Estate Planning Information - Personal Data Page 4

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Real Property: Identity as to location, actual or estimated value, amount of any mortgage,
residential or commercial property and form of ownership. Condominium interest. Actual cost
basis and date of purchase. Cost basis information important for limited capital gain tax in estate
under 1976 Tax Reform Act.
Cash Accounts: Total amounts of cash in checking and savings account/certificate grouped as to
form of ownership (if Joint account, identify who contributed the funds).
Stocks and Bonds: Group total values as to form of ownership. You need not identify
individual securities unless readily available.
Life Insurance: Indicate type of insurance, ownership of policy and designated beneficiaries.
Note on this page accidental death insurance, do not include in insurance inventory.
Annuities: Indicate type of annuity, ownership of policy and designate beneficiaries.
Pension/Retirement Plans: State name of company or whether or not it is qualified with the
IRS, and if you contribute to it; also, give general value of current and death benefits, and the
designated beneficiary.
Personal Property: Estimated value of household furnishings, automobile(s) and other non-
income producing assets; location and ownership.
Trust Interests: If you are a trustee, grantor or beneficiary of any testamentary or intervivos
trust, give a general description and value of that interest.
Business Interest: Nature of business, i.e.: corporation, partnership, sole proprietorship.
Type of business; Valuation; Copy of shareholder or other agreements; Deferred compensation.
Copy of financial statement is helpful, if available.
Debts: Loans (bank, mortgage, insurance, brokerage account margin), amount, lender due date.
Unpaid charitable pledges. Other liabilities, e.g., guarantees outstanding, obligations.
(INFORMATION NOTES MAY BE MADE ON THIS PAGE WITH SUMMARIES ON
CHART ATTACHED).
S:/Forms/Estate Planning/Personal Data Form

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