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

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1 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 investment performance. You face financial and life decisions that affect you, those around you, and those who will follow tomorrow. This checklist has been provided to help you organize your financial information all in one place. It is intended to be utilized as a tool by your family members, Financial Advisor, and Attorney should anything happen to you. Once completed, please remember to store this document in a secure location or give it to your Advisor or Attorney for safe keeping. Persons to Notify in an Emergency My Professionals Notes/Special Considerations and Location of Important Papers My Money My Property Employment Information End of Life Decisions

2 Persons to Notify in an Emergency Primary Contact Guardian of Children Employer Medical POA (Power of Attorney) Name Financial POA (Power of Attorney) Pet Sitter/Animal Care

3 Spiritual Advisor Executor of my Estate Name : Medical Information Hospital/Clinic Preference: Primary Physician s ([ ]) Insurance Company Contact: ([ ]) Insurance Policy Number: Blood Type: Allergies: Notes:

4 My Professionals Attorney Financial Advisor Institution Address City, ST ZIP Code Institution Address City, ST ZIP Code Banker Accountant/CPA Institution Address City, ST ZIP Code Institution Address City, ST ZIP Code Insurance Agent- Life, Disability, Long-term Care Insurance Agent- Property/Casualty/Umbrella Institution Address City, ST ZIP Code Institution Address City, ST ZIP Code

5 Notes/Special Considerations & Location of Important Papers If you do not use a tax professional to prepare your taxes, please list the location of your past returns below. You may also want to include any passwords or notes if you e-filed. The location of your estate plans, financial records, etc. should also be noted.

6 My Money Safety Deposit Box Institution where box is located: Location of key: In whose name: Account number: Contents: Personal Safe Location: Lock Code: Contents:

7 Bank and Brokerage Accounts Financial Institution: ([ ]) Name of Joint Account Holder: Checking Savings Retirement Individual Joint Online Password: Login ID: Financial Institution: ([ ]) Name of Joint Account Holder: Checking Savings Retirement Individual Joint Online Password: Login ID: Financial Institution: ([ ]) Name of Joint Account Holder: Checking Savings Retirement Individual Joint Online Password: Login ID: Financial Institution: ([ ]) Name of Joint Account Holder: Checking Savings Retirement Individual Joint Online Password: Login ID:

8 My Property Primary Residence Remaining Debt: Yes* No *Mortgage Company: Insurance Company: Policy Number: Secondary Residence/ Vacation Home Remaining Debt: Yes* No *Mortgage Company: Insurance Company: Investment Property Policy Number: Residential Commercial Remaining Debt: Yes* No *Mortgage Company: Insurance Company: Policy Number: Primary Vehicle: Auto Boat Plane Remaining Debt: Yes* No *Loan Company: Insurance Company Policy Number: Secondary Vehicle: Auto Boat Plane Remaining Debt: Yes* No *Loan Company: Insurance Company: Policy Number:

9 Other Auto Boat Plane Remaining Debt: Yes* No *Loan Company: Insurance Company: Policy Number: Current Employment Benefit Information Please check the following boxes below if you participate. Pension/ Deferred Compensation Plan Stock Options Profit Sharing/ 401 (k) Plan Life / Disability Insurance Location of documents: Past Employment Benefit Information Business/Employer Pension/ Deferred Compensation Plan Stock Options Profit Sharing/ 401 (k) Plan Life / Disability Insurance Business/Employer: Pension/ Deferred Compensation Plan Stock Options Military Service: Profit Sharing/ 401 (k) Plan Life / Disability Insurance Serial number/grade: Honors or decorations: Country served: Branch: Service-connected disability:

10 End of Life Decisions & Instructions I have have not executed a Directive to Physician (Living Will). I have have not made pre-arrangements for my funeral and burial. Please contact: ([ ]) If you have not made pre-arrangements for your funeral and burial, please complete the information below. My Funeral Preferences Choice of funeral home: ([ ]) Burial Cremation Church or place of worship: ([ ]) Participating organizations (fraternal/military): Pallbearers (Names & Phone numbers): Readings/songs: Organist: ([ ]) Soloist name/phone: ([ ]) Visitation: Yes No Casket: Open Closed Clothing:

11 I do do not have an address book/contact record. Location of address book/contact record: If you do not have an address book/contact record, please record those who should be notified regarding your passing. Relatives and Friends who should be notified:

12 Information for Obituary Date of birth: Place of birth: Education: Share Cause of death: YES NO Father s name: Mother s name: Spouse s name: Children s names: Other survivors: Remembrances can be made to: Additional considerations: