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Funeral, Cemetery,
Cremation, Burial; Printable Final Arrangements Planning Form #2
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Final
Arrangements Network
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FUNERAL, CEMETERY, CREMATION AND BURIAL PLANNING PAGES [2 of 3]
(Your
Printer Should Printout From 4 to 5 pages)
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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