Survivor Notebook

This very helpful Outline was prepared by KW4SPN and is being posted for your use. Feel free to print it out, use it, and share with others.

Survivor Notebook Outline

*Can include a generic calendar showing due dates, etc.

I. Personal information

a. Name – full

b. Date of birth

c. Place of birth

d. Social Security number

e. ?

II. List of Immediate Contacts – name, phone number, email

a. Spouse (or Significant Other)

i. Name

ii. Phone number(s) – work, cellular

iii. Email

b. Children

i. Name

ii. Phone number(s) – work, cellular

iii. Email

c. Parents

i. Name

ii. Phone number(s) – work, cellular

iii. Email

d. Close friends/neighbors

i. Name

ii. Phone number(s) – work, cellular

iii. Email

e. Employer – supervisor or HR

i. Name

ii. Phone number(s) – work, cellular

iii. Email

f. Pet and/or House sitter

i. Name

ii. Phone number(s) – work, cellular

iii. Email

III. Burial

a. Obituary – if you don’t write it, list the following for someone else to prepare

i. Date of birth

ii. Place of birth

iii. Parents’ names

iv. Surviving family member names (that you want listed)

v. Education

vi. Employment

vii. Interesting note about self, or something you want folks to remember you for/by

b. Funeral Home Information

c. Pallbearers

d. Minister/Priest

i. Name

ii. Phone number(s) – work, cellular

iii. Email

e. Music to be played

f. Service Readings (religious or otherwise)

IV. Professionals – name, address, and phone numbers for each applicable

a. Doctor – Primary physician

i. Name

ii. Practice name

iii. Address

iv. Phone number

b. Lawyer

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

c. Insurance agents

i. Life

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

ii. Home

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

iii. Automobile

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

iv. Other

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

d. Accountant

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

e. Banker

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

f. Financial Advisor(s) / Securities Broker(s)

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

g. Dentist

i. Name

ii. Practice name

iii. Address

iv. Phone number

V. Assets

a. Directions – include the following information for each, as applicable, plus any other data that will help

i. Account type – ex: Savings, Checking

ii. Bank, brokerage firm, credit card provider name

iii. Account holder name – if joint with spouse or child/parent, state who

iv. Account ownership type – single, joint, joint with survivor, etc

v. Account number

vi. Corporate Address

vii. Corporate Phone number

viii. Personal representative full contact information

ix. Online account URL and login (user name, password, security question answers)

b. Personal

i. Life and burial insurance – (include credit life for home and credit cards?)

ii. Checking accounts

iii. Savings accounts

iv. Brokerage accounts

v. Stocks and bonds (not in brokerage account)

vi. Mutual funds and money market accounts

vii. Certificates of deposit

viii. Retirement Accounts

1. Individual Retirement Accounts (IRAs)

2. ROTH account

3. Employer 401-k account

4. Pension or employer profit-sharing plan

5. Retirement Plans – not already considered, ex: Annuities

ix. Safe deposit box

1. Bank name

2. Box number

3. Key location

x. Household safe or lock box

1. Location

2. Contents list

3. Combination or location of key

xi. Jewelry – include descriptions, receipts, photographs, history

xii. Vehicles – automobiles, campers/RVs, snowmobiles, boats

1. Listing of make/model

2. Location of titles

3. Automobile insurance company and representative

xiii. Real Estate – by location

1. Location

2. Ownership information – who else is on title/loan

3. Bills

a. Regularly occurring – TV, internet, water/sewage, electric

i. Type

ii. Company

1. Name

2. Mailing address

3. Phone number

iii. Account number

iv. Due date

v. Amount

b. Periodic or special – heating oil, insurance, snow plow, etc

i. Type

ii. Company

1. Name

2. Mailing address

3. Phone number

iii. Account number

iv. Due date

v. Amount

xiv. Household Inventory

1. Standard items – suggest basic itemized list by Room

2. Special Item (repeat for each specialty item as needed – ex: “Great-gramma’s sideboard”, family silver, etc)

a. Description

b. Location

c. Disposition – special wishes not included in Will

d. History/provenance

e. Estimated/insured value

xv. Valuable collections (artwork, stamps, coins, etc)

xvi. Other assets not covered –

1. Promissory notes owed to you,

2. Joint ownership in items (real estate, vehicles, etc) other than with your spouse, etc

VI. Liabilities

a. Mortgage information

i. Mortgage holder

ii. Home Owner’s Insurance

iii. Taxes

1. Type – school, property, automobile

2. Due dates

3. Mailing address and phone number

4. Amounts

b. Credit cards

i. Card/bank/store name

ii. Card number

iii. Number of cards on account – and in whose name(s)

iv. Billing

1. Mailing address

2. Phone number

3. Due date (if balance)

c. Outstanding payable by you

i. Estimated Federal and/or State Income taxes

1. Amount

2. Due date

3. Mailing address

ii. Home equity loan

1. Amount

2. Due date

3. Mailing address

iii. Loan against retirement account

VII. Documents – include a copy and/or location where each can be located

a. Will

b. Trust

c. Advance Directives: (http://www.medicinenet.com/advance_medical_directives/article.htm)

i. Living Will

ii. Health Proxy – including DNR if desired

iii. Durable Power of Attorney (DPOA)

1. Medical DPOW

2. Legal DPOA

d. Tax returns for the last 3 years

VIII. Other

a. Pets

i. Veterinarian –

1. Name

2. Address

3. Phone number

ii. Daily feeding/care instructions

iii. Pet future caregivers/guardians –

1. Name

2. Address

3. Phone number

4. Email

iv. Funds set aside for pet care

b. ??

IX. Business

a. Sole owner

i. Directions for immediate and short term continuation of business

ii. Disposition of business and/or business assets

iii. Checking accounts

iv. Savings accounts

v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

vi. Assets

vii. Liabilities

b. Joint ownership or partnership

i. Business Buy-Sell agreements

ii. Partnership certificates

iii. Checking accounts

iv. Savings accounts

v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

vi. Assets

vii. Liabilities

*Can include a generic calendar showing due dates, etc.

X. Personal information

a. Name – full

b. Date of birth

c. Place of birth

d. Social Security number

e. ?

XI. List of Immediate Contacts – name, phone number, email

a. Spouse (or Significant Other)

i. Name

ii. Phone number(s) – work, cellular

iii. Email

b. Children

i. Name

ii. Phone number(s) – work, cellular

iii. Email

c. Parents

i. Name

ii. Phone number(s) – work, cellular

iii. Email

d. Close friends/neighbors

i. Name

ii. Phone number(s) – work, cellular

iii. Email

e. Employer – supervisor or HR

i. Name

ii. Phone number(s) – work, cellular

iii. Email

f. Pet and/or House sitter

i. Name

ii. Phone number(s) – work, cellular

iii. Email

XII. Burial

a. Obituary – if you don’t write it, list the following for someone else to prepare

i. Date of birth

ii. Place of birth

iii. Parents’ names

iv. Surviving family member names (that you want listed)

v. Education

vi. Employment

vii. Interesting note about self, or something you want folks to remember you for/by

b. Funeral Home Information

c. Pallbearers

d. Minister/Priest

i. Name

ii. Phone number(s) – work, cellular

iii. Email

e. Music to be played

f. Service Readings (religious or otherwise)

XIII. Professionals – name, address, and phone numbers for each applicable

a. Doctor – Primary physician

i. Name

ii. Practice name

iii. Address

iv. Phone number

b. Lawyer

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

c. Insurance agents

i. Life

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

ii. Home

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

iii. Automobile

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

iv. Other?

1. Name

2. Firm name

3. Address

4. Phone number

5. Email address

d. Accountant

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

e. Banker

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

f. Financial Advisor(s) / Securities Broker(s)

i. Name

ii. Firm name

iii. Address

iv. Phone number

v. Email address

g. Dentist

i. Name

ii. Practice name

iii. Address

iv. Phone number

XIV. Assets

a. Directions – include the following information for each, as applicable, plus any other data that will help

i. Account type – ex: Savings, Checking

ii. Bank, brokerage firm, credit card provider name

iii. Account holder name – if joint with spouse or child/parent, state

iv. Account ownership type – single, joint, joint with survivor, etc

v. Account number

vi. Corporate Address

vii. Corporate Phone number

viii. Personal representative full contact information

ix. Online account URL and login (user name, password, security question answers)

b. Personal

i. Life and burial insurance – (include credit life for home and credit cards?)

ii. Checking accounts

iii. Savings accounts

iv. Brokerage accounts

v. Stocks and bonds (not in brokerage account)

vi. Mutual funds and money market accounts

vii. Certificates of deposit

viii. Retirement Accounts

1. Individual Retirement Accounts (IRAs)

2. ROTH account

3. Employer 401-k account

4. Pension or employer profit-sharing plan

5. Retirement Plans – not already considered, ex: Annuities

ix. Safe deposit box

1. Bank name

2. Box number

3. Key location

x. Household safe or lock box

1. Location

2. Contents list

3. Combination or location of key

xi. Jewelry – include descriptions, receipts, photographs, history

xii. Vehicles – automobiles, campers/RVs, snowmobiles, boats

1. Listing of make/model

2. Location of titles

3. Automobile insurance company and representative

xiii. Real Estate – by location

1. Location

2. Ownership information – who else is on title/loan

3. Bills

a. Regularly occurring – TV, internet, water/sewage, electric

i. Type

ii. Company

1. Name

2. Mailing address

3. Phone number

iii. Account number

iv. Due date

v. Amount

b. Periodic or special – heating oil, insurance, snow plow, etc

i. Type

ii. Company

1. Name

2. Mailing address

3. Phone number

iii. Account number

iv. Due date

v. Amount

xiv. Household Inventory

1. Standard items – suggest basic itemized list by Room

2. Special Item (repeat for each specialty item as needed – ex: “Great-gramma’s sideboard”, family silver, etc)

a. Description

b. Location

c. Disposition – special wishes not included in Will

d. History/provenance

e. Estimated/insured value

xv. Valuable collections (artwork, stamps, coins, etc)

xvi. Other assets not covered –

1. Promissory notes owed to you,

2. Joint ownership in items (real estate, vehicles, etc) other than with your spouse, etc

XV. Liabilities

a. Mortgage information

i. Mortgage holder

ii. Home Owner’s Insurance

iii. Taxes

1. Type – school, property, automobile

2. Due dates

3. Mailing address and phone number

4. Amounts

b. Credit cards

i. Card/bank/store name

ii. Card number

iii. Number of cards on account – and in whose name(s)

iv. Billing

1. Mailing address

2. Phone number

3. Due date (if balance)

c. Outstanding payable by you

i. Estimated Federal and/or State Income taxes

1. Amount

2. Due date

3. Mailing address

ii. Home equity loan

1. Amount

2. Due date

3. Mailing address

iii. Loan against retirement account

XVI. Documents – include a copy and/or location where each can be located

a. Will

b. Trust

c. Advance Directives: (http://www.medicinenet.com/advance_medical_directives/article.htm)

i. Living Will

ii. Health Proxy – including DNR if desired

iii. Durable Power of Attorney (DPOA)

1. Medical DPOW

2. Legal DPOA

d. Tax returns for the last 3 years

XVII. Other

a. Pets

i. Veterinarian –

1. Name

2. Address

3. Phone number

ii. Daily feeding/care instructions

iii. Pet future caregivers/guardians –

1. Name

2. Address

3. Phone number

4. Email

iv. Funds set aside for pet care

b. ??

XVIII. Business

a. Sole owner

i. Directions for immediate and short term continuation of business

ii. Disposition of business and/or business assets

iii. Checking accounts

iv. Savings accounts

v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

vi. Assets

vii. Liabilities

b. Joint ownership or partnership

i. Business Buy-Sell agreements

ii. Partnership certificates

iii. Checking accounts

iv. Savings accounts

v. Life insurance for business

1. Company – name, address, phone number

2. Policy number and value

3. Insurance agent – name, address, phone number

vi. Assets

vii. Liabilities