End-of-Life Planning Checklist:

Harold Robert Meyer and The ADD Resource Center                             04/01/2025

Your last update: / /202x

Personal Information

□ Full legal name: ___________________________________________________
□ Date of birth: ______________________________________________________
□ Place of birth: ______________________________________________________
□ Social Security number: _____________________________________________
□ Legal residence: ____________________________________________________
□ Phone number: _____________________________________________________
□ Email address: _____________________________________________________
□ Religion: __________________________________________________________
□ Clergy contact: _____________________________________________________

Family Information

□ Spouse/Partner’s name: ______________________________________________
□ Children’s names and contact information:

□ Parents’ names (if living): ____________________________________________
□ Siblings’ names and contact information:

Important Contacts

□ Primary care physician: ______________________________________________
□ Specialists: ________________________________________________________
□ Attorney: __________________________________________________________
□ Financial advisor: ___________________________________________________
□ Accountant: ________________________________________________________
□ Insurance agent: ____________________________________________________
□ Employer: _________________________________________________________
□ Close friends to be notified:

□ Business associates to be notified:

Legal Documents

□ 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: _____________________________________

Financial Information

□ 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 and Recurring Charges

□ Credit cards to be canceled (issuer, card number, expiration date, cancellation method):

□ Subscriptions and recurring charges to cancel:

Insurance Policies

□ Life insurance (company, policy number, beneficiary):

□ Health insurance: ___________________________________________________
□ Long-term care insurance: ____________________________________________
□ Homeowners/Renters insurance: _______________________________________
□ Auto insurance: _____________________________________________________

Digital Assets

□ Email accounts and passwords: ________________________________________
□ Social media accounts and passwords: __________________________________
□ Online banking login information: ______________________________________
□ Subscription services: ________________________________________________
□ Digital storage accounts: _____________________________________________
□ Instructions for handling digital assets: _________________________________

Property

□ Home deed location: _________________________________________________
□ Mortgage information: _______________________________________________
□ Vehicle titles and registration: _________________________________________
□ Other valuable property (art, jewelry, collectibles): ________________________

End-of-Life Wishes

□ Funeral preferences: _________________________________________________
□ Burial or cremation: _________________________________________________
□ Preferred funeral home: ______________________________________________
□ Cemetery plot deed location: __________________________________________
□ Obituary preferences: ________________________________________________
□ Organ donation wishes: ______________________________________________

Final Arrangements

□ Preferred officiant: __________________________________________________
□ Music selections: ____________________________________________________
□ Readings or poems: _________________________________________________
□ Pallbearers: ________________________________________________________
□ Charity for donations in lieu of flowers: _________________________________

Distribution of Personal Effects

□ Specific bequests not covered in will: ___________________________________
□ Sentimental items and intended recipients:

Additional Instructions

□ 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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