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

3

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

4

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

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

6

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

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

9

10

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

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

11

12

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

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

13

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

14

Land/Farm

___________________________________________________________Address

___________________________________________________________Phone

___________________________________________________________Mortgage

____________________________Account No.

____________________________Interest Rate

___________________________________________________________Deed

___________________________________________________________Location of Records

Time Share

________________________________________________________________________________________________________________________Address

___________________________________________________________Phone

___________________________________________________________Location of Records

15

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

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

17

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:

_____________________________________________________________________________________________________________________

20

XIX. Additional Notes

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

21

©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.

#1431