Important papers worksheet

PERSONAL RECORDS of
A RESIDENT OF THE
STATE OF MICHIGAN 

Your name _______________________________________________________________

Address _________________________________________________________________

________________________________________________________________________

Telephone no. ____________________________________________________________

Date completed ___________________________________________________________

 

Where Important Papers May Be Found

YOUR WILL

Do you have a will? _______________________________________________________________

My will is kept ___________________________________________________________________

Personal representative ____________________________________________________________

Address ________________________________________________________________________

_______________________________________________________________________________

Lawyer ________________________________________________________________________

Address ________________________________________________________________________

_______________________________________________________________________________

Date of will _____________________________________________________________________

The date is important. If your will is OLD, you may also wish to review it in the light of changed circumstances such as: marriage; divorce; change in state or federal law; change of residence; unavailability of witnesses; or death, age, or failing powers of the person named as personal representative.

REMEMBER: If you do not have a will, your estate will be distributed as provided by stated law. Its formula for distribution may not be the same as you would want. Your wishes and your family’s special needs can best be satisfied if you make a will.

REAL ESTATE

Do you own real estate? ________________Home ________________Other________________

For each piece of real estate you own:

Real Estate #1

Is title to the property in your name alone or in joint names? _______________________

Is there a mortgage on the property? __________________________________________

Who holds the mortgage? __________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

 

The deed, a copy of the mortgage, survey, title insurance policy, and closing documents are kept

 

_______________________________________________________________________

 

Real Estate #1 (Continued)

Real estate tax receipts are kept _____________________________________________

Do you have fire insurance? ________________________________________________

Do you have liability insurance? _____________________________________________

Policies are kept __________________________________________________________

For advice as to keeping or selling the property, consult ___________________________

Address _________________________________________________________________

________________________________________________________________________

 

Real Estate #2

Is title to the property in your name alone or in joint names? _______________________

Is there a mortgage on the property? __________________________________________

Who holds the mortgage? __________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

 

The deed, a copy of the mortgage, survey, title insurance policy, and closing documents are kept

_____________________________________________________________________

Real estate tax receipts are kept _____________________________________________

Do you have fire insurance? ________________________________________________

Do you have liability insurance? _____________________________________________

Policies are kept __________________________________________________________

For advice as to keeping or selling the property, consult ___________________________

Address _________________________________________________________________

________________________________________________________________________

Real Estate #3

Is title to the property in your name alone or in joint names? _______________________

Is there a mortgage on the property? __________________________________________

Who holds the mortgage? __________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

The deed, a copy of the mortgage, survey, title insurance policy, and closing documents are kept

_______________________________________________________________________

Real estate tax receipts are kept _____________________________________________

Do you have fire insurance? ________________________________________________

Do you have liability insurance? _____________________________________________

Policies are kept __________________________________________________________

For advice as to keeping or selling the property, consult ___________________________

Address _________________________________________________________________

________________________________________________________________________

Additional notes

_______________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

LIFE INSURANCE

Do you have insurance? ____________________________________________________

Company _______________________ Policy No. _______________________________

Is the life insurance in trust? _________________________________________________

Trustee __________________________________________________________________

Address _________________________________________________________________

________________________________________________________________________

Who is the beneficiary? ____________________________________________________

Policies are kept __________________________________________________________

Any unpaid loans secured by policies? _________________________________________

Who is the lender? _________________________________________________________

Insurance advisor __________________________________________________________

Address __________________________________________________________________

_________________________________________________________________________

MILITARY, FRATERNAL OR COMPANY INSURANCE

Do you have military, fraternal, or company insurance? ____________________________

Company _________________________ Policy No. ______________________________

Who is the beneficiary? _____________________________________________________

Is the life insurance in trust? _________________________________________________

Address _________________________________________________________________

________________________________________________________________________

Policies are kept __________________________________________________________

Any unpaid loans secured by policies? ________________________________________

Who is the leader? ________________________________________________________

Insurance advisor _________________________________________________________

Address _________________________________________________________________

________________________________________________________________________

 

OTHER PERSONAL INSURANCE – Do you have:

Health and accident insurance? _____________________________________________________

Company _______________________________________________________________

Policy No. ______________________________________________________________

Hospitalization insurance? _________________________________________________________

Company _______________________________________________________________

Policy No. ______________________________________________________________

Insurance for medical and surgical expenses? __________________________________________

Company _______________________________________________________________

Policies are kept __________________________________________________________

 

SOCIAL SECURITY

Social Security No. _______________________________________________________

Card is kept _____________________________________________________________

Employment record is kept _________________________________________________

PENSION AND RETIREMENT INFORMATION

Do you have a pension or other retirement program? _____________________________

No. __________________ Is there a survivor benefit? ____________________________

Contact _________________________________________________________________

Address ________________________________________________________________

FAMILY RECORDS

Born in _________________________________________________________________

Date ____________________________________________________________________

Married in _______________________________________________________________

Date ____________________________________________________________________

When are birth certificates (or other proof of dates of birth) of members of family, marriage certificates, any naturalization papers, or discharge papers and other data as to military service?

________________________________________________________________________

________________________________________________________________________

BANK RECORDS

Do you have a checking account(s)? __________________________________________

Where is/are your checking account(s)? _______________________________________

Bank ___________________________________________________________

Address _________________________________________________________

Account No. _____________________________________________________

Is it in your name or in joint names? __________________________________

Do you have a savings account(s)? __________________________________________

Where is/are your savings account(s)? ________________________________

Bank ___________________________________________________________

Address _________________________________________________________

Account No. _____________________________________________________

Is it in your name or in joint names? __________________________________

Do you have a certificate of deposit? _________________________________________

Where is your certificate of deposit? __________________________________

Bank ___________________________________________________________

Address _________________________________________________________

Account No. _____________________________________________________

Is it in your name or in joint names? __________________________________

Bank books and canceled checked are kept ____________________________________

Do you have an IRA? _____________________________________________________

IRA account location ______________________________________________

Do you have a safe deposit box? ____________________________________________

Bank ___________________________________________________________

Address _________________________________________________________

Is it jointly held? __________________ Key is kept ______________________

U.S. SAVINGS BONDS

Do you have any U.S. savings bonds? _________________________________________

Where are they? __________________________________________________________

In whose names are they registered? __________________________________________

I have designated a co-owner or beneficiary, whose name is listed below:

Yes ______ Name ____________________________________________ No ______

Do you have a list of bonds, by serial number and denomination? ___________________

Location of this list ________________________________________________________

OTHER BONDS AND CORPORATE STOCKS

Do you own any other bonds or any preferred or common stocks?

Sole owner ____________________________ Joint owner ________________________

Where are they? __________________________________________________________

Broker __________________________________________________________________

Address _________________________________________________________________

________________________________________________________________________

List and records of purchases are kept _________________________________________

OTHER PERSONAL PROPERTY

In whose name is your motor vehicle(s) titled under? _____________________________

Vehicle and insurance policy are kept _________________________________________

Are household furnishings insured? ___________________________________________

Household furnishings insurance policy is kept __________________________________

Policies, inventory, and bills of sale are kept ____________________________________

CEMETERY PLOT

Do you own a cemetery plot? ________________________________________________

Where? _________________________________________________________________

Deed is kept _____________________________________________________________

IS SELF-EMPLOYED

Business name ___________________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

Copies of business agreements, other documents are kept _________________________

For advice as to handling or disposition of the business, consult ____________________

 

Address ________________________________________________________________

_______________________________________________________________________

F NOT SELF-EMPLOYED

Employer ______________________________________________________________

Address _______________________________________________________________

______________________________________________________________________

Telephone _____________________________________________________________

In emergency, call ______________________________________________________

THER MATTERS

Personal creditors or debtors, if any ___________________________________________

Copies of notes, loan agreements, and receipts are kept ____________________________

Income tax records and supporting data are kept _________________________________

Credit card records are kept _________________________________________________

Tax advisor ______________________________________________________________

Address _________________________________________________________________

 

Names, ages and relationship of those who would inherit property under your will (heirs,

Devisees, and beneficiaries):

 

Name Age Relationship Address

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Are any of the above under legal disability or otherwise represented by personal representatives?

Name Legal Disability Represented by: Name and address

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Medical and Prescription Records

MEDICAL INFORMATION

My allergies and drug sensitivities: ___________________________________________

________________________________________________________________________

My blood type: ___________________________________________________________

Medical conditions I have ___________________________________________________

________________________________________________________________________

 

DOCTORS WHO ARE TREATING ME

Name ____________________ Specialty ____________________ Phone ___________________

Name ____________________ Specialty ____________________ Phone ___________________

Name ____________________ Specialty ____________________ Phone ___________________

 

Hospital ________________________________________________________________________________

Name ____________________ Emergency Phone Number _______________________________

 

Pharmacy _______________________________________________________________________________

Name ______________________________________Phone_______________________________

 

Dentist __________________________________________________________________________________

Name ______________________________________ Phone ______________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

 

 

 

 

 

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________

Prescription Information

Name of drug ___________________________

Date

Prescribed ______________________________

Doctor’s name ___________________________

Prescribed for what? ______________________

Color/shape/strength ______________________

Directions/cautions _______________________

_______________________________________