Funeral, Cemetery,
Cremation, Burial; Printable Final Arrangements Planning Form #2
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FUNERAL, CEMETERY, CREMATION AND BURIAL PLANNING PAGES [2 of 3]
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MY Special & Financial Information Forms
| MY Special Information | |||
| For Social Security Claims. I have this Information |
Social Security Number | Yes | No |
| Marriage License | Yes | No | |
| Eligible Child's Birth Certificate | Yes | No | |
| W-2's Last Two Years | Yes | No | |
| Widow's proof over 62 | Yes | No | |
| Death Certificate | No | ||
| Special Arrangements I Have Also Made | Yes | No | Contact for Information | Documentation Location, Description & Notes |
| Long Term Care | ___ | ___ | ____________________ | ______________________________ |
| Power Of Attorney | ___ | ___ | ____________________ | ______________________________ |
| Healthcare Power Of Attorney | ___ | ___ | ____________________ | ______________________________ |
| Guardian & Custodian | ___ | ___ | ____________________ | ______________________________ |
| Do Not Resuscitate Directive | ___ | ___ | ____________________ | ______________________________ |
| Living Will | ___ | ___ | ____________________ | ______________________________ |
| Other Arrangements | ___ | ___ | ____________________ | ______________________________ |
MY Financial Information
| My Documents Location | ||||
| Where | Where | |||
| Mortgage | Other Title 1(?) | |||
| Other Mortgage 1(?) | Other Title 2(?) | |||
| Other Mortgage 2(?) | Other Title 2 (?) | |||
| Deed or Notes 1 (?) | Safety Deposit Box | |||
| Deed or Notes 2(?) | Will | |||
| Deed or Notes 3(?) | Children's Birth Certificates | |||
| Income Tax Returns | ||||
| Banks, Investments | ||||
| Account/Item Type | Location | Account Number | Memo/Description | |
| 1) | __________________ | _______________ | ________________ | _______________________ |
| 2) | __________________ | _______________ | ________________ | _______________________ |
| 3) | __________________ | _______________ | ________________ | _______________________ |
| 4) | __________________ | _______________ | ________________ | _______________________ |
| 5) | __________________ | _______________ | ________________ | _______________________ |
| 6) | __________________ | _______________ | ________________ | _______________________ |
| 7) | __________________ | _______________ | ________________ | _______________________ |
| 8) | __________________ | _______________ | ________________ | _______________________ |
| 9) | __________________ | _______________ | ________________ | _______________________ |
| 10) | __________________ | _______________ | ________________ | _______________________ |
| Other Financial Matters | ||||
| Account Number if Applicable | Description/Disposition | |||
| IRA | Yes | No | ____________________________ | __________________________ |
| Roth IRA | Yes | No | ____________________________ | __________________________ |
| 401K Plan | Yes | No | ____________________________ | __________________________ |
| Keogh | Yes | No | ____________________________ | __________________________ |
| Loans I Hold | Yes | No | ____________________________ | __________________________ |
| Liens I Hold | Yes | No | ____________________________ | __________________________ |
| Notes I Hold | Yes | No | ____________________________ | __________________________ |
| Credit Card #1 | Yes | No | ____________________________ | __________________________ |
| Credit Card #2 | Yes | No | ____________________________ | __________________________ |
| Credit Card #3 | Yes | No | ____________________________ | __________________________ |
| Personal Property, Effects & Valuables | |||
| Location | Wish to Go To: | Special Instructions | |
| 1) | _____________ | ______________ | ____________________ |
| 2) | _____________ | ______________ | ____________________ |
| 3) | _____________ | ______________ | ____________________ |
| 4) | _____________ | ______________ | ____________________ |
| 5) | _____________ | ______________ | ____________________ |
| 6) | _____________ | ______________ | ____________________ |
| 7) | _____________ | ______________ | ____________________ |
| 8) | _____________ | ______________ | ____________________ |
| 9) | _____________ | ______________ | ____________________ |
| 10) | _____________ | ______________ | ____________________ |
| MY Insurance Information | |||
| Name of Company, Union, Organization, etc., paying MY death benefit | Type of Policy | Location of Policy | Policy Number |
| 1) | ______________ | ____________ | ________________ |
| 2) | ______________ | ____________ | ________________ |
| 3) | ______________ | ____________ | ________________ |
| 4) | ______________ | ____________ | ________________ |
| 5) | ______________ | ____________ | ________________ |
| Long Term Health Care | ______________ | ____________ | ________________ |
| Home Owner | ______________ | ____________ | ________________ |
| Automotive | ______________ | ____________ | ________________ |
| Accident | ______________ | ____________ | ________________ |
| Group | ______________ | ____________ | ________________ |
| Membership | ______________ | ____________ | ________________ |
| Union | ______________ | ____________ | ________________ |
| ADDITIONAL INSURANCE INFORMATION
|
|||
| MY Wills & Trusts | ||||
| Location of Documentation | Description of Type & Contact for Information | |||
| MY Will | Yes | No | ________________________ | _____________________ |
| My Living Will | Yes | No | ________________________ | _____________________ |
| MY Trust | Yes | No | ________________________ | _____________________ |
| Other #1 | Yes | No | ________________________ | _____________________ |
| Other #2 | Yes | No | ________________________ | _____________________ |
| Other #3 | Yes | No | ________________________ | _____________________ |
Click for: [WORK FORMS PAGE THREE-MY Burial/Mausoleum/Cremation Arrangements]
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