WORKBOOK. Record Keeper. This booklet provides you with a clear, precise record of your personal

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1 Record Keeper E S TAT E PL A N N I NG WORKBOOK This booklet provides you with a clear, precise record of your personal and financial information. It can be used to prepare an estate plan and is also a convenient way of organizing information for your loved ones. You may wish to provide a copy to a family member and to your executor as a safeguard against loss. Update your records annually. You should enter the date every time you look over the booklet even if you don t change any of the information. This will assure the reader of the current accuracy of the entries. This document should not be returned to the Presbyterian Foundation or its representatives. presbyterianfoundation.org 1

2 Date Revised Dates Reviewed PERSONAL INFORMATION Date of Birth Birth Certificate No Yes Located INVESTMENTS I own various stocks and bonds, held in street name, which are located at Citizenship date/place of naturalization if not U.S. citizen by birth Social Security # Father s Full Mother s Full RELIGIOUS AFFILIATION Church MARITAL STATUS Single Married Widowed Divorced Separated STOCKS/BONDS/MUTUAL FUNDS Shares Date Purchased Cost Basis Shares Date Purchased Cost Basis Shares Date Purchased Cost Basis Records of purchase and sale are located at Spouse s Date & State married Certificate located Previous marriage? Yes No Date Marriage ended by Death Divorce CHILDREN U.S. SAVINGS BONDS I own under the following ownership registrations: My name alone Joint with Type Face Value Issue Date Maturity Date Serial Number MILITARY SERVICE Date(s) Service Serial # Discharge papers located Type Issue Date Serial Number Certificates of Deposit Amount Certificates of Deposit Amount PARTNERSHIPS Face Value Maturity Date Date of Redemption Date of Redemption 2 presbyterianfoundation.org

3 LIVING WILL DIRECTIVE & ORGAN DONATION I have a living will directive stating my wishes for medical care FUNERAL & BURIAL ARRANGEMENTS I have given instructions regarding my funeral in a and treatment. The document is dated is located. Individuals having copies: and Will Letter Other I own a Cemetery plot Cemetery vault None Location Section # Plot # Location of Deed Other funeral arrangements I have agreed to donate organs to (organization): Papers are located POWER OF ATTORNEY I have given the following person durable power of attorney which will go into effect upon my inability to act for myself: BANK ACCOUNTS & SAFE DEPOSIT BOX BANK NAME Checking Saving Account # Joint Individual BANK NAME Checking Saving Account # Joint Individual BANK NAME Checking Saving Account # Joint Individual SAFE DEPOSIT BOX Location LAST WILL & TESTAMENT Box # Key Location Will written Executor of Will Attorney TESTAMENTARY TRUST Trustee Located RETIREMENT ACCOUNTS COMPANY NAME Account # Beneficiary Pension SOCIAL SECURITY Assets in Trust Beneficiaries In my will, I have left the following charitable bequests: Charity Bequest Amount Charity Bequest Amount INDIVIDUAL RETIREMENT ACCT ANNUITIES Beneficiary(ies) OTHER RETIREMENT BENEFITS Beneficiary(ies) presbyterianfoundation.org 3

4 TRUST FUNDS CHARITABLE REMAINDER TRUST Testamentary Trust Trustee Assets in Trust Charitable Beneficiaries LIFE INSURANCE ALL POLICIES OWNED BY ME ON MY LIFE. Insurance Insurance Agent Income Recipients Papers are located at EXISTING TRUST I have created a trust for the benefit of Policy # Location Beneficiary(ies) Death Benefit POLICIES WHICH I OWN ON THE LIVES OF OTHERS I am a beneficiary under a Trust established by Insurance Date Established Trust Agreement located Attorney who drafted the Trust Agreement Firm Insurance Agent Policy # Location Beneficiary(ies) Death Benefit PERSONAL EMPLOYMENT EMPLOYER I participate in the following benefit plans I HAVE UNPAID LOANS AGAINST THESE POLICIES. Policy # Amount Due Policy # Amount Due POLICIES OWNED BY OTHERS ON MY LIFE (including charities) Other business interests INSURANCE I personally carry accident, disability, sickness, hospitalization and other such forms of insurance (this is in addition to and exclusive of any such insurance or benefits provided through my employer). Yes No TANGIBLE PERSONAL PROPERTY Automobile(s) Jewelry, Art, Antiques, Collectibles Coverage Insurance Agent Complete inventory of my personal property is located at: Policy # Location of Policy 4 presbyterianfoundation.org

5 PERSONAL ADVISORS PHYSICIAN Specialty PHYSICIAN Specialty CLERGY PERSON ATTORNEY ACCOUNTANT INSURANCE AGENT TRUST OFFICER INVESTMENT BROKER OTHER CHARITABLE GIVING LOCAL CHURCHES NATIONAL CHURCH OTHER PC(USA) ENTITIES (Board of Pensions, Presbyterian Foundation, retirement homes, seminaries, etc.) MISSION ORGANIZATIONS OTHER presbyterianfoundation.org 5

6 PERSONAL CREDITORS CREDITOR RESIDENCE & OTHER REAL ESTATE Residence Loan # Amount of Loan Date of Final Payment I own residence Yes No Ownership title is held in CREDITOR My name alone Joint with Loan # Amount of Loan Date of Final Payment Mortgage on property Yes No Held by Documents concerning this property are located at: CREDIT CARD DEBT I own other real estate located at: Account # Account # PERSONAL DEBTORS of Debtor Amount owed of Debtor Amount owed TAX RETURNS Tax Preparer Firm Copies of my income tax returns are located at: Homeowners insurance broker Firm DIGITAL AUDIT Account Type Username Password Account Type Username Password Account Type Username Password Account Type Username Password 6 presbyterianfoundation.org

7 ADDITIONAL NOTES presbyterianfoundation.org 7

8 For additional copies of this booklet, please contact us at: 200 E 12th Street, Jeffersonville, IN presbyterianfoundation.org ERK