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 ______
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 ______
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