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 Copy of Will located: Date of Will: Lawyer who prepared Will: Address: Executor: Cox & Palmer Scotia Centre, Suite 1000 235 Water Street St. John's, NL A1C 1B6 Phone 709.738.7300 Alternate Executor (if any): Address: Guardian(s): Address:
Certificates Birth Certificate location: Marriage Certificate location: Passport location: Other personal records: Real Estate (includes cottages, woodlots, property outside of Canada, etc.) Property Location: Ownership Mortgage Company Is your mortgage life insured? Yes No If yes, what company and address: Where is Policy located? Deeds and copies of mortgage are located: Identity of lawyer and law firm who acted for you when you purchased the property: Life Insurance Issuing Company: Owner of Policy: Policy Number: Face Value: Date of Issuance of Policy: Name of Beneficiary: Insurance Agent: Location of Policy:
Life Insurance Continued Issuing Company: Owner of Policy: Policy Number: Face Value: Date of Issuance of Policy: Name of Beneficiary: Insurance Agent: Location of Policy: Are you entitled to any group coverage through your employment? Yes No If yes, what type of coverage? Who should executor contact about payment? Registered Retirement Savings Plans Company Account Number Beneficiary Location Non-Registered Investment Accounts Company Account Number Beneficiary Location Registered Education Saving Plans Company Account Number Who is named as Location successor subscriber? Credit Cards: Card Number Expiry Date
Monies Owed on Chattels: (furniture, appliances, etc.) Chattel Cond.Sale/Chattel Mtg. Company Amount Personal Loans Company Amount Is It Life Insured: Does Anyone Owe You Money? Who Amount Security (Mtg./Promissory Note) Motor Vehicles or Boats Description Make Year Serial Number Ownership papers are located: Bank Accounts Company Branch Type of Account Account # Joint?
Securities: (bonds, investment certificates, term deposits, mutual funds, stocks, mortgages, etc.) Security Serial Number Number of Shares Location Do you own any shares in small private companies? Yes No Security Number of Shares Location Contact Person Have You Guaranteed any Loans? For whom Who is holding Guarantee? Amount Do you have any payment or other obligations pursuant to a court order or separation agreement?
Electronic Assets and Instructions: List electronic accounts (Facebook, Twitter, email, etc) Account Username Password Instructions (close account / save files / etc.)
Funeral and Burial Instructions: Cemetery plot located at: Deed to plot located: Is there provision for perpetual care of plot: Yes No Instructions for funeral: If cremation, before or after wake? Donation of organs to medical science or for transplant: Yes No Organ Donated to Instructions for Executor: (These may not be binding on Executor:)
Family Full Name of Spouse: Full Name of Children: Date of Birth Address Full Names of Siblings: Address Full Names of Parents: Address Names and Addresses of any Other Beneficiaries
Solicitor/Accountant for Estate: I suggest you employ the following professionals to settle my estate: Solicitor: Law Firm: Address: Accountant: Accounting Firm: Address:
Information for Executor There may be some informal instructions you may wish to leave your executor. You should be aware that these instructions may not be legally binding on the executor, but he or she may find it helpful in carrying out your wishes. (i.e. there may be items of sentimental value about which you may wish to leave special instructions). Information for Guardian(s):