Chapter 15 of the Complete Eldercare Planner

THE DOCUMENTS LOCATOR

Chapter 15 of The Complete Eldercare Planner

Name

Today’s Date

PIN NUMBERS / ACCESS CODES

Bank by phone______

Bank online______

Debit cards ______

Cash station______

Telephone voice mail ______

Cell phone______

Personal Digital Assistant (PDA) ______

Property______

COMPUTER & INTERNET USAGE

Computer access password

Wireless security code

E-mail address______

E-mail access code______

Important websites & passwords______

Location of CD ROMs & flash drive backup files

PERSONAL BANK ACCOUNTS

Account name and number______

Names on account______

Bank ______

Telephone ______

Type of account______

Location of account documents ______

Second signature______

Power of attorney ______

AUTOMATIC BILL PAYING

Name of store and service ______

Contact name ______

Telephone ______

Date payment deducted ______

Bank and account number ______

Name of store/service ______

Contact name ______

Telephone ______

Date payment deducted ______

Bank and account number ______

ELECTRONIC FUNDS TRANSFER ACCOUNT (ETA)

Account name and number______

Names on account______

Bank ______

Telephone ______

PERSONAL LOAN

Name(s) on loan ______

Loan number______

Bank ______

Telephone ______

Type of loan______

Location of loan papers______

OUTSTANDING LIEN AGAINST PROPERTY

Name(s) on loan ______

Loan number______

Bank ______

Telephone ______

Location of loan papers______

PAID LIENS AGAINST PROPERTY

Name(s) on loan ______

Loan number______

Bank ______

Telephone ______

Location of proof of payment papers ______

INSTALLMENT LOAN

Name(s) on loan ______

Loan number______

Bank ______

Telephone ______

Location of loan papers______

BUSINESS BANK ACCOUNT

Bank ______

Telephone ______

Location of account documents ______

Business name on account ______

Account number ______

Type of account______

Second signature______

Power of attorney______

BUSINESS LOAN

Name(s) on loan ______

Loan number______

Type of loan______

Bank ______

Telephone ______

Location of loan papers______

CREDIT UNION

Union name______

Telephone ______

Name on account(s) ______

Type of account(s)______

Account number(s) ______

Location of documents ______

FOREIGN BANK ACCOUNT

Name(s) on account ______

Account number ______

Type of account______

Bank ______

Telephone ______

Location of account papers ______

COMPANY PENSION

Name on pension ______

Reference number ______

Dates of employment ______

Company name ______

Telephone ______

Location of pension papers ______

RETIREMENT ACCOUNT

Name on account ______

Account reference number ______

Type of account______

Bank ______

Telephone ______

Location of account documents ______

SAVINGS CERTIFICATE

Depositor______

Certificate number ______

Bank ______

Telephone ______

Location of certificates ______

SAVINGS BOND

Bond held by ______

Type of bond ______

Bond series number ______

Location of bond______

STOCK CERTIFICATE

Stockholder(s)______

Stock name ______

Stock number ______

Broker ______

Telephone ______

Location of stock documents ______

SAFE-DEPOSIT BOX

Box holder ______

Has access to box______

Telephone number ______

Box number______

Bank ______

Telephone ______

Key location______

CASH-ON-HAND

Location ______

HOME SAFE

Has access to safe______

Telephone ______

Location of combination or key ______

BUSINESS SAFE

People with access to safe ______

Telephone ______

Location of combination or key ______

WILL

Will of ______

Attorney ______

Telephone ______

Location of original will papers______

People with copies of will papers ______

Telephone ______

TRUST

Established by ______

Trust for______

Attorney ______

Telephone ______

Location of original trust papers______

People with copies of trust papers______

LIVING WILL

Will of ______

Attorney ______

Telephone ______

Location of original living will ______

People with copies of living will ______

Telephone ______

POWER OF ATTORNEY FOR PROPERTY

Given to______

Telephone ______

Attorney ______

Telephone ______

Location of original document ______

People with copy of papers ______

POWER OF ATTORNEY FOR HEALTH CARE

Location of original document ______

People with copies of the document ______

Agent ______

Telephone ______

LETTERS OF INSTRUCTION

Written by ______

Location of original documents ______

Telephone ______

People with copy of documents ______

Telephone ______

FUNERAL INSTRUCTIONS / MEMORIAL SERVICES

Arranged by______

Funeral home ______

Telephone ______

Location of instruction papers ______

People with copies of instructions______

Telephone ______

DONOR ARRANGEMENT

Location of documentation ______

AUTOPSY PERMISSION

Location of documentation ______

SOCIAL SECURITY

Social Security number ______

Location of Social Security card ______

MILITARY DISCHARGE PAPERS

Veteran name______

Service number ______

Discharge papers location ______

INCOME TAX FILINGS

Name of taxpayer ______

Tax identification number______

Tax adviser______

Telephone ______

Location of tax records ______

PASSPORT

Name on passport ______

Passport number ______

Location of passport ______

DRIVER’S LICENSE

Name on license ______

License number ______

State license issued ______

License renewal date ______

CREDIT CARDS / CHARGE ACCOUNTS

Account name ______

Account number ______

Name on account ______

Location of card ______

MEDICARE

Name ______

Number ______

Effective date ______

MEDICAID

Name ______

Number ______

Effective date ______

HEALTHCARE INSURANCE

Subscriber’s name ______

Contract number______

Group number ______

Insurance company ______

Telephone ______

LONG-TERM CARE INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

LIFE INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

ANNUITY

Name on annuity______

Insurance company ______

Contract number______

Location of papers______

DISABILITY INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

HOME OWNER’S INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

REAL ESTATE INVESTMENT INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

RENTER’S INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

BUSINESS INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

LIABILITY INSURANCE

Name on policy ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

VEHICLE INSURANCE

Policy holder ______

Vehicle insured ______

Vehicle registration number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of title ______

VEHICLE

Vehicle ______

Make and model ______

Serial number ______

Where purchased______

Telephone ______

Name on title______

Location of title papers ______

Location of electronic toll collection system

VALUABLES INSURANCE

Policy holder ______

Item insured ______

Policy number ______

Insurance company ______

Insurance agent ______

Telephone ______

Location of policy ______

REAL ESTATE OWNERSHIP DOCUMENTS

Property address ______

Owner ______

Telephone ______

Co-owner ______

Telephone ______

Bank or mortgage company ______

Telephone ______

Location of documents ______

CEMETERY PLOT

Owner ______

Plot intended for ______

Cemetery ______

Plot location ______

Telephone ______

Location of plot deeds______

SUBSCRIPTIONS

Name of publication ______

Sent to ______

Name of publication ______

Sent to ______

Name of publication ______

Sent to ______

CLUB MEMBERSHIPS

Organization ______

Telephone ______

Organization ______

Telephone ______

MEMBERSHIP / SMART CARDS

Account name ______

Account number ______

Name on account ______

Location of card ______

RELIGIOUS AFFILIATION

Place of worship______

Address ______

Clergy person ______

Telephone ______

Documentation of special Instructions

RELIGIOUS RITES AND CEREMONIES

Event______

Event date______

Place of event______

Records storage location ______

ITEMS IN STORAGE

Stored in name of ______

What is being stored ______

Storage company ______

Telephone ______

Location of storage documents ______

ITEMS—REPAIRED/RESTORED/CLEANED

Item owner ______

Item description ______

Shop name______

Telephone ______

Claim ticket location ______

ITEMS BORROWED

Item description ______

Lent to ______

Telephone ______

ITEMS ON ORDER

Ordered for ______

Item description ______

Order reference number ______

Shop name______

Telephone ______

Expected order date______

Location of paperwork ______

PERSONAL CONTRACTS/AGREEMENTS

Names on contract ______

Telephone ______

Nature of agreement ______

Location of paperwork ______

MEDICAL HISTORY

History of ______

Birth date______

Location of records ______

BIRTH RECORD

Name at birth ______

Birth date______

Place of birth ______

Birth certificate location ______

ADOPTION PAPERS

Adoption name ______

Adopted by ______

State of adoption ______

Adoption agency ______

Telephone ______

Location of paperwork ______

NATURALIZATION PAPERS

Citizen name ______

Place of naturalization______

Location of papers______

MARRIAGE LICENSE

Names on license______

Marriage date ______

State license issued ______

License location______

DIVORCE DECREE

Names on decree ______

Divorce date ______

State divorce granted ______

Decree location ______

SCHOOL RECORDS

Student name ______

School ______

School location ______

Telephone ______

Dates attended______

Graduation date ______

Diploma location ______

EMPLOYMENT HISTORY

Employee name ______

Dates of employment ______

Company______

Company address ______

Telephone ______

MOTHER’S HISTORY

Mother’s name at birth ______

Date of birth ______

Place of birth ______

Birth certificate location ______

Mother’s name at death______

Cause of death______

Date of death______

Location of death ______

Burial location______

Death certificate location ______

FATHER’S HISTORY

Father’s name at birth ______

Date of birth ______

Place of birth ______

Birth certificate location ______

Father’s name at death______

Cause of death______

Date of death______

Location of death ______

Burial location______

Death certificate location ______

DEPENDENTS

Name______

Date of birth ______

Location of birth certificate______

GROWN CHILDREN—NO LONGER DEPENDENTS

Name______

Date of birth ______

Address ______

City/State/Zip ______

Telephone ______

PETS

Name of pet______

Breed ______

Date of birth ______

Sex ______

Animal hospital ______

Telephone ______

Breeder______

Is promised to ______

HOME INVENTORY (fixtures, furniture, equipment, appliances)

Item description ______

Model number______

Purchase price ______

Value of item today ______

Location of receipt ______

Location of warranty______

Location of item instructions

Is promised to ______

PERSONAL ITEMS INVENTORY (clothes, books, photos, mementos)

Item description ______

Purchase price ______

Value of item today ______

Location of receipt ______

Is promised to ______

VALUABLES INVENTORY (collect ions, jewelry, artwork, antiques)

Item description ______

Serial number ______

Purchase price ______

Value of item today ______

Location of receipt ______

Is promised to ______

BUSINESS INVENTORY (fixtures, furniture, equipment, appliances)

Item description ______

Model number______

Purchase price ______

Value of item today ______

Location of receipt ______

Location of warranty______

Location of item instructions

Is promised to ______