Spouse / Significant Other Contact Information. Medical Contact Information. Employment Information. Military Service. Living Will
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- Wilfrid Morton
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1 Personal Information Recording your personal information will provide your family with a helpful guide in case of an emergency. Simply record the information in the categories below, to create a handy reference. You can enter your information directly into this PDF document and then save it on your computer or print it out. Spouse / Significant Other Contact Information Work Phone: Military Service Branch of Service: Serial Number: Date Enlisted: Date Discharged: Social Security Number: Children Contact Information Home Phone: Medical Contact Information Practice Name: Family Doctor: Employment Information Employer: Living Will Location: Name: Power Of Attorney Relationship: Executor Relationship: Safety Deposit Box Location: Key Location/Combination: Contents:
2 Financial Information In this section, record information about your financial, banking and investment accounts. Be sure to include any online login details for each. Banking Accounts Bank Name: Named Beneficiary: Bank Address: Checking Account Number: Savings Account Number: Investment Accounts Named Beneficiary: Credit Card Company: Card Number: Credit Cards Credit Card Company: Card Number: Insurance Information It is important for your family members to know what insurance policies you have, so that they are aware of the benefits and type of coverage that applies, in case of an emergency. Life Insurance Type Of Policy: Beneficiary: Health Insurance Type Of Policy:
3 Home Insurance Type Of Policy: Auto Insurance Type Of Policy: Autopay: Yes No Payment Date: Charge Card: Retirement Information Information recorded in this section should include details about any retirement accounts. Be sure to list accounts that are through work, as well as, individual accounts that have been set up. Be sure to indicate where the accounts are held. Pension / 401(k) / 403b _ IRA Company: Other Plans _ Company:
4 Home and Vehicle Information By providing your family with home mortgage and auto loan information, they will be able to continue to manage payments if you are unable to. If there are no outstanding vehicle loans, simply list the title information. Mortgage / Title Lending Institution: Account Charged: Vehicles Vehicle Title #: Make Of Vehicle: Vehicle ID #: License Plate #: Auto Loan Lending Institution: Autopay: Yes No Payment Date: Account Charged: Professional Advisors In the event of an emergency, it is important for your family to know who your professional advisors are. Your network of professional advisors will be able to assist with managing your affairs until you are able to. Attorney Investment Advisor / Broker Insurance Agent CPA Fax:
5 Home Utility & Provider Information In this section, record information about all of your home utilities and providers such as: waste/trash, sewer, power, cable, internet, electric, and gas. Be sure to include any online login details and autopay features for each. If you need more space to list additional expenses, such as school loans, subscriptions, gym membership, etc., simply copy this page.
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