Living Trust Information Form (Short Form) Page 3
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9Life Insurance
Whose life?
Company
Face
Cash
Policy
Beneficiary
Is insured
Name
Value
Value
Number
_________
___________________
________
________
____________________
__________
_________
___________________
________
________
____________________
__________
_________
___________________
________
________
____________________
__________
_________
___________________
________
________
____________________
__________
_________
___________________
________
________
____________________
__________
Are the owners of any policy different from the person whose life is insured? Yes ____ No ____. If yes, please explain
Other Property with Designated Beneficiaries
Do you have IRAs, vested pension plans, annuities, or other assets that would pass on your death to a particular beneficiary that you
have designated? Yes ____ No ____. If yes, please provide the following information:
Description
Value
Designated beneficiary
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
Do you or your spouse expect an inheritance? Yes ____ No ____. If yes, please explain:
_________________________________________________________________________________________________
Do you or your spouse expect the value of your estate to increase by a significant amount? Yes ____ No ___. If yes, please explain:
_________________________________________________________________________________________________
Personal Property
For example, autos, RVs, boats, antiques, heirlooms, jewelry, and collections
Description of property
Value
In whose name?
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
_______________________
______________
__________________________________________
Legal Papers
Date made
Location of original
Last will and testament
_________________
____________________________________________________
Durable power of attorney (s)
_________________
____________________________________________________
Living will/health care
_________________
____________________________________________________
power of attorney
_________________
____________________________________________________
Living trust
_________________
____________________________________________________
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