Life Insurance Value in Gold Coins - DOC

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Life Insurance Value in Gold Coins - DOC Powered By Docstoc
					                    PERSONAL AND FAMILY FINANCIAL ASSETS
                             Dated as of: __________


1.   Personal Residence

     Address:[                         ]

     Description (single family, condo, co-op or similar description): [                        ]

     How you hold title (if joint tenancy, then list joint tenant; if tenants in common, then list
     co-owner and their share of the property): [                         ]

     FMV: [                        ] Mortgage balance, if any: [                       ]

     Mortgage life insurance? [                        ]


2.   Other personal residences or vacation homes:

     Address:[                         ]

     Description (single family, condo, co-op or similar description): [                        ]

     How you hold title (if joint tenancy, then list joint tenant; if tenants in common, then list
     co-owner and their share of the property): [                         ]

     FMV: [                        ] Mortgage balance, if any: [                       ]

     Mortgage life insurance? [                        ]


3.   Personal and household effects: If you think that the general categories do not provide an
     adequate description, please provide additional detail. Also state your best estimate of
     the value of each kind of property and who owns it and how you hold title.

     A.       Automobiles/Boats/Etc:

                [                      ]
                [                      ]
                [                      ]

     B.       List general personal and household effects such as furnishings, furniture, books
              and pictures of no special value:

            [                      ]



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            [                      ]
            [                      ]

     C.     List valuable jewelry, artwork, antiques and other valuable collections such as
            coins, stamps or gold (indicate if insured):

            [                      ]
            [                      ]
            [                      ]

     D.     Other tangible property not covered by other categories: [                        ]


4.   Cash, cash deposits, and cash equivalents: State the name and address of each bank or
     institution and who owns each item

     A.     List checking accounts, including money market accounts and how title is held:

            [                      ]
            [                      ]
            [                      ]

     B.     List ordinary savings accounts and how title is held:

            [                      ]
            [                      ]
            [                      ]

     C.     List certificates of deposit and how title is held

            [                      ]
            [                      ]
            [                      ]

     D.     List any other accounts and how title is held:

            [                      ]
            [                      ]
            [                      ]

            [                      ]
            [                      ]
            [                      ]




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5.   Investment assets:

     If you hold investment assets through a brokerage account and all assets in the account
     are held in the same manner, then complete the following for each such account:

     A.     Name of brokerage firm:
     B.     Address:
     C.     Account Number:
     D.     How assets are held and who has rights of survivorship:
     E.     Approximate value:

     If you hold investment assets separately from a brokerage account, then complete the
     following for each such asset (copy section as appropriate), where it is held (and how title
     is held:

     A. Asset type (e.g., stock, bond, cd, etc.):
     B. Location of title (e.g., registered security through a clearing house, or certificated
        security held in safe deposit box, etc.):
     C. How assets are held and who has rights of survivorship:
     D. Approximate value:


6.   Pension and profit sharing plans, 401(k) accounts, IRAs, Roth IRAs, SEP IRAs, SIMPLE
     IRAs, Keogh plans, ESOPs, or other tax favored benefit plans, list the following for each
     such plan:

     A.     Name and location of plan:
     B.     How is title held and who is named as the beneficiary(ies):
     C.     Vested percentage, if applicable:
     D.     Current value:

7.   Insurance on you and/or your spouse’s life

     A.     Policy Number:
     B.     Type of insurance (life, term, accident & health, etc.):
     C.     Insurer:
     D.     Insured:
     E.     Face amount of policy:
     F.     Who owns the policy:
     G      Beneficiaries:
     H.     Loans, if any against it:
     G.     Accidental death benefits, if any:
     H.     Any other insurance, e.g., term/group term insurance:




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8.    Closely held business interests: Describe any interest you have in a family or other
      business with limited shareholders. Include the nature of the business, its form of
      organization (e.g., corporation partnership, or the like), whether you are active in its
      operations, and estimate its value. If it is a corporation, please indicate whether an “S”
      election is in force with respect to the federal taxation of the corporation.

      [                                                                              ]
      [                                                                              ]

9.    List any other assets owned and how title is held:

      [                                                                              ]
      [                                                                              ]

10.   List all assets that are separate, and not community, property
      [                                                                              ]
      [                                                                              ]




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                            REFERENCE GUIDE FOR WILL


1.   Your legal name:

2.   Your spouse’s legal name:

3.   Legal name of each of your children and your children’s birthdates:

4.   Name of any predeceased children and whether they have any living children:

5.   List each specific bequest (e.g., my wedding ring, my car, etc.) you would like to make in
     the will and the beneficiary and if the beneficiary predeceases you, who, if anyone,
     should the bequest go to in their place? A specific bequest identifies a specific asset. If
     the asset is no longer in your estate at your death, then the bequest lapses, i.e., they don’t
     automatically have a right to claim against the estate for an equivalent value.

     [                      ]
     [                      ]

6.   List any cash bequests, the beneficiaries and any alternate beneficiary:

     [                      ]
     [                      ]

7.   List any specific bequests of real estate, the beneficiary(ies), any alternate beneficiary,
     and whether the beneficiary will take the property subject to any mortgages and liens
     (note if the property is in joint tenancy, it will pass to the joint tenant and not through
     your will; if you want to transfer your half of the property it will need to be re-titled as a
     co-tenancy).

     [                      ]
     [                      ]

8.   Name of the person(s) who will take the residuary of your estate and their respective
     share.

     [                      ]
     [                      ]


9.   Who do you want to be the executor of your will and if they decline, who will be the
     alternate executor? The executor is the person appointed under your will to manage your
     estate after you die. The executor will offer your will to the court for probate, file an
     inventory of your assets with the court, pay all debts, expenses of administration and
     taxes, sell any property that needs to be sold to put the estate in a position to be closed
     and petition the court to make an order for distribution of your estate.



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      [                                            ]


12.   Do you have a living will (if so, when was it written, and attach a copy):

13.   List, and attach copies of any power of attorneys:

14.   Attach a copy of your existing will.




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