1
Memo to My Loved Ones
Name: ______Date: ______
OUR WILL
Our will is located at ______
Our attorney who has a copy is ______Phone no: ______
His address is ______
The executor who is designed to carry out the provisions of our will is ______
If they decline or cannot serve, the alternate is ______.
Our accountant is ______. His phone number is: ______
Two other people (financial advisors) I recommend to assist you with financial matters are:
______Phone: ______
______Phone: ______
The main provisions of the will are:
Our will includes/does not include a trust. The main provisions of the trust are:
Trustee: ______
Assets in the trust: ______
______
Beneficiaries: ______
Terms: ______
______
I have the following special things I would like distributed as follows: (include a separate page if necessary)
ItemGive to
______
______
______
______
______
DESIRES FOR LIFE SUPPORT:
I have the following desires as far as keeping me on life support is concerned.
ORGAN DONORS:
I am an organ donor and I would like my organs to go to ______
BANKING:
We have the following bank accounts:
PINApprox.Phone
Name and address of bankAccount numberNumberbalanceNumber
1.______
2.______
3.______
4.______
Our bank statements, cancelled checks and other check registers may be found:
Our bank statements and cancelled checks may be found:
RETIREMENT ACCOUNTS:
We have the following retirement accounts:
Type ofAccountApprox.Phone
Name of accountAccountnumberbalanceNumber
1.______
2.______
3.______
4.______
Our retirement account statements, cancelled checks and other check registers may be found:
CREDIT CARDS: We have the following credit cards:
Credit card nameCC NumberExp.DateBalance due
1. ______
2. ______
3. ______
4. ______
5. ______
INSURANCE:
We have the following life insurance:
Amount ofWho to call
Insurance CompanyPolicy No.InsuredCoverageBeneficiaryPhone #
1.______
2.______
3.______
4.______
You will need to contact the insurance company and enclose a copy of the death certificate.
Our homeowners insurance is with ______
Our agent is ______and his phone number is ______
Our auto insurance is with ______
Our agent is ______and his phone number is ______
Our policies are located______
INVESTMENTS:
Our stock broker or investment advisor is: ______. You can call him/her at ______. A listing of our stocks and bonds are located ______
We have the following brokerage accounts:
PINApprox.Phone
Name of brokerage firmAccount numberNumberbalanceNumber
1.______
2.______
3.______
OTHER ASSETS: (land, partnerships, etc.)
Our latest statement of Net Worth is located______
We have the following other assets:
- ______
- ______
3. ______
- ______
- ______
DEBTS OWED TO US:
PresentLocation of
DescriptionTermsbalancedocuments
______
______:
DEBTS WE OWE:
Apart from our home mortgage listed above, we have the following liabilities:
OriginalMonthlyDate
Owed tobalancepaymentDue
Car payment: ______
Credit Card:______:
Credit Card:______
Credit Card:______:
Credit Card:______
Other liab:______:
Other liab:______
SOCIAL SECURITY BENEFITS:
Upon my death you should contact the social security office. Their phone number is ______. The amount of benefits you should receive from them is ______
DOCUMENTS:
The deed to our home is located______
And it states that we own it (nature of title) as ______
I feel that the value is approximately $______. The first mortgage balance is $______and the monthly payment is $______. The second mortgage (if applicable) balance is $______and the monthly payment is $______.
The files which pertain to the home such as cost of purchase, improvements, original closing, etc are located ______
Instructions for getting into our personal computer are as follows: ______
We have/do not have a safety deposit box at ______. The contents of the box are______
Our tax records are located______
Our birth certificates are located ______
Our automobiles are in ______name and the titles are located ______.
Our marriage certificate is located ______
SPECIAL INFORMATION:
Children’s Names and AddressesDate of BirthS.S. Number
______
______
______
______
SPECIAL DESIRES FOR THE CHILDREN:
I have the following special desires for the children.
ChildSpecial Desires
1. ______
2. ______
3. ______
4. ______
5. ______
FUNERAL INSTRUCTIONS:
- Who to contact
In the event of my death, please contact the following people as soon as possible:
______
______
______
______
- Grave/burial site
We do/do not have a grave site already purchased for our family. If we do it is:
Location ______
Person to contact ______Phone number ______
- Funeral home
Please contact the following funeral home or homes
Funeral home:______
Person to contact ______Phone number ______
- Disposition of remains
I direct cremation of remains. If so in the following manner.
____No ashes to remain
____Disposition of ashes as follows:______
______
I request burial in the following manner: ______
- Services
I request the following services:
____I wish a memorial service with no casket present.
____I desire a funeral with remains present.
I desire an ___ open casket ___ closed casket.
Church ______
Clergyman ______
Other service participants ______
Special music or hymns ______
Solo’s ______
Special scripture or poems ______
Other instructions ______
Readings to surviving family members. I have written notes to surviving family members to be read at my service. These notes are located ______
- Memorial Gifts
I request that memorial gifts be given to:
Church or organization: ______
Address: ______
Key contact ______Phone number ______