This list highlights the type of information that your fiduciary (e.g. Personal Representative or Attorney-in-Fact) will need to step in seamlessly to protect your independence and estate. In the same vein, if you are someone’s fiduciary, it is the type of information you will need to protect someone independence and estate.

PERSONAL INFORMATION STATEMENT

I. INTRODUCTION

The information that follows can be very helpful to a personal representative, attorney in fact and/or successor trustee. It lists critical information regarding your personal life, your assets, your liabilities, and your professional relationships that will facilitate the successful handling of your affairs in case of incapacity or death. Some of the information requested may appear too obvious to you to be worthy of recording here. However, it is rare that your personal representative, attorney in fact and/or successor trustee will know all this information unless they are your surviving spouse. MANY PEOPLE JUST USE THIS FORM AS A CHECKLIST TO COMPILE THEIR OWN STATEMENT WHICH WORKS VERY WELL.

II. PERSONAL DATA

Name:

Residence:

Place and date of Birth:

Education:

Career Service:

Military Service:

Citizenships:

Spouse:

Children and addresses:

Siblings:

Parent's (and Mother's maiden Name):

Burial requests:

III. IMPORTANT PAPERS

Please record the location of the documents identified below so your successor trustee, attorney in fact and/or personal representative can access them for review purposes quickly and easily.

  1. Marriage License:

  2. Divorce Records:

  3. Birth Certificate:

  4. Safe Deposit:

  5. Employments Contract:

  6. Partnership Agreement:

  7. Retirement Plan Reports:

  8. Buy Sell Agreements:

  9. Tax returns:

  10. Lease Agreement:

  11. Credit Agreements:

  12. Military Discharge:

  13. Citizenship/Passport:

  14. Living Trust:

  15. Will:

  16. Power of Attorney:

  17. Health Care Directive:

  18. Community Property Agreement:

  19. Others:

IV. CONSULTANTS AND CONTACTS

Your successor trustee, attorney in fact and/or personal representative should know the identity of these professionals since they have information that can facilitate the management of your estate in case of incapacity or death.

Consultant Name and Address Phone No.

  1. Attorney:

  2. Accountant:

  3. Life Insurance Agent:

  4. Casualty Ins. Agent:

  5. Medical Ins. Agent:

  6. Real Estate Agent:

  7. Stock Broker:

  8. Banker:

  9. Financial Advisor:

  10. Pension Plan Trustee:

  11. Retirement Plan Trustee:

  12. Primary Physician:

  13. Other Advisors:

V. ASSETS AND INSURANCE.

In this age of identity theft, you do not want to give someone too much information unless you really trust them. Just record the information necessary so that someone who has to step into your shoes to protect your independence or settle your estate knows what and where your assets are.

  1. Bank Accounts.

Description

Bank/branch

Location

Account

Number

Name of

Account

Authorized

Signer

  1. Stocks, Bonds & Brokerage Accounts.

Description

Brokerage Name/Location

Account Number

Name on the Account

Authorized Signer

  1. Life Insurance.

Company Name

Policy Type and Number

Premium Due Date/Amount

Beneficiaries

Face Value

  1. Medical Insurance.

Company Name

Policy Type

Number

Premium Due

Date/Amount

Beneficiaries

Deductible

  1. Real Estate.

Property Description

Purchase

Price/Date

Assessed

Value/Date

Cost of Improving

VI. LIABILITIES

Again, you do not want to give someone too much information unless you really trust them. Just record the information necessary so that someone who has to step into your shoes to protect your independence or settle your estate knows what and your liabilities are and to whom.

Description of Debt

Lender and Address

Loan or Card Number

Secured or Unsecured

Insurance on Debt

VII. MISCELLANEOUS

Here, you need to record anything else that your successor should know about.