Estate Planning And Will Information Form Page 6

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IRA’s/Mutual Funds/Securities/401k’s, ESOP’s etc.
Account Owner:__________________________________________________
Type of Account:_________________________________________________
Name of Broker:__________________________________________________
Approximate Avg. Balance:_________________________________________
Account Owner:__________________________________________________
Type of Account:_________________________________________________
Name of Broker:__________________________________________________
Approximate Avg. Balance:_________________________________________
Account Owner:__________________________________________________
Type of Account:_________________________________________________
Name of Broker:__________________________________________________
Approximate Avg. Balance:_________________________________________
Account Owner:__________________________________________________
Type of Account:_________________________________________________
Name of Broker:__________________________________________________
Approximate Avg. Balance:_________________________________________
Life Insurance:
Policy Owner:____________________________________________________
Type of Policy:___________________________________________________
Amount of Policy:_________________________________________________
Beneficiary (ies)__________________________________________________
Policy Owner:____________________________________________________
Type of Policy:___________________________________________________
Amount of Policy:_________________________________________________
Beneficiary (ies)__________________________________________________
Policy Owner:____________________________________________________
Type of Policy:___________________________________________________
Amount of Policy:_________________________________________________
Beneficiary (ies)__________________________________________________
Policy Owner:____________________________________________________
Type of Policy:___________________________________________________
Amount of Policy:_________________________________________________
Beneficiary (ies)__________________________________________________

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