has relevant personal information been gathered? Name,

More information

PERSONAL DOCUMENT ORGANIZER

PERSONAL DOCUMENT ORGANIZER PERSONAL DOCUMENT ORGANIZER We suggest saving this organizer in a secure location either in printed format or electronic format. You may also wish to consider emailing a copy of this document to your attorney,

More information

Xáàtàx cätçç Çz. Your Records and Personal Information. What Information Do You Need?

Xáàtàx cätçç Çz. Your Records and Personal Information. What Information Do You Need? Xáàtàx cätçç Çz Your Records and Personal Information Take time now to put your estate planning information together. Put it in three-ring notebooks or folders, label it, and let your family and fiduciaries

More information

CHECKLIST FOR NEW HAMPSHIRE MEDICAID APPLICATION This is a general list of items information needed in order to file for Medicaid

CHECKLIST FOR NEW HAMPSHIRE MEDICAID APPLICATION This is a general list of items information needed in order to file for Medicaid CHECKLIST FOR NEW HAMPSHIRE MEDICAID APPLICATION This is a general list of items information needed in order to file for Medicaid PERSONAL INFORMATION: CCC Copy of Birth Certificate of Applicant (also

More information

PERSONAL AND FINANCIAL RECORDS

PERSONAL AND FINANCIAL RECORDS PERSONAL AND FINANCIAL RECORDS TABLE OF CONTENTS I. MY LAST WILL AND TESTAMENT II. MY DURABLE POWER OF ATTORNEY III. MY LIVING WILL IV. MY HEALTH CARE POWER OF ATTORNEY V. MY PERSONAL HISTORY VI. MY FAMILY

More information

Financial & Estate Planning. Organizer

Financial & Estate Planning. Organizer Financial & Estate Planning Organizer Securities offered through Cetera Financial Specialists LLC, (doing insurance business in CA as CFGFS Insurance Agency) member FINRA/SIPC. Advisory services offered

More information

personal SAFEkeeper Hills Bank and Trust Company Notes: Credit and Debit Checklist Include in your personal SAFEkeeper

personal SAFEkeeper Hills Bank and Trust Company Notes: Credit and Debit Checklist Include in your personal SAFEkeeper Credit and Debit Checklist Review your credit report annually to be sure it is accurate. You are entitled to one free credit report annually, which can be obtained at www.annualcreditreport.com. Contact

More information

Estate. Settlement. In Utah

Estate. Settlement. In Utah Estate Settlement In Utah Marc A. Austin, P.C. All rights reserved. No portion of this booklet may be reproduced without written permission. Marc A. Austin, P.C. Attorney at Law 3521 North University Avenue

More information

Important Information

Important Information W223 Important Information The Household Date Prepared Taking time to organize your important papers and records may be the best investment you ever made. Completing the document will: ¾ Help you organize

More information

It is important to meet with an experienced elder law attorney who understands the Medicaid rules before making any changes to your property.

It is important to meet with an experienced elder law attorney who understands the Medicaid rules before making any changes to your property. 230 North Elm Street, Suite 1500 Greensboro, NC 27401 100 Europa Drive, Suite 271 Chapel Hill, NC 27517 336.370.8800 MEDICAID (fax) 370.8830 www.schellbray.com Medicaid is a government program that can

More information

Your fiscal fitness review. Financial wellness tips, tools and checklists from TIAA-CREF

Your fiscal fitness review. Financial wellness tips, tools and checklists from TIAA-CREF Your fiscal fitness review Financial wellness tips, tools and checklists from TIAA-CREF Keeping fiscally fit is more important than ever before No matter where you are in your life and career, chances

More information

ADVISORINSTITUTE. Surviving Spouse Checklist. A 12-month guide to working with your advisors

ADVISORINSTITUTE. Surviving Spouse Checklist. A 12-month guide to working with your advisors ADVISORINSTITUTE Surviving Spouse Checklist A 12-month guide to working with your advisors 1 THE FIRST WEEK In the first week after the death of a spouse, the most important thing is taking care of yourself

More information

THE INSURANCE ORGANIZER

THE INSURANCE ORGANIZER THE INSURANCE ORGANIZER SENIOR SOLUTIONS OF AMERICA, INC. www.todaysseniors.com COPYRIGHT 2007 SENIOR SOLUTIONS OF AMERICA, INC. ALL RIGHTS RESERVED. ORGANIZING YOUR INSURANCE POLICIES Your safe deposit

More information

Law Office of. 8664 E. Chama Road Telephone: (480) 348-1470 Scottsdale, Arizona 85255 Facsimile: (480) 348-1471 e-mail: soman@omanlaw.

Law Office of. 8664 E. Chama Road Telephone: (480) 348-1470 Scottsdale, Arizona 85255 Facsimile: (480) 348-1471 e-mail: soman@omanlaw. Law Office of STEVEN P. OMAN, P.C. 8664 E. Chama Road Telephone: (480) 348-1470 Scottsdale, Arizona 85255 Facsimile: (480) 348-1471 e-mail: soman@omanlaw.net AFTER A DEATH OCCURS A Checklist What follows

More information

Casey House Foundation 119 Isabella Street Toronto, ON M4Y 1P2 Tel: 416.962.7600 www.caseyhouse.com

Casey House Foundation 119 Isabella Street Toronto, ON M4Y 1P2 Tel: 416.962.7600 www.caseyhouse.com Will Planning Work Sheet This document is intended to assist you in gathering information to prepare a will. We hope you find it helpful. Casey House Foundation 119 Isabella Street Toronto, ON M4Y 1P2

More information

***You may complete this form electronically by filling in the Word Document, or print and complete by hand*** Personal Information Your Spouse

***You may complete this form electronically by filling in the Word Document, or print and complete by hand*** Personal Information Your Spouse ***You may complete this form electronically by filling in the Word Document, or print and complete by hand*** WEINER & McCULLOCH, PLLC ATTORNEYS & COUNSELORS AT LAW 5599 San Felipe Suite 900 Houston,

More information

Organizing your financial life

Organizing your financial life Organizing your financial life Critical information at your fingertips Building the life you want means more than wealth and money. It means being prepared to meet new opportunities and to adapt when significant

More information

PRELIMINARY FACT FINDER

PRELIMINARY FACT FINDER CLIENT INFORMATION Family Information Client Spouse Full Name (First, MI, Last) Date of Birth (MM/DD/YYYY) Social Security # Drivers License # / State Address City / State / Zip Home Phone # Business Phone

More information

PERSONAL ESTATE PLANNING WORKSHEET PERSONAL AND FAMILY INFORMATION. Name. Address. City State Zip. Phone. Email

PERSONAL ESTATE PLANNING WORKSHEET PERSONAL AND FAMILY INFORMATION. Name. Address. City State Zip. Phone. Email PERSONAL ESTATE PLANNING WORKSHEET Name Address City State Zip Phone Email PERSONAL AND FAMILY INFORMATION Date of Birth Social Security Number Marital Status: q Single q Married q Domestic Partners /

More information

Estate Organizer. Janney Montgomery Scott LLC

Estate Organizer. Janney Montgomery Scott LLC Estate Organizer Janney Montgomery Scott LLC W E A L T H M A N A G E M E N T Table of Contents Desired Disposition of Estate... 1 General Information for Family... 2 Advisors... 4 Memorial Directions...

More information

Lifetime Income Financial Evaluation

Lifetime Income Financial Evaluation Lifetime Income Financial Evaluation Client Name We will hold in the strictest confidence the information collected and entered in this document, other documents, and computerized software programs. We

More information

PERSONAL RECORDS, INVENTORY, AND PLANS UPON DEATH

PERSONAL RECORDS, INVENTORY, AND PLANS UPON DEATH Jewish Social Service Agency PERSONAL RECORDS, INVENTORY, AND PLANS UPON DEATH Name: Date Updated: CONTENTS: PART I PART II PART III INVENTORY: CONTACTS, ASSETS, DOCUMENTS AND LOCATIONS 1. Personal Details

More information

Getting Organized. The purpose of this chapter is to discuss what needs to be done soon, but not necessarily immediately after a death.

Getting Organized. The purpose of this chapter is to discuss what needs to be done soon, but not necessarily immediately after a death. Getting Organized The purpose of this chapter is to discuss what needs to be done soon, but not necessarily immediately after a death. Going Into the Home A distinction should be made between things a

More information

Your fiscal fitness review. Financial wellness tips, tools and checklists from TIAA-CREF

Your fiscal fitness review. Financial wellness tips, tools and checklists from TIAA-CREF Your fiscal fitness review Financial wellness tips, tools and checklists from TIAA-CREF Keeping fiscally fit is more important than ever before. No matter where you are in your life and career, chances

More information

Estate Planning Questionnaire

Estate Planning Questionnaire Estate Planning Questionnaire (Compiled by the University of Colorado American Indian Law Clinic) i I. General Information 1. Full name: 2. Nickname, maiden name, or other names used: 3. Marital status:

More information

CHAYET, DAWSON & DANZO, LLC

CHAYET, DAWSON & DANZO, LLC CHAYET, DAWSON & DANZO, LLC PROBATE ADMINISTRATION QUESTIONNAIRE ESTATE OF : COUNTY OF PROBATE: DATE OF DEATH: SOCIAL SECURITY #: DATE OF BIRTH: UNITED STATES CITIZEN: YES NO. IF NO, WHAT COUNTRY TRUSTEE:

More information

BEDROCK DIVORCE ADVISORS, LLC INFO@BEDROCKDIVORCE.COM WWW.BEDROCKDIVORCE.COM

BEDROCK DIVORCE ADVISORS, LLC INFO@BEDROCKDIVORCE.COM WWW.BEDROCKDIVORCE.COM BEDROCK DIVORCE ADVISORS, LLC 515 North Flagler Drive Suite P-300 West Palm Beach, FL 33401 917-602-6977 917-591-4394 (Fax) INFO@BEDROCKDIVORCE.COM WWW.BEDROCKDIVORCE.COM The following is a checklist of

More information

ESTATE PLANNING QUESTIONNAIRE

ESTATE PLANNING QUESTIONNAIRE ESTATE PLANNING QUESTIONNAIRE Please complete this form to the best of your ability and bring it with you to our initial meeting. Your cooperation in this regard will make your appointment more productive

More information

Request for Production of Documents

Request for Production of Documents Print out, then collect the information Request for Production of Documents Instructions: These items that you may have to make available are called Request for Production of Documents. Please review this

More information

What My Family Needs To Know

What My Family Needs To Know 1 Career Transition Center George P. Shultz National Foreign Affairs Training Center U.S. Department of State What My Family Needs To Know This list contains important information in that you can modify

More information

Estate Planning Questionnaire

Estate Planning Questionnaire Estate Planning Questionnaire INSTRUCTIONS: In order to properly advise you in planning your estate and drafting your w ill and related documents I need to have a w ide range of information about you and

More information

Helping you through this difficult time.

Helping you through this difficult time. Helping you through this difficult time. New York Life Insurance Company New York Life Insurance and Annuity Corporation (A Delaware Corporation) 51 Madison Avenue New York, NY 10010 www.newyorklife.com

More information

Getting Your Affairs In Order. A Guide for Your Survivors. and. Office of the New York State Comptroller Alan G. Hevesi

Getting Your Affairs In Order. A Guide for Your Survivors. and. Office of the New York State Comptroller Alan G. Hevesi Getting Your Affairs In Order and A Guide for Your Survivors Office of the New York State Comptroller Alan G. Hevesi New York State and Local Retirement System Employees Retirement System Police and Fire

More information

Please note that this document is for discussion purposes only and does not constitute or replace a Will. Surname: Given name: Any other names used:

Please note that this document is for discussion purposes only and does not constitute or replace a Will. Surname: Given name: Any other names used: Before meeting with your lawyer or notary to create your Will, use this Will Planning Guide. The information in this guide will assist your discussion with your lawyer/notary. Please note that this document

More information

Organizing your financial life

Organizing your financial life Organizing your financial life Critical information at your fingertips Date Your Name Financial Advisor / Team Name Financial Advisor / Team Phone Number Financial Advisor / Team Email Financial Advisor

More information

Financial Organizer. No matter what your age or situation, it s important to consider

Financial Organizer. No matter what your age or situation, it s important to consider Member FDIC Financial Organizer www.bruningbank.com No matter what your age or situation, it s important to consider How do you want your assets to pass to your heirs? How can you ease the burden your

More information

Your Estate Planning Record

Your Estate Planning Record Your Estate Planning Record Office of Philanthropy and Stewardship United Church of Christ Thank you for your support of the United Church of Christ through Our Church s Wider Mission. Your gifts have

More information

PROBATE QUESTIONNAIRE FORM. DARRYL V. PRATT Attorney at Law Certified Public Accountant

PROBATE QUESTIONNAIRE FORM. DARRYL V. PRATT Attorney at Law Certified Public Accountant DARRYL V. PRATT Attorney at Law Certified Public Accountant PRATTLAW A Professional Limited Liability Company ATTORNEYS & COUNSELORS AT LAW Stonebriar Financial Center 2500 Legacy Drive, Suite 228 Frisco,

More information

Personal financial affairs directory

Personal financial affairs directory Personal financial affairs directory With everything going on in your life, managing your financial affairs can sometimes be a challenge. By completing this booklet, you re taking a step toward organizing

More information

LONG-TERM CARE PLANNING QUESTIONNAIRE

LONG-TERM CARE PLANNING QUESTIONNAIRE LONG-TERM CARE PLANNING QUESTIONNAIRE Please complete this form to the best of your ability and bring it with you to our initial meeting. Your cooperation in this regard will make your appointment more

More information

Personal Inventory and Executor Information

Personal Inventory and Executor Information Name: Social Insurance Number: Pension Number: Health Benefits Number: Safety Deposit Box Location of Box: Registered under Names: Location of Key: Advised executor of location of Key: Yes No Will Original

More information

Form M-433-OIS Statement of Financial Condition and Other Information

Form M-433-OIS Statement of Financial Condition and Other Information Form M-433-OIS Statement of Financial Condition and Other Information Rev. 6/09 Massachusetts Department of Revenue Complete all entries with the most current information available. For entries that do

More information

LAW OFFICES OF BRADLEY J. FRIGON, LLC PROBATE INTAKE FORM PERSONAL INFORMATION

LAW OFFICES OF BRADLEY J. FRIGON, LLC PROBATE INTAKE FORM PERSONAL INFORMATION Member National Academy of Elder Law Attorneys Member Special Needs Trust Alliance ** Certified Elder Law Attorney by the National Elder Law Foundation www.specialneedsalliance.com LAW OFFICES OF BRADLEY

More information

Organize Your Personal Financial Information

Organize Your Personal Financial Information Concannon Wealth Management 1525 Valley Center Parkway Suite 310 Bethlehem, PA 18017 610-814-2474 www.cwm.us.com Organize Your Personal Financial Information Page 2 of 7 Personal Document Locator Please

More information

Elder Law Information Sheet and Checklist

Elder Law Information Sheet and Checklist Information Sheet and Checklist ELPOLAW ESTATE PLANNING/PROBATE DIVISION 1101 College Street P.O. Box 770 Bowling Green, KY 42102-0770 270-781-6500 (P) 270-782-7782 (F) www.elpolaw.com What to Bring to

More information

CATHY R. COOK ATTORNEY AT LAW 114 E. Eighth Street Cincinnati, OH 45202 Telephone: 513-241-4029

CATHY R. COOK ATTORNEY AT LAW 114 E. Eighth Street Cincinnati, OH 45202 Telephone: 513-241-4029 CATHY R. COOK ATTORNEY AT LAW 114 E. Eighth Street Cincinnati, OH 45202 Telephone: 513-241-4029 CLIENT S LIST OF DOCUMENTS TO BE PREPARED AND FURNISHED IF APPLICABLE AND IF IN YOUR POSSESSION 1. Tax Returns:

More information

SWIFT DATOO & COMPANY LAW CORPORATION

SWIFT DATOO & COMPANY LAW CORPORATION SWIFT DATOO & COMPANY LAW CORPORATION Suite 201-467 Cumberland Road Courtenay, British Columbia V9N 2C5 Phone: (250) 334-4461 Fax: (250) 334-2335 The information requested in this questionnaire is required

More information

Confidential Estate Planning Questionnaire

Confidential Estate Planning Questionnaire Confidential Estate Planning Questionnaire Single Person This questionnaire is designed to help me evaluate your unique situation and create an estate plan that addresses your specific needs. Effective

More information

A Quick Guide to Long Term Care Medicaid

A Quick Guide to Long Term Care Medicaid COMMISSIONERS Jimmy Dimora Timothy F. Hagan Peter Lawson Jones A Quick Guide to Long Term Care Medicaid DSAS Services & Solutions for Better Living INTRODUCTION The Department of Senior & Adult Services

More information

DATE OF APPOINTMENT (MM/DD/YYYY) INVENTORY VALUES AS OF DATE (MM/DD/YYYY) FILING DUE DATE (MM/DD/YYYY)

DATE OF APPOINTMENT (MM/DD/YYYY) INVENTORY VALUES AS OF DATE (MM/DD/YYYY) FILING DUE DATE (MM/DD/YYYY) District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Protected Person Attorney or Party Without Attorney (Name and Address): Case Number: COURT USE ONLY Phone Number:

More information

GEOFFREY W. WHITE LAW CORPORATION

GEOFFREY W. WHITE LAW CORPORATION GEOFFREY W. WHITE LAW CORPORATION ESTATE ADMINISTRATION QUESTIONNAIRE The information requested in this questionnaire is required in order to obtain the necessary personal information of the Deceased and

More information

Personal Financial Planning Questionnaire

Personal Financial Planning Questionnaire MULHOLLAND FINANCIAL SERVICES Personal Financial Planning Questionnaire Conservative Financial Advice This comprehensive, personal financial planning summary is designed to help you take inventory and

More information

Caring for a. Loved One s Estate. Serving as a Personal Representative

Caring for a. Loved One s Estate. Serving as a Personal Representative Caring for a Loved One s Estate Serving as a Personal Representative Introduction A Personal Representative (sometimes referred to as an Executor) is the person or entity who oversees a person s estate

More information

THE RICE LAW FIRM, PLLC Fax: (281) 601-4870 Email: ricelawhouston@gmail.com Email: ricelawthewoodlands@gmail.com

THE RICE LAW FIRM, PLLC Fax: (281) 601-4870 Email: ricelawhouston@gmail.com Email: ricelawthewoodlands@gmail.com THE RICE LAW FIRM, PLLC Fax: (281) 601-4870 Email: ricelawhouston@gmail.com Email: ricelawthewoodlands@gmail.com ESTATE PLANNING QUESTIONNAIRE FOR MARRIED COUPLE If you are interested in preparation of

More information

1) GENERAL INFORMATION

1) GENERAL INFORMATION 1) GENERAL INFORMATION IDENTIFICATION Name : Occupation: Citizenship: Social Insurance number: Medicare number: Date of birth: PROFESSIONAL INFORMATION Employer s name: Date of commencement of employment:

More information

Steps to Take After Your Loss. Survivor s Resource. The Baptist Foundation of Oklahoma Estate Planning & Gift Services

Steps to Take After Your Loss. Survivor s Resource. The Baptist Foundation of Oklahoma Estate Planning & Gift Services Steps to Take After Your Loss Survivor s Resource The Baptist Foundation of Oklahoma Estate Planning & Gift Services The Baptist Foundation of Oklahoma Survivor s Resource Steps to Take After Your Loss

More information

ESTATE PLANNING WORKSHEET

ESTATE PLANNING WORKSHEET ESTATE PLANNING WORKSHEET The worksheets on the following pages comprise an informationgathering vehicle to assist you in preparing to meet with the attorney who will draft your estate planning documents.

More information

Personal Financial Planning Questionnaire

Personal Financial Planning Questionnaire Part I: Personal and Family Information 1. Your General Information Your Full Name Your Date of Birth Your Place of Birth Your State of Residency s Full Name s Date of Birth s Place of Birth s State of

More information

PREPARING YOUR PERSONAL/FINANCIAL INFORMATION BINDER

PREPARING YOUR PERSONAL/FINANCIAL INFORMATION BINDER PREPARING YOUR PERSONAL/FINANCIAL INFORMATION BINDER Imagine waking up in the middle of the night only to find your house on fire. Besides the kids, what would you grab? Hundreds of thoughts cross your

More information

The Kreager Law Firm 7373 Broadway, Suite 500 San Antonio, Texas 78209 (210) 829-7722. Estate Planning Information

The Kreager Law Firm 7373 Broadway, Suite 500 San Antonio, Texas 78209 (210) 829-7722. Estate Planning Information Estate Planning Information Please complete this questionnaire and bring it with you for your initial consultation with us. Of course, this information will be kept in strictest confidence. A. Husband

More information

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) Supplemental Security Income (SSI) Contact Social Security Visit our website Our website, www.socialsecurity.gov, is a valuable resource for information about all of Social Security s programs. At our

More information

Your Name Date Completed / Last Updated

Your Name Date Completed / Last Updated Estate Planning Directory Your Name Date Completed / Last Updated Ken Stern TEP, CHAIP Financial Advisor INSURANCE, RETIREMENT & ESTATE PLANNING Suite 500, 1867 Yonge St., Toronto, Ontario M4S 1Y5 www.kenstern.ca

More information

After the loss of a loved one. A guide to estate settlement

After the loss of a loved one. A guide to estate settlement After the loss of a loved one A guide to estate settlement We re here to help The loss of a loved one can be one of life s most difficult times. In addition to the grief, there s the matter of settling

More information

ESTATE PLANNING QUESTIONNAIRE

ESTATE PLANNING QUESTIONNAIRE ESTATE PLANNING QUESTIONNAIRE MALOUF NAKOS SWINSON & JACKSON, P.C. Merit Tower 12222 Merit Drive, Suite 1000 Dallas, Texas 75251 Tel: (214) 273-0600 Fax: (214) 273-0601 General Personal Information FAMILY

More information

TRANSFERRING Inventory of assets. The importance of informing others of your intentions

TRANSFERRING Inventory of assets. The importance of informing others of your intentions TRANSFERRING Inventory of assets The importance of informing others of your intentions This tool will help you pass on important information about yourself to the people you re close to. The information

More information

Social Security Number: Occupation: Email Address: Current Address (if not listed on W2 form or 1099 Taxpayer Name: Spouse Name: form):

Social Security Number: Occupation: Email Address: Current Address (if not listed on W2 form or 1099 Taxpayer Name: Spouse Name: form): For New Clients only - please submit with your forms and documentations TAX RETURN QUESTIONNAIRE - TAX YEAR 2014 Current Address (if not listed on W2 form or 1099 Taxpayer Name: Spouse Name: form): Phone

More information

PROBATE ADMINISTRATION FORM

PROBATE ADMINISTRATION FORM 4045 SMITHTOWN ROAD, SUITE K SUWANEE, GEORGIA 30024 RICHARD S. BRYSON, ESQ. Attorney at Law Member, National Academy of Elder Law Attorneys TEL: (404) 909-8842 FAX: (404) 591-7921 richard@brysonlawfirmpc.com

More information

INDIVIDUAL ESTATE PLANNING QUESTIONNAIRE Virginia L. Ross, P.C., Attorney at Law 503-292-7674 / RossLawOffice@Comcast.Net

INDIVIDUAL ESTATE PLANNING QUESTIONNAIRE Virginia L. Ross, P.C., Attorney at Law 503-292-7674 / RossLawOffice@Comcast.Net INDIVIDUAL ESTATE PLANNING QUESTIONNAIRE Virginia L. Ross, P.C., Attorney at Law 503-292-7674 / RossLawOffice@Comcast.Net FAMILY INFORMATION Please complete the following as thoroughly as possible. You

More information

SCHWAB OPENVIEW WORKFLOW LIBRARY ONBOARD CLIENT WORKFLOW SERIES: INVESTMENT PLAN CREATION & REVIEW MEETING PROCESS

SCHWAB OPENVIEW WORKFLOW LIBRARY ONBOARD CLIENT WORKFLOW SERIES: INVESTMENT PLAN CREATION & REVIEW MEETING PROCESS SCHWAB OPENVIEW WORKFLOW LIBRARY ONBOARD CLIENT WORKFLOW SERIES: INVESTMENT PLAN CREATION & REVIEW MEETING PROCESS Document ID: 012359 Document Date: June 12, 2012 Document Version: 12.06.A Disclosures:

More information

Collection Information Statement for Wage Earners and Self-Employed Individuals

Collection Information Statement for Wage Earners and Self-Employed Individuals Form 433-A (Rev. December 2012) Department of the Treasury Internal Revenue Service Collection Information Statement for Wage Earners and Self-Employed Individuals Wage Earners Complete Sections 1, 2,

More information

Personal financial affairs directory

Personal financial affairs directory Personal financial affairs directory With everything going on in your life, managing your financial affairs can sometimes be a challenge. By completing this booklet, you re taking a step toward organizing

More information

YOUR PERSONAL FINANCIAL ORGANIZER

YOUR PERSONAL FINANCIAL ORGANIZER YOUR PERSONAL FINANCIAL ORGANIZER WHAT'S INSIDE INTRODUCTION: UNDERSTANDING YOUR FINANCIAL ORGANIZER...1 I. FIGURING YOUR FINANCES...2 Net Worth Analysis...2 Cash Flow Analysis...4 II. GOALS, PRODUCTS

More information

Personal Document Locator

Personal Document Locator Ameriprise Financial Stephanie Milosavlevski, CFP Financial Advisor 2182 Commons Parkway Okemos, MI 48864 517-349-2880 stephanie.j.milosavlevski@ampf.com Personal Document Locator Page 1 of 7, see disclaimer

More information

Thank you for downloading this packet - we hope you and your loved ones find it useful.

Thank you for downloading this packet - we hope you and your loved ones find it useful. The Gift Thank you for downloading this packet - we hope you and your loved ones find it useful. As the first hospice in Central Texas, Hospice Austin was established in 1980 to ease the physical, emotional

More information

Settling A Decedent s Estate

Settling A Decedent s Estate After a death, the financial affairs of the deceased person must be resolved. If the surviving family members have little knowledge of the scope of these responsibilities, the situation can be overwhelming.

More information

Persons to Notify in an Emergency...2. My Professionals...4. Notes/Special Considerations and Location of Important Papers... 5. My Money...

Persons to Notify in an Emergency...2. My Professionals...4. Notes/Special Considerations and Location of Important Papers... 5. My Money... Checklist for Life Empowering you to build beyond finance to a more fulfilling life Guidelines At Cornerstone Advisors, Inc., we appreciate that for many, BUILDING financial success and legacy goes BEYOND

More information

CFA Survivor s Guide

CFA Survivor s Guide CFA Survivor s Guide May 2003 SOMETHING YOU SHOULD KNOW A GUIDE FOR CFA MEMBERS & THEIR LOVED ONES Unless you are diagnosed with a fatal illness or know someone who has recently died or is dying, most

More information

Compliments of the Caregiver Class from BJC, hosted by BJC Hospice. Contact us at 636-916-9830.

Compliments of the Caregiver Class from BJC, hosted by BJC Hospice. Contact us at 636-916-9830. Important names, addresses, and phone numbers Name: Social security #: Spouse/Partner s name: Social security number: Address: Date prepared: Tip* Each time you update these forms, you may want to add

More information

Your Pre-Tax Premiums Plan

Your Pre-Tax Premiums Plan Your Pre-Tax Premiums Plan Updated September 2015 INTRODUCTION Through s Pretax Premiums plan, your health, dental, vision and/or Accidental Death and Dismemberment (AD&D) monthly premiums are deducted

More information

Comprehensive Financial Inventory

Comprehensive Financial Inventory READ ME FIRST Introduction The Comprehensive Financial Inventory is designed to support individuals and families in their effort to summarize financially related information. This inventory is not only

More information

ESTATE PLANNING PROCESS

ESTATE PLANNING PROCESS ESTATE PLANNING PROCESS OVERVIEW Generally, the estate plan consists of 4 documents: a will, revocable trust, healthcare power of attorney, and financial power of attorney. In larger estates (over $10M

More information

Vanguard Landing, Inc. Estate & Financial Fact Finder

Vanguard Landing, Inc. Estate & Financial Fact Finder Vanguard Landing, Inc. Estate & Financial Fact Finder A guide to life planning for a family member with an Intellectual Disability Securities and Insurance offered through Infinex Investments, Inc. Member

More information

INVENTORY AND APPRAISEMENT., files this inventory and appraisement of all assets and COMMUNITY PROPERTY

INVENTORY AND APPRAISEMENT., files this inventory and appraisement of all assets and COMMUNITY PROPERTY INVENTORY AND APPRAISEMENT OF, files this inventory and appraisement of all assets and liabilities, community and separate estates, as follows: COMMUNITY PROPERTY 1. REAL PROPERTY (including any property

More information

Executors Checklist for Estate Administration

Executors Checklist for Estate Administration FAMILY WEALTH PLANNERS PERSONAL TAX ADVISORS www.finplans.net 519-884-7087 Executors Checklist for Estate Administration March 2011 (Prepared for clients and business colleagues of Personal Wealth Strategies)

More information

ESTATE PLANNING PERSONAL AND FINANCIAL QUESTIONNAIRE

ESTATE PLANNING PERSONAL AND FINANCIAL QUESTIONNAIRE ESTATE PLANNING PERSONAL AND FINANCIAL QUESTIONNAIRE If you and you spouse will have different estate plans, then each must complete a separate questionnaire GENERAL INFORMATION DATE: 1. Marital Status:

More information

Email Address: Home Work Preference for use: Home Work Your Driver License No. Exp. Date Significant Other Driver License No. Exp.

Email Address: Home Work Preference for use: Home Work Your Driver License No. Exp. Date Significant Other Driver License No. Exp. FAMILY INFORMATION Brett M. Sause, Mark Apolenis, are Registered Representatives of and offers securities products & services through NYLIFE Securities LLC, Member FINRA/ SIPC, A Licensed Insurance Agency,

More information

Complimentary Financial Planner

Complimentary Financial Planner Complimentary Financial Planner Creating Wealth Since 1922 PERSONAL INFORMATION Name Social Security Number Date of Birth Home Street Address You Your Spouse City, State, Zip Home Telephone Marital Status

More information

Hill Law Group, PA ELDER PLANNING QUESTIONNAIRE (For a SINGLE person)

Hill Law Group, PA ELDER PLANNING QUESTIONNAIRE (For a SINGLE person) Hill Law Group, PA ELDER PLANNING QUESTIONNAIRE (For a SINGLE person) NOTE: The main person this form is about is the person who is intended to receive assistance. All questions that ask about you refer

More information

What Should I Do, Lord?

What Should I Do, Lord? What Should I Do, Lord? And the poor have the good news proclaimed to them. Luke 7:22 Office of Individual & Family Assistance June 11, 2015 Personal Record Keeping Need to become better organized so you

More information

Estate Administration

Estate Administration CLIENT GUIDE Advanced Markets Estate Administration A Guide to Settling an Estate John Hancock Life Insurance Company (U.S.A.) (John Hancock) John Hancock Life Insurance Company of New York (John Hancock)

More information