Estate Planning and Administration

Personal Information for Family-Executor-Trustee 2015

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Introduction

This provides information for one’s family, executor, or trustee. This should be helpful in gathering information and settling matters on death or disability. This is not a financial statement, but simply to let family members, executors, or trustees know one's advisors, where things are kept, and other information. Also, before making decisions and undertaking actions, it is essential that family, executors, and trustees seek proper legal, tax, and financial advice.


The Schmiedeskamp Estate Planning and Administration Group

This form has been provided for the convenience of clients and friends of the Schmiedeskamp Robertson Neu & Mitchell LLP Estate Planning and Administration Group. Our clients are families and individuals from all walks of life, along with individual and corporate executors, trustees, and fiduciaries, as well as public and private charities. The Group provides estate planning and administration services from the simple to the complex. Services relate to wills, trusts, beneficiary arrangements, and other estate planning techniques and approaches. We advise our clients regarding the effective and efficient transfer of wealth and succession planning. We work closely with our client's accountant, financial, insurance, and other advisors. For more information about the Estate Planning and Administration Group and all our lawyers, please visit www.srnm.com.


Review Information and Plan Periodically

This information should be updated periodically. Equally important is to make certain one’s estate planning is up-to-date. One’s estate plan should be reviewed periodically. Also, titling of assets or beneficiaries also should be reviewed to make certain that they are consistent with one’s estate planning.


General Information

  • Name(s): ____________________________ _______________________________
  • Birthdate(s): ____________________________ _______________________________
  • Birthplace(s): ____________________________ _______________________________
  • SSN(s): ____________________________ _______________________________
  • Permanent Address: _________________________________________________________
  • Telephone:
    • Home:______________________
    • Cell:___________________________
  • Email(s): ____________________________ _______________________________
  • Marital Status:
    • [ ] Single
    • [ ] Married:
      • Date and Place: __________________________________
    • [ ] Widowed:
      • Deceased spouse:_________________________________
      • Date of death: ___________________________________
      • Place of death:___________________________________
    • [ ] Civil Union:
      • Date and Place: _________________________________
    • Military Information:__________________________________________________________
    • Family and Beneficiaries:
      • Name: _____________________________
      • Relationship: ___________________________
      • Address: ___________________________
      • Telephone: _____________________________
      • Email:_________________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

      • Name: _________________________________
      • Relationship: _______________________
      • Address: _______________________________
      • Telephone: _________________________
      • Email:_____________________________

Estate Planning

  • Will of:_____________________________
  • Date: _______________________________
  • Executor:____________________________
  • Address: ____________________________
  • Telephone:___________________________
  • First Alternate: _______________________
  • Address: ____________________________

Living (revocable) trust(s):

  • Date:________________________________
  • Trustee:______________________________
  • Address:_____________________________
  • Telephone:___________________________
  • First Alternate:________________________
  • Address:_____________________________
  • Telephone:___________________________

  • Date:________________________________
  • Trustee:______________________________
  • Address:_____________________________
  • Telephone:___________________________
  • First Alternate:________________________
  • Address:_____________________________
  • Telephone:___________________________

Other trust(s):

  • Describe:_____________________________
  • Date: ________________________________
  • Trustee: _____________________________
  • Address: _____________________________
  • Telephone: ___________________________
  • First Alternate: ________________________
  • Address:_____________________________
  • Telephone:____________________________

  • Describe:_____________________________
  • Date: ________________________________
  • Trustee: _____________________________
  • Address: _____________________________
  • Telephone: ___________________________
  • First Alternate: ________________________
  • Address:_____________________________
  • Telephone:____________________________

Non-Probate

I (we) confirm:

  • [ ] Some assets have beneficiaries or joint owners named (e.g., life insurance, retirement plans).
  • [ ] The beneficiary designations or joint owners ARE intended to be effective.
  • [ ] The beneficiary designations or joint owners ARE NOT intended but were for convenience.
  • [ ] Explanation:_______________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

Client Note: Please remember that wills and trusts DO NOT override beneficiary designations or joint ownership arrangements.


Powers of Attorney and Related Matters

  • Power of Attorney – Property of:
    __________________________________ ________________________________
  • Agent: _______________________________ ________________________________
  • First Alternate(s):_______________________ ________________________________
  • Power of Attorney – Health of:
    __________________________________ [ ] Same as Property
    __________________________________ [ ] Same as Property
  • Agent: _______________________________ ________________________________
  • First Alternate(s):_______________________ ________________________________
  • Other Information: __________________________________________________________

  • Living Will(s) or Advanced Directive(s) [ ] Yes [ ] No

  • Organ Donor: [ ] Yes [ ] No

  • Disposition of Remains:
    • [ ] Agent designated for disposition of remains, if any: _________________________
    • [ ] Burial
    • [ ] Cremation
    • [ ] Donation to science: __________________________________________________
    • [ ] Prearranged funeral at: ________________________________________________
    • [ ] If not prearranged, preferred funeral home: ________________________________
    • [ ] Cemetery: __________________________________________________________
    • [ ] Other information:____________________________________________________

Document Location

  • [ ] Safe deposit box number: _________ [ ] Safe deposit box number:____________
  • Location:______________________ Location:_________________________
  • Key kept at:____________________ Key kept at:_______________________
  • By: [ ] Owner By:                           [ ] Owner
  • [ ] Co-Owner                                  [ ] Co-Owner
  • [ ] _____________________              [ ] _______________________
  • [ ] None ________________             [ ] None___________________
  • [ ] Home safe: Combination provided to:_____________________________________
  • [ ] Attorney office:_______________________________________________________
  • [ ] Other: ______________________________________________________________

Automatic Payments, Passwords, Etc.

The following deposits are made automatically:

  • [ ] For _____________________________: Name ______________ PW ___________

  • [ ] Social security to: __________________________________________________
  • [ ] Pension from ____________________ to: _______________________________
  • [ ] _______________________________ to: _______________________________
  • [ ] _______________________________ to: _______________________________

The following payments are made automatically:

  • [ ] ________________________________ from: _____________________________
  • [ ] ________________________________ from: _____________________________
  • [ ] ________________________________ from: _____________________________

My (our) computer names and passwords are:

  • [ ] Provided on a list kept:_________________________________________________

  • [ ] For _____________________________: Name ______________ PW ___________
  • [ ] For _____________________________: Name ______________ PW ___________
  • [ ] For _____________________________: Name ______________ PW ___________
  • [ ] For _____________________________: Name ______________ PW ___________

Assets

(Attach Lists as Necessary)
(I=Individually T=Trust JT=Joint TE=Tenants by the Entirety TC=Tenants in Common)
(Note if Joint with Others)

Real Estate:

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Checking or Savings Account(s):

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Stocks and Bonds (not in brokerage account):

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Brokerage Account(s):

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

U.S. Savings Bonds:

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Do you have an electronic account and, if so, provide the account number(s), passwords, etc.? __________________________________________________________________________ __________________________________________________________________________


Timeshares:

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Vehicles, Campers, Boats, Motorcycles, Etc.:

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Notes or Debts Owed to Me (Us):

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Other Assets:

    Description
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
    How Titled
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________
  • ____________________________________

Life Insurance and Annuities

  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________
  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________
  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________
  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________
  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________
  • Company: ____________________________________
  • Policy Number: ____________________________________
  • Insured: ____________________________________
  • Beneficiary: ____________________________________
  • Owner: ____________________________________

Retirement Plans

  • Owner: ___________________________________
  • Primary Beneficiary: ___________________________________
  • 1st Contingent Beneficiary: ___________________________________
  • 2nd Contingent Beneficiary: ___________________________________
  • Owner: ___________________________________
  • Primary Beneficiary: ___________________________________
  • 1st Contingent Beneficiary: ___________________________________
  • 2nd Contingent Beneficiary: ___________________________________
  • Owner: ___________________________________
  • Primary Beneficiary: ___________________________________
  • 1st Contingent Beneficiary: ___________________________________
  • 2nd Contingent Beneficiary: ___________________________________
  • Owner: ___________________________________
  • Primary Beneficiary: ___________________________________
  • 1st Contingent Beneficiary: ___________________________________
  • 2nd Contingent Beneficiary: ___________________________________

Liabilities

    Mortgages:
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
    Credit Cards:
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
    Other Debt:
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
    Regular bills:
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
    Bills paid by autopay:
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________
  • ____________________________________ ____________________________________

Advisors

Attorney:

  • James A. Rapp
  • Schmiedeskamp Robertson Neu & Mitchell LLP
  • 525 Jersey Street
  • Quincy, Illinois 62301
  • Telephone: 217.223.3030
  • Fax: 217.223.1005
  • Email: jrapp@srnm.com

Accountant or Tax Preparer:

  • Name: _____________________________________
  • Firm: _____________________________________
  • Address: _____________________________________
  • Telephone: _____________________________________
  • Other contact information:_________________________

Financial Advisor(s) or Broker(s):

  • Name:_________________________________ Name:_____________________________
  • Firm:__________________________________ Firm:______________________________
  • Address:_______________________________ Address:___________________________
  • Telephone:______________________________ Telephone:__________________________
  • Other contact information:_______________________________________________________

Life Insurance Agent(s):

  • Name:_________________________________ Name:_____________________________
  • Company:__________________________________ Company:______________________________
  • Address:_______________________________ Address:___________________________
  • Telephone:______________________________ Telephone:__________________________
  • Other contact information:_______________________________________________________

General Insurance Advisor(s) or Broker(s):

  • Automobile: ______________________________________________________________
  • Home/Business/General: ____________________________________________________
  • Other Advisors: ____________________________________________________________

Religious Affiliation:

  • Church/Synagogue/Place of Worship: ______________________________________________________________
  • Address: ____________________________________________________
  • Telephone: ____________________________________________________________
  • Preferred minister, priest, rabbi, etc: ____________________________________________________________
  • Church/Synagogue/Place of Worship: ______________________________________________________________
  • Address: ____________________________________________________
  • Telephone: ____________________________________________________________
  • Preferred minister, priest, rabbi, etc: ____________________________________________________________

Other Information

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________


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This is not intended to be legal advice, but rather, to provide accurate information regarding education law matters. For more information regarding education law matters, please contact any member of our estate planning and administration group: Dennis W. Gorman (dgorman@srnm.com), James A. Rapp (jrapp@srnm.com), Harold B. Oakley (hoakley@srnm.com), Michael A. Bickhaus (mbickhaus@srnm.com), Natalie L. Oswald (noswald@srnm.com) or Joseph B. Ott (jott@srnm.com). Our telephone number is (217) 223-3030. Please visit our website: www.srnm.com. We invite and welcome all questions and comments. © 2013 Schmiedeskamp Robertson Neu & Mitchell LLP Vol. 2015-1







Schmiedeskamp Robertson Neu & Mitchell LLP
525 Jersey Street, Quincy, Illinois 62301
(217) 223-3030

Copyright © 2013 | All Rights Reserved

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