This document is provided compliments of Russell, Krafft & Gruber, LLP, a general practice law firm serving Lancaster County and the surrounding communities. This document is published as a service to clients and friends of the firm. It should not be used as a substitute for legal advice. If you have specific questions regarding Estate Planning or other legal matters, please contact us at one of the offices listed below.
Lancaster |
Hempfield Center, Suite 300 |
|
930 Red Rose Court |
|
|
Lancaster, PA 17601 |
|
|
(717) 293-9293 |
|
Willow Street |
214-B Willow Valley Lakes Drive |
|
Willow Street, PA 17584 |
|
|
(717) 464-2223 |
|
Ephrata |
108 West Main Street |
|
Ephrata, PA 17522 |
|
|
(717) 733-9500 |
|
Name _________________________________________________ Social Security No. _______ -______-_______
Spouse ________________________________________________
Social Security No. _______ -______-_______
Attorney |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Accountant |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Stockbroker |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Financial Planner |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Insurance Agent |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Funeral Director |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Other |
__________________________________________________ |
| __________________________________________________ | |
| __________________________________________________ | |
|
Phone: ______________________________ |
Bank Name Account Names or Numbers
____________________________________ ____________________________
____________________________________ ____________________________
____________________________________ ____________________________
____________________________________ ____________________________
____________________________________ ____________________________
____________________________________ ____________________________
My valuable papers and assets are stored in these locations:
A. Residence (Address plus where to look)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
B. Safe Deposit Box
_________________________________________________
(Bank)
_________________________________________________
(Address)
_________________________________________________
Box number ______________________________________
Key Location ____________________________________
C. Other Locations
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
|
ITEM |
LOCATION |
||
|
Residence |
Safe Deposit Box |
Other |
|
|
Will (original) |
________ | ________ | ____________________________________ |
|
Memorandum |
________ | ________ | ____________________________________ |
|
Accompanying will (if any) |
________ | ________ | ____________________________________ |
|
Living Will |
________ | ________ | ____________________________________ |
|
Powers of Attorney |
________ | ________ | ____________________________________ |
|
Memorial instructions |
________ | ________ | ____________________________________ |
|
Cemetery plot deed |
________ | ________ | ____________________________________ |
|
Trust agreements |
________ | ________ | ____________________________________ |
|
Safe combination |
________ | ________ | ____________________________________ |
|
Retirement Home |
________ | ________ | ____________________________________ |
|
Agreement |
________ | ________ | ____________________________________ |
|
Life insurance, Individual |
________ |
________ |
____________________________________ |
|
Other death benefits |
________ |
________ |
____________________________________ |
|
Health insurance policy |
________ | ________ | ____________________________________ |
|
Homeowners insurance policy |
________ | ________ | ____________________________________ |
|
Auto insurance policy |
________ | ________ | ____________________________________ |
|
Other insurance policy |
________ | ________ | ____________________________________ |
|
Employment Contract |
________ | ________ | ____________________________________ |
|
Partnership Agreement |
________ | ________ | ____________________________________ |
|
Corporation Documents |
________ | ________ | ____________________________________ |
|
Deeds to Real Estate |
________ | ________ | ____________________________________ |
|
Notes & Loan |
________ | ________ | ____________________________________ |
|
Agreements |
________ | ________ | ____________________________________ |
|
Vehicle Titles |
________ | ________ | ____________________________________ |
|
Keogh or IRA plans |
________ | ________ | ____________________________________ |
|
Pension Plans |
________ | ________ | ____________________________________ |
|
Investment Securities |
________ | ________ | ____________________________________ |
|
Stock Certificates |
________ | ________ | ____________________________________ |
|
Brokerage Account |
________ | ________ | ____________________________________ |
|
Annuity contracts |
________ | ________ | ____________________________________ |
|
Tax Returns |
________ | ________ | ____________________________________ |
|
Other |
|||
|
_______________________ |
________ | ________ | ____________________________________ |
|
_______________________ |
________ | ________ | ____________________________________ |
|
_______________________ |
________ | ________ | ____________________________________ |
Other
_______________________ ________ ________ ____________________________________
_______________________ ________ ________ ____________________________________
_______________________ ________ ________ ____________________________________
One of the most important things that needs to be done at the time of death is to notify family and friends. You may wish to complete this list to help your survivors notify the proper parties.
Name Address Phone Number
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
_______________________________ ____________________________________ ________________________
Date prepared _______________________________________________
Copies given to ______________________________________________
______________________________________________
______________________________________________
zNOTES: