One of the best things you can do for your heirs is to prepare a detailed list of your important personal data. The form that follows is intended to provide an organized structure for you to record important personal data.

Personal History

• Your full legal name:
• Your address:
• Your telephone number:
• Your state of domicile and date of domicile:
• Your home of record:
• Your date of birth:
• Your place of birth:
• Your Social Security number:
• The country of your citizenship, if other than the United States:
• Your marital status: (single, married, divorced, separated, widowed):
• Your spouse's full legal name (including maiden name):
• Your spouse's address:
• Your spouse's Social Security number:
• Your spouse's date of birth:
• Your spouse's place of birth:
• Date of marriage:
• Former spouse(s) full legal names (including maiden name(s)), if applicable:
• Former spouse(s) address:
• Date of marriage to former spouse(s):
• Date of divorce from former spouse(s) and name of court granting the divorce:
• Your children's full legal names (including maiden names):
• Your children's addresses and telephone numbers:
• Your children's date of birth:
• Your father's full legal name:
• Your mother's full legal name (including maiden name):
• Your grandchildren's full legal names (including maiden names):

Military Service (if applicable)

• Your branch of service:
• Your dates of service:
• Your rank:
• Your service number:
• Date of discharge:
• Type of discharge:
• Your service-connected disabilities ( %):
• Your pension and retirement information is located:

Employment

• Your present employer:
• Your present work address:
• Your present work telephone number:
• Your date of employment:
• Your position:
• Your employment benefits (life insurance plans, stock options, pension plans, profit-sharing plans) (Include contact information for each):

• Address of real estate currently owned:
• How the real estate is owned (sole owner, jointly)
• If property is owned jointly, names and addresses of other owners:
• Real estate purchase price:
• Date real estate purchased:
• Current tax assessment value:
• Mortgage or deed of trust held by:
• Current loan amount:
• Location of deeds, deeds of trust, title insurance, title abstracts:
• If real estate is leased, provide name, address, and telephone number of lessee and location of lease

Financial Accounts

• Name of bank or financial institution:
• Account number(s):
• Type of account (checking, savings, certificate of deposit, money market, Individual Retirement Account):
• Current balance:
• Name of owner of account (Provide all joint owners' names and addresses):

Stocks and Bonds

• Investment broker name, address, and telephone number:
• Type of asset (stocks, bonds, mutual fund):
• Account number, certificate number or serial number:
• Purchase price:
• Current value:
• Maturity date, if applicable:
• Location of certificates or bonds:
• Name of owner of accounts or certificates (Provide all joint owners' names and addresses):

Automobiles

• Make, model, and year:
• Location of title:
• Loan amount:
• Name of holder of loan and address:
• Name of owner (Provide all joint owners' names and addresses):

Business Interests (if applicable)

• Type of business (sole proprietorship, partnership, limited liability company, corporation):
• Type and amount of ownership (sole owner, shares, membership interest):
• Estimated value of business or share of ownership interest:
• Name, address, and telephone number of business contacts (CPA, attorney, manager, president):

Titled Assets

• Description of asset (boats, RVs, trailers, etc.):
• Location of asset:
• Location of title to asset:
• Purchase price of asset:
• Current value of asset:
• Name of owner (Provide all joint owners' names and addresses):

Safe-Deposit Boxes

• Location of safe-deposit box:
• Location of key:
• Names and addresses of individuals with signature access to box:

Insurance Policies

• Type of policy (life, health, disability, automobile, homeowners, renters):
• Policy number:
• Name, address, and telephone number of insurance agent:
• Amount of coverage:
• Location of insurance policy:

Funeral/Burial Instructions

• Instructions for burial or cremation:
• Cemetery name and address and lot numbers, if applicable:
• Location of deed to cemetery lot, if applicable:
• Name and address of memorial gifts, if applicable:
• Special wishes for ceremony:
• Provide a copy of any prepaid funeral policy, if applicable.

Tax Returns

• Location of filed tax returns:
• Name, address, and telephone number of individual or company who prepared tax returns:

Will

• Location of original will and any codicils:
• Date of will and any codicils:
• Name, address, and telephone number of attorney who prepared will:
• Name, address, and telephone number of executor:

Trusts

• Location of any trusts:
• Date of trust:
• Name, address, and telephone number of attorney who prepared trust:
• Name, address, and telephone number of trustees:

Financial Power of Attorney

• Name of agent:
• Address and telephone number of attorney-in-fact (agent):
• Location of original power of attorney:

Medical Power of Attorney

• Name of agent:
• Address and telephone number of agent:
• Location of power of attorney:

Living Will

• Location of living will:

Additional Contacts

• Attorney name, address, and telephone number:
• Accountant name, address, and telephone number:
• Doctor name, address, and telephone number:

Important Personal Friends

• The following individuals should be notified of my death:

If you prefer, you can also use this Checklist for Life form to enter your data