Your last update: / /202x
□ Full legal name: ___________________________________________________
□ Date of birth: ______________________________________________________
□ Place of birth: ______________________________________________________
□ Social Security number: _____________________________________________
□ Legal residence: ____________________________________________________
□ Phone number: _____________________________________________________
□ Email address: _____________________________________________________
□ Religion: __________________________________________________________
□ Clergy contact: _____________________________________________________
□ Spouse/Partner’s name: ______________________________________________
□ Children’s names and contact information:
□ Parents’ names (if living): ____________________________________________
□ Siblings’ names and contact information:
□ Primary care physician: ______________________________________________
□ Specialists: ________________________________________________________
□ Attorney: __________________________________________________________
□ Financial advisor: ___________________________________________________
□ Accountant: ________________________________________________________
□ Insurance agent: ____________________________________________________
□ Employer: _________________________________________________________
□ Close friends to be notified:
□ Business associates to be notified:
□ Will location: ______________________________________________________
□ Living will location: _________________________________________________
□ Power of attorney (financial) location: __________________________________
□ Power of attorney (healthcare) location: ________________________________
□ Trust documents location: ____________________________________________
□ Birth certificate location: _____________________________________________
□ Marriage certificate location: __________________________________________
□ Divorce papers location: _____________________________________________
□ Military discharge papers location: _____________________________________
□ Bank accounts (include bank name, account type, and account number):
□ Investment accounts: ________________________________________________
□ Retirement accounts (401(k), IRA, pension): _____________________________
□ Safe deposit box location and key: _____________________________________
□ Loans and debts (creditor, account number, payment details):
□ Tax returns location: ________________________________________________
□ Credit cards to be canceled (issuer, card number, expiration date, cancellation method):
□ Subscriptions and recurring charges to cancel:
□ Life insurance (company, policy number, beneficiary):
□ Health insurance: ___________________________________________________
□ Long-term care insurance: ____________________________________________
□ Homeowners/Renters insurance: _______________________________________
□ Auto insurance: _____________________________________________________
□ Email accounts and passwords: ________________________________________
□ Social media accounts and passwords: __________________________________
□ Online banking login information: ______________________________________
□ Subscription services: ________________________________________________
□ Digital storage accounts: _____________________________________________
□ Instructions for handling digital assets: _________________________________
□ Home deed location: _________________________________________________
□ Mortgage information: _______________________________________________
□ Vehicle titles and registration: _________________________________________
□ Other valuable property (art, jewelry, collectibles): ________________________
□ Funeral preferences: _________________________________________________
□ Burial or cremation: _________________________________________________
□ Preferred funeral home: ______________________________________________
□ Cemetery plot deed location: __________________________________________
□ Obituary preferences: ________________________________________________
□ Organ donation wishes: ______________________________________________
□ Preferred officiant: __________________________________________________
□ Music selections: ____________________________________________________
□ Readings or poems: _________________________________________________
□ Pallbearers: ________________________________________________________
□ Charity for donations in lieu of flowers: _________________________________
□ Specific bequests not covered in will: ___________________________________
□ Sentimental items and intended recipients:
□ Care instructions for pets: ____________________________________________
□ Business succession plans: ___________________________________________
□ Special messages for loved ones: ______________________________________
Remember to keep this information secure and inform a trusted individual about its location. Regularly review and update the information to ensure it remains current.
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