Post on 15-Oct-2020
transcript
Personal Information Guide
Organizing and maintaining family and financial records can be a challenge. However daunting it may seem, having this information readily accessible could be vital, especially in an emergency involving a loved one.
This Personal Information Guide is designed to help you gather all of your personal and financial information into one document. Using this guide can help:
• locate information in the future
• reduce confusion and stress in the event of a family emergency
• decrease the likelihood of unclaimed assets for your heirs
This guide is designed for informational use and is not legally binding. We recommend that you maintain all copies in a secure location and update your personal information regularly.
Private Wealth Management Solutions
Table of Contents
I. Personal Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
II. Spouse/Domestic Partner Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
III. Children Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
IV. Pet Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
V. Employee Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
VI. Military Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
VII. Safe Deposit Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
VIII. Personal Safe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
IX. Rental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X. Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
XI. Financial/Investment Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
XII. Bank Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
XIII. Loans and Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
XIV. Online Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
XV. Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
XVI. Emergency Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
XVII. Will, Trust, Estate and Power of Attorney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
XVIII. Funeral Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
XIX. Additional Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
I. Personal Information
_________________________________________________________Full Legal Name
_________________________________________________________Maiden/Former Name
_____________________________________________________________________________________________________________________Address
___________________________Home Phone
___________________________Cell Phone
_________________________________________________________E-mail Address
_________________________________________________________Social Security No.
_________________________________________________________Birth Date
_________________________________________________________Driver’s License No.
_________________________________________________________Passport No.
_________________________________________________________Primary Care Physician
_________________________________________________________Phone
_________________________________________________________ Health Insurance Plan
_________________________________________________________ID No.
_________________________________________________________Blood Type
_________________________________________________________Allergies
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________Medications and Dosage
_________________________________________________________Dentist
_________________________________________________________Phone
_________________________________________________________Current Employer
_________________________________________________________Work Phone
_____________________________________________________________________________________________________________________Employer Address
_________________________________________________________HR Contact
_________________________________________________________Phone
_________________________________________________________Supervisor
_________________________________________________________Phone
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II. Spouse/Domestic Partner Information
_________________________________________________________Full Legal Name
_________________________________________________________Maiden/Former Name
_____________________________________________________________________________________________________________________Address
___________________________Home Phone
___________________________Cell Phone
_________________________________________________________E-mail Address
_________________________________________________________Social Security No.
_________________________________________________________Birth Date
_________________________________________________________Driver’s License No.
_________________________________________________________Passport No.
_________________________________________________________Primary Care Physician
_________________________________________________________Phone
_________________________________________________________ Health Insurance Plan
_________________________________________________________ID No.
_________________________________________________________Blood Type
_________________________________________________________Allergies
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________Medications and Dosage
_________________________________________________________Dentist
_________________________________________________________Phone
_________________________________________________________Current Employer
_________________________________________________________Work Phone
_____________________________________________________________________________________________________________________Employer Address
_________________________________________________________HR Contact
_________________________________________________________Phone
_________________________________________________________Supervisor
_________________________________________________________Phone
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III. Children Information
_________________________________________________________Full Legal Name
_____________________________________________________________Child’s Phone
___________________________Social Security No.
___________________________Birth Date
_____________________________Driver’s License No.
_____________________________Passport No.
_________________________________________________________School Name
_____________________________________________________________School Phone
___________________________Teacher
___________________________Grade
_____________________________________________________________Allergies
___________________________Blood Type
___________________________________________________________________________________________Medications and Dosage
_________________________________________________________Full Legal Name
_____________________________________________________________Child’s Phone
___________________________Social Security No.
___________________________Birth Date
_____________________________Driver’s License No.
_____________________________Passport No.
_________________________________________________________School Name
_____________________________________________________________School Phone
___________________________Teacher
___________________________Grade
_____________________________________________________________Allergies
___________________________Blood Type
___________________________________________________________________________________________Medications and Dosage
_________________________________________________________Full Legal Name
_____________________________________________________________Child’s Phone
___________________________Social Security No.
___________________________Birth Date
_____________________________Driver’s License No.
_____________________________Passport No.
_________________________________________________________School Name
_____________________________________________________________School Phone
___________________________Teacher
___________________________Grade
_____________________________________________________________Allergies
___________________________Blood Type
___________________________________________________________________________________________Medications and Dosage
_________________________________________________________Full Legal Name
_____________________________________________________________Child’s Phone
___________________________Social Security No.
___________________________Birth Date
_____________________________Driver’s License No.
_____________________________Passport No.
_________________________________________________________School Name
_____________________________________________________________School Phone
___________________________Teacher
___________________________Grade
_____________________________________________________________Allergies
___________________________Blood Type
___________________________________________________________________________________________Medications and Dosage
5
_________________________________________________________Pediatrician
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Dentist
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Specialist
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Day Care Provider
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
IV. Pet Information
_____________________________________________________________________________________________________________________Pet Name
_____________________________________________________________________________________________________________________Special Considerations
_____________________________________________________________________________________________________________________Pet Name
_____________________________________________________________________________________________________________________Special Considerations
_____________________________________________________________________________________________________________________Pet Name
_____________________________________________________________________________________________________________________Special Considerations
_________________________________________________________Veterinarian
_________________________________________________________Phone
Other important information about self, spouse, children or pets
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
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V. Employee BenefitsNote: Remember to include former employers from whom you may still be eligible to receive benefits.
_________________________________________________________Name
_________________________________________________________Employer
_________________________________________________________Employer Phone
_________________________________________________________Benefit Type
_________________________________________________________Name
_________________________________________________________Employer
_________________________________________________________Employer Phone
_________________________________________________________Benefit Type
_________________________________________________________Name
_________________________________________________________Employer
_________________________________________________________Employer Phone
_________________________________________________________Benefit Type
VI. Military Records
_________________________________________________________Record For (Name)
_________________________________________________________Type of Record
_________________________________________________________Record For (Name)
_________________________________________________________Type of Record
VII. Safe Deposit Box
_________________________________________________________Registered in the name of
_________________________________________________________Name of Institution
_________________________________________________________Location of Keys
_________________________________________________________Box No.
VIII. Personal Safe
_____________________________________________________________________________________________________________________Location
_____________________________________________________________________________________________________________________Combination
IX. Rental Post office box, storage unit, etc.
_________________________________________________________Renter
_________________________________________________________Phone
_________________________________________________________Contact Name
_________________________________________________________Locations of Records
Other important employment, military service, safe deposit boxes or rental information
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________7
X. InsuranceLife & Health
_________________________________________________________Insurance Company Name
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Life Insurance Policy No.
_________________________________________________________Disability Policy No.
_________________________________________________________Long-Term Care Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Life Insurance Policy No.
_________________________________________________________Disability Policy No.
_________________________________________________________Long-Term Care Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Life Insurance Policy No.
_________________________________________________________Disability Policy No.
_________________________________________________________Long-Term Care Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Life Insurance Policy No.
_________________________________________________________Disability Policy No.
_________________________________________________________Long-Term Care Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Life Insurance Policy No.
_________________________________________________________Disability Policy No.
_________________________________________________________Long-Term Care Policy No.
_________________________________________________________Other 8
Property & Casualty
_________________________________________________________Insurance Company Name
_________________________________________________________Agent
_________________________________________________________Address
_________________________________________________________Phone
_________________________________________________________Homeowner Policy No.
_________________________________________________________Auto Policy No.
_________________________________________________________Umbrella Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Agent
_________________________________________________________Address
_________________________________________________________Phone
_________________________________________________________Homeowner Policy No.
_________________________________________________________Auto Policy No.
_________________________________________________________Umbrella Policy No.
_________________________________________________________Other
_________________________________________________________Insurance Company Name
_________________________________________________________Agent
_________________________________________________________Address
_________________________________________________________Phone
_________________________________________________________Homeowner Policy No.
_________________________________________________________Auto Policy No.
_________________________________________________________Umbrella Policy No.
_________________________________________________________Other
Other important insurance information
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
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XI. Financial/Investment Information
_________________________________________________________Financial Professional Name
_________________________________________________________Phone
_________________________________________________________Firm Name
_________________________________________________________Address
_________________________________________________________Account 1
_________________________________________________________Account 2
_________________________________________________________Account 3
_________________________________________________________Account 4
_________________________________________________________Financial Professional Name
_________________________________________________________Phone
_________________________________________________________Firm Name
_________________________________________________________Address
_________________________________________________________Account 1
_________________________________________________________Account 2
_________________________________________________________Account 3
_________________________________________________________Account 4
Other Professionals
_________________________________________________________Attorney Name
_________________________________________________________Phone
_________________________________________________________Firm Name
_________________________________________________________Address
_________________________________________________________Tax Professional Name
_________________________________________________________Phone
_________________________________________________________Firm Name
_________________________________________________________Address
XII. Bank Information
_________________________________________________________Bank Name
_________________________________________________________Bank Name
_________________________________________________________Address
_________________________________________________________Address
_________________________________________________________Phone
_________________________________________________________Phone
_________________________________________________________Checking Account No.
_________________________________________________________Checking Account No.
_________________________________________________________Savings Account No.
_________________________________________________________Savings Account No.
_________________________________________________________Certificate of Deposit No.
_________________________________________________________Certificate of Deposit No.
_________________________________________________________Bank Name
_________________________________________________________Bank Name
_________________________________________________________Address
_________________________________________________________Address
_________________________________________________________Phone
_________________________________________________________Phone
_________________________________________________________Checking Account No.
_________________________________________________________Checking Account No.
_________________________________________________________Savings Account No.
_________________________________________________________Savings Account No.
_________________________________________________________Certificate of Deposit No.
_________________________________________________________Certificate of Deposit No.
Dependent Accounts
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
_________________________________________________________Name of Dependent
___________________________________________________________Type (Savings, 529s, etc.)
Other important financial or bank information
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
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XIII. Loans and Credit
_________________________________________________________Auto Loan Holder
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Auto Loan Holder
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Miscellaneous Loan
_________________________________________________________Phone
_____________________________________________________________________________________________________________________Address
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Credit Card
_________________________________________________________Name as It Appears on Card
_________________________________________________________Billing Address
_________________________________________________________Phone
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Credit Card
_________________________________________________________Name as It Appears on Card
_________________________________________________________Billing Address
_________________________________________________________Phone
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Credit Card
_________________________________________________________Name as It Appears on Card
_________________________________________________________Billing Address
_________________________________________________________Phone
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Credit Card
_________________________________________________________Name as It Appears on Card
_________________________________________________________Billing Address
_________________________________________________________Phone
_________________________________________________________Account No.
_________________________________________________________Interest Rate
_________________________________________________________Credit Card
_________________________________________________________Name as It Appears on Card
_________________________________________________________Billing Address
_________________________________________________________Phone
_________________________________________________________Account No.
_________________________________________________________Interest Rate
XIV. Online Accounts
_________________________________________________________Account Name
_________________________________________________________Login
_________________________________________________________Account Name
_________________________________________________________Login
_________________________________________________________Account Name
_________________________________________________________Login
Other important loans and credit information
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
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XV. Real Estate
Primary Residence
___________________________________________________________Address
___________________________________________________________Phone
___________________________________________________________Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Second Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Home Equity Loan
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Deed
___________________________________________________________Location of Records
Secondary Residence
___________________________________________________________Address
___________________________________________________________Phone
___________________________________________________________Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Second Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Home Equity Loan
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Deed
___________________________________________________________Location of Records
Rental
___________________________________________________________Address
___________________________________________________________Phone
___________________________________________________________Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Second Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Home Equity Loan
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Deed
___________________________________________________________Location of Records
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Land/Farm
___________________________________________________________Address
___________________________________________________________Phone
___________________________________________________________Mortgage
____________________________Account No.
____________________________Interest Rate
___________________________________________________________Deed
___________________________________________________________Location of Records
Time Share
________________________________________________________________________________________________________________________Address
___________________________________________________________Phone
___________________________________________________________Location of Records
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XVI. Emergency Information In case of emergency: Dial 9-1-1
Emergency Contact List
____________________________Name
____________________________Relationship
____________________________Home Phone
____________________________Cell Phone
____________________________Name
____________________________Relationship
____________________________Home Phone
____________________________Cell Phone
____________________________Name
____________________________Relationship
____________________________Home Phone
____________________________Cell Phone
Non-Emergency Numbers
_____________________________________________________________________________________________________________________Local Police
_____________________________________________________________________________________________________________________Local Fire Department
_____________________________________________________________________________________________________________________Local Hospital
Household Emergency
__________________________________________________________Plumber
__________________________________________________________Phone
__________________________________________________________Electrician
__________________________________________________________Phone
__________________________________________________________Heating Provider
__________________________________________________________Phone
__________________________________________________________Telephone Company
__________________________________________________________Phone
__________________________________________________________Electric Company
__________________________________________________________Phone
__________________________________________________________Cable Company
__________________________________________________________Phone
__________________________________________________________Town Hall
__________________________________________________________Phone
__________________________________________________________AAA/Towing
__________________________________________________________Phone
__________________________________________________________Other
__________________________________________________________Phone
16
Nearest Neighbors
__________________________________________________________Name
__________________________________________________________Phone
__________________________________________________________Name
__________________________________________________________Phone
__________________________________________________________Name
__________________________________________________________Phone
Other important emergency information
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
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XVII. Will, Trust, Estate and Power of Attorney
_________________________________________________________Last Will and Testament For
_________________________________________________________Dated
_________________________________________________________Executor or Personal Representative
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Living Will and Testament
__________________________________________________________Last Will and Testament For
_________________________________________________________Dated
_________________________________________________________Executor or Personal Representative
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Living Will and Testament
__________________________________________________________Revocable (Living) Trust For
_________________________________________________________Dated
_________________________________________________________Current Trustee
_________________________________________________________Successor Trustees
______________________________________________________________________________________________________________________Location of Trust
__________________________________________________________Revocable (Living) Trust For
_________________________________________________________Dated
_________________________________________________________Current Trustee
_________________________________________________________Successor Trustees
______________________________________________________________________________________________________________________Location of Trust
__________________________________________________________Durable Power of Attorney (Financial) For
_________________________________________________________Dated
_________________________________________________________Agent or Proxy
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Durable Power of Attorney (Financial)
__________________________________________________________Durable Power of Attorney (Financial) For
_________________________________________________________Dated
_________________________________________________________Agent or Proxy
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Durable Power of Attorney (Financial)
18
_________________________________________________________Durable Power of Attorney (Medical) For
_________________________________________________________Dated
_________________________________________________________Agent or Proxy
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Durable Power of Attorney (Medical)
__________________________________________________________Durable Power of Attorney (Medical) For
_________________________________________________________Dated
_________________________________________________________Agent or Proxy
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Durable Power of Attorney (Medical)
__________________________________________________________Living Will (Medical) For
_________________________________________________________Dated
_________________________________________________________Location
_________________________________________________________Attorney
__________________________________________________________Living Will (Medical) For
_________________________________________________________Dated
_________________________________________________________Location
_________________________________________________________Attorney
__________________________________________________________Irrevocable Life Insurance Trust For
_________________________________________________________Dated
_________________________________________________________Trustee
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Irrevocable Life Insurance Trust
__________________________________________________________Irrevocable Life Insurance Trust For
_________________________________________________________Dated
_________________________________________________________Trustee
_________________________________________________________Attorney
______________________________________________________________________________________________________________________Location of Irrevocable Life Insurance Trust
19
XVIII. Funeral Arrangements Disposal of my remains
I have made prior arrangements for:
____ anatomical gift donation ____ bequest (or gift) of my body to medical school
Legal documents detailing these wishes are located at:
_____________________________________________________________________________________________________________________
I ____ do or ____ do not wish to be:
____ cremated ____ directly cremated
Standard cremation usually involves viewing in a rented casket followed by a traditional service. Direct cremation refers to immediate cremation, no viewing and may be followed by a traditional service.
I ____ do or ____ do not wish to be embalmed.
I am a member of the following organization (military veterans, Masons, etc.) and desire an organizational service.
_____________________________________________________________________________________________________________________
I desire that services be held at:
____ funeral home ____ church ____ graveside ____ other _________________
I request that memorial contributions be made to:
_____________________________________________________________________________________________________________________
I ____ have or ____ have not made funeral prearrangements with the funeral home.
I ____ have or ____ have not made any prepayment of funeral expenses. I have made prepayment as follows:
_____________________________________________________________________________________________________________________
I own burial property.
____ yes ____ no
I have purchased a funeral/burial plan.
____ yes ____ no
If yes, the following is the location of the deed, title or plan
______________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________Name of cemetery, mausoleum or garden
____________________________ Section
____________________________ Tier
____________________________ Lot
____________________________ Spaces
Title of property or plan in the name of:
_____________________________________________________________________________________________________________________
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XIX. Additional Notes
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©2010 Robert W. Baird & Co. Incorporated. Robert W. Baird & Co. 777 East Wisconsin Avenue, Milwaukee, WI 53202. 800-RW-BAIRD. rwbaird.com. Member SIPC. MC-30478.
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