PERSONAL ESTATE PLANNING COURSE
RECORD BOOK
So you can keep more of what’s yours and give to those you love and support
!
getorganized
3 Reasons You Should Start
Using This Record Book Now
You owe it to yourself and your family to complete your personal estate planning record. Keep
in mind that as you progress with your estate planning, your attorney should counsel you on all
aspects of your plans as well as draft all legal documents. Of course, we would also be happy to
assist you with your charitable intentions at the outset or after you have completed your record.
Good to Know!
If you’re married or
partnered, you and
your spouse should
prepare separate
record books. While
some sections contain
shared information,
most sections are
distinctly personal.
Plus it makes it easier
for loved ones to
manage your unique
affairs over time. For
additional copies of
this record book, please
contact us.
::
representative) when it comes time to
1
Your record provides important
personal information about
you and your family that will
be helpful to your executor (personal
settle your estate. Your executor will be
able to locate beneficiaries, your safe-
deposit box, abstracts, titles, stock or
bond certificates, will, trust agreements
and other important documents.
Your record serves as the basis
for creating your estate plan
and providing for the future
well-being of your family and the causes
you care about most. It will show you
what constitutes your estate and what
your beneficiaries can inherit. It will
prompt you to consider the disposition
of your assets. Will your assets pass by
joint ownership? Are they documented
for distribution in some other way? Or
must you address their distribution in
your will? If you have not yet made a will,
you will find it easier to do so with this
information at hand.
2
3
Your record also serves as a
basis from which to determine
what your estate taxes would
be under various plans of distribution.
Knowing the assets and the values to
be considered will help you and your
advisors find ways to minimize estate
taxes and identify liquid assets to cover
estate settlement expenses.
How to Use
This Record Book
Step 1: To complete the forms, simply click
inside the blue boxes. Begin typing to fill them
in with the appropriate information.*
Step 2: To save your work, go to the File menu
and select “Save As.” Rename the file using a
unique file name or the date and save it to your
desktop or another easy-to-access location. (By
renaming the file, you will be able to use the
original record book file again and again.)
Step 3: When you are finished, print the
completed records and keep them in a secure
place, such as a safe-deposit box.
*You may also print the forms and fill them out by hand.
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You
::
You owe it to yourself and your family to complete your personal estate planning record. Keep
in mind that as you progress with your estate planning, your attorney should counsel you on all
aspects of your plans as well as draft all legal documents. Of course, we would also be happy to
assist you with your charitable intentions at the outset or after you have completed your record.
Your name (Please print above.)
Address
City, State ZIP
Home phone/cell phone
Email
Date of birth/birthplace
Location of birth certificate
Location of adoption documents
Social Security number
Driver’s license number and state
Location of tax records
Location of titles, abstracts and leases
Location of stock and bond certificates
Military service, branch, years of service
Location of military documents
Continued on Page 4
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You
::
First spouse’s name
Date of first marriage/location of certificate
Prenuptial agreement/location of document
Date of divorce, annulment, legal separation or death (Please print above.)
Location of documents
Second spouse’s name
Date of second marriage/location of certificate
Prenuptial agreement/location of document
Date of divorce, annulment, legal separation or death
Location of documents
Your Parents
Mother’s name
Address
City, State ZIP
Home phone/cell phone
Email
Date of birth/birthplace
Location of birth certificate
Date of death/resting place
Location of death certificate
Continued on Page 5
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Your Parents
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Social Security number
Father’s name
Address
City, State ZIP (Please print above.)
Home phone/cell phone
Email
Date of birth/birthplace
Location of birth certificate
Date of death/resting place
Location of death certificate
Social Security number
Your Spouse
Spouse’s name
Maiden name
Date of birth/birthplace
Location of birth certificate
Social Security number
Driver’s license number and state
Your Children
First child’s name/phone number
Continued on Page 6
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Your Children
::
Date of birth/birthplace
Location of birth certificate
Location of adoption documents
Social Security number (Please print above.)
Driver’s license number and state
Second child’s name/phone number
Date of birth/birthplace
Location of birth certificate
Location of adoption documents
Social Security number
Driver’s license number and state
Third child’s name/phone number
Date of birth/birthplace
Location of birth certificate
Location of adoption documents
Social Security number
Driver’s license number and state
Fourth child’s name/phone number
Date of birth/birthplace
Location of birth certificate
Continued on Page 7
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Your Children
Location of adoption documents
Social Security number
Driver’s license number and state
Fifth child’s name/phone number (Please print above.)
Date of birth/birthplace
Location of birth certificate
Location of adoption documents
Social Security number
Driver’s license number and state
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Your Pets
First pet’s name/species and coloring
Vet’s contact information
Food/other care
Second pet’s name/species and coloring
Vet’s contact information
Food/other care
Third pet’s name/species and coloring
Vet’s contact information
Food/other care
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Current/Retired Employer(s)
Employer’s Contact Information
::
Are you retired?
Yes No
Company name (Please print above.) Phone Supervisor
Current benefits and location of documents
Position Start date (and end date, if retired)
Ownership interest Yes No
Employer’s Contact Information
Company name Phone Supervisor
Current benefits and location of documents
Position Start date (and end date, if retired)
Previous Employer(s)
Ownership interest Yes No
Employer’s Contact Information
Company name Phone Supervisor
Current benefits and location of documents
Position Start date and end date
Ownership interest Yes No
Employer’s Contact Information
Company name Phone Supervisor
Current benefits and location of documents
Position Start date and end date
Ownership interest Yes No
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Will and Trust
Do you have a will? Yes No
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Are you the creator or beneficiary of any trusts?
Yes No
Please record documents here:
Document title (Please print above.)
Date prepared
Prepared by (name, title, contact information)
Location of document
Location of copies
Executor or trustee
Alternate executor or trustee
Additional notes
Document title
Date prepared
Prepared by (name, title, contact information)
Location of document
Location of copies
Executor or trustee
Alternate executor or trustee
Additional notes
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Power of Attorney
::
Have you signed a financial durable power of attorney? Yes No
Document title (Please print above.)
Date prepared
Prepared by (name, title, contact information)
Name of person appointed to act on your behalf
Names of alternates to act on your behalf
Effective date of power holder to act: Immediately Upon your incapacity Other
Location of original document
Location of copies
Additional notes
Health Care Directives
Do you have a living will? Yes No
Do you have a health care power of attorney?
Yes No
Name of person appointed to act on your behalf
Names of alternates to act on your behalf
Continued on Page 11
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Health Care Directives
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Please record documents here:
Document title
Date prepared
Effective date for power holder to act: Immediately Upon your incapacity Other
Prepared by (name, title, contact information) (Please print above.)
Location of original document
Locations of copies (We suggest attaching a copy to this record book.)
Document title
Date prepared
Effective date for power holder to act: Immediately Upon your incapacity Other
Prepared by (name, title, contact information)
Location of original document
Locations of copies (We suggest attaching a copy to this record book.)
Long-Term Care
Do you have a long-term care insurance policy? Yes No
Insurance agent’s name
Company name
Policy number
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Body, Organ and Tissue Donations
Do you wish to donate your body, organs or tissues? Yes No
Second donation (identify the particular organ or tissue)
Receiving organization’s name and contact information
Location of documents
First donation (identify the particular organ or tissue, or indicate entire body) (Please print above.)
Receiving organization’s name and contact information
Location of documents
Secured Place
::
Third donation (identify the particular organ or tissue)
Receiving organization’s name and contact information
Location of documents
Please note: This is not intended as a legal form. Consult with your doctor and attorney today to
create the appropriate documents.
Do you have a safe-deposit box? Yes No
Bank name, branch location and contact information
People with authorized access
Box number and location of keys
Contents
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Passwords Funeral Instructions
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First product/service, account name, user name or account number/password (Please print above.)
Second product/service, account name, user name or account number/password
Third product/service, account name, user name or account number/password
Fourth product/service, account name, user name or account number/password
You have a preference. That’s why it is not unusual for you to plan your funeral
arrangements now. When the day arrives, your family will lovingly appreciate your
proactive nature and concern for them as well.
Funeral home preference
Type of preparation Cremation Burial Donation of body
Location of memorial service
Cemetery preference
Casket and vault preference
Pastor preference
Casket bearer 1
Casket bearer 2
Casket bearer 3
Casket bearer 4
Casket bearer 5
Casket bearer 6
Music Preferences
Song/Hymn 1
Continued on Page 14
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Funeral Instructions
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Song/Hymn 2 (Please print above.)
Song/Hymn 3
Song/Hymn 4
Soloist name
Soloist name
Organist name
Favorite Scriptures
Reading 1
Reading 2
Reading 3
Reading 4
Favorite flowers
Memorial ideas
Type of service (Open or closed casket, religious or secular, and any other preferences)
Headstone preference
Burial clothing preference
Obituary (Things you want included and newspapers where you want it published)
____________________
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Other Matters That Need Family Attention
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Here’s a checklist of actions that need completion in the period of time between your
death and up to a year after. Check the boxes that apply to you, so your family members
can take care of them later.
Contact the attorney to have the will read and to see what has to be done in regard
to estate settlement.
Contact the Social Security Administration. Social Security pays a lump sum
death benefit of $255. A surviving spouse can get survivor’s benefits as early as age
60—earlier if a surviving spouse is disabled. Children under age 18 may also be entitled
to survivor’s benefits when a parent dies.
Call the Veterans Administration (VA). A surviving spouse and dependent
children may be entitled to a small pension if the deceased served in the Armed Forces.
The VA will pay partial burial expenses and provide a headstone or marker as well as
an American flag to drape over the casket, without charge. If burial is in a national
cemetery, the VA will provide a grave site and pay burial costs.
Notify organizations where the deceased held memberships. Some offer
memorial services. They may have life insurance and may return part of dues paid.
Organizations to notify: ___________________________________________________
___________________________________________________
Contact former employers for benefits resulting from that employment. Refer
to the list in the employment history section (see Page 8).
Collect life insurance policies and call the companies and ask for death claim
forms. The beneficiary can choose to take proceeds in a lump sum or spread them out
as payments over the years.
Contact companies holding retirement plans. There may be money left in them
to be paid out to survivors. Like life insurance, proceeds can be paid out in a lump
sum or in installments. Tax advisors should be consulted before beneficiaries make
that decision.
Consult with the health insurance company. It may pay some expenses of your
last illness. Future premiums may also be less if the policy has covered two or more
people and now there will be one less person covered. Some health insurance policies
are also combination policies that provide some death benefits.
calculateestate’sworth
Worksheets to Help You Create Your Estate
What Is Your Estate Really Worth?
Your estate’s value from an estate
planning viewpoint is different from your
net worth, which is a snapshot of what
you own and what you owe.
Fortunately, most people find they
have much more in their estate than they
thought when they account for savings,
employer and personal life insurance,
retirement plan benefits and perhaps even
a future inheritance. For estate planning
purposes, an inventory of your assets and
liabilities will help you determine what
you can leave to your heirs after your
lifetime and how to best provide for the
distribution of your estate.
Make an Inventory of Your Assets
If you are married, be sure to include your
spouse’s assets and all jointly owned or
community property. Use the current
market value for everything you own and
the face value (not cash value) for any life
insurance. Don’t strive for exact amounts;
round numbers will do.
Make Property Decisions
Once you’ve made an inventory of your
property, you’re ready to decide where you
want it to go. The following pages can help
you organize your plans.
Once the worksheets are complete, you
are ready to meet with your attorney for
important counsel and the drafting of
necessary documents.
HOW TO TELL
Mine” From “Ours”
Sole property is anything
that belongs to you
alone. Joint property are
items that are shared. To
determine whether or not
you can pass all or part of an
asset by your will, you should
know the form of title. There
are four ways property can
be owned jointly.
1.Joint tenancy with right
of survivorship. When
one owner passes away,
the surviving joint owner
owns the entire asset.
2.Tenancy in common.
You and others have
an undivided interest
in an asset. You can pass
your interest by will. The
surviving joint tenant
doesn’t automatically take
title to your interest.
3.Tenancy by the entirety.
This form of ownership is
recognized by many states.
It’s limited to married
couples and generally to
real property.
4.Community property.
This is a form of property
ownership between
spouses in select states.
Generally, all property
acquired during marriage
is community property,
regardless of which spouse
holds title. You can will
only half the property; the
other half belongs to your
surviving spouse.
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List Your Assets
1. Cash (savings, money market and checking accounts, CDs)
Owned
Owned by Owned by jointly or
Type of account Institution you alone your spouse community
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
2. Real Estate
Owned
Description and Date of Cost Owned by Owned by jointly or
location of property purchase basis you alone your spouse community
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
3. Stocks, bonds, mutual funds
Owned
Date of Cost Owned by Owned by jointly or
Description purchase basis you alone your spouse community
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
___________________________ ________ $___________ $___________ $___________ $___________
4. Obligations due me (mortgages held, notes receivable, accounts receivable)
Owned
Owned by Owned by jointly or
Name of debtor Address you alone your spouse community
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________ _____________________ $___________ $___________ $___________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
________
________
________
________
________
________
________
________
________
________
________
________
________
________
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List Your Assets
5. Personal assets (automobiles, jewelry, furniture, boats, paintings, collections, etc.)
Description
6. Life insurance
Date of
purchase
Cost
basis
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
$___________
Owned
Owned by Owned by jointly or
you alone your spouse community
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $__________
$___________ $___________ $__________
$___________ $___________ $__________
$___________ $___________ $___________
$___________ $___________ $___________
Face Amount*
Owned
Owned by Owned by jointly or
Name of company Insured Beneficiary you alone your spouse community
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
________________ _______________ _______________ $___________ $___________ $___________
*Note any policy loans
7. Annuities
Present Value
Owned
Cost Owned by Owned by jointly or
Description Annuitant Beneficiary basis you alone your spouse community
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
_______________ _________ _________ $___________ $___________ $___________ $___________
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List Your Assets
8. Retirement benefits (pension, profit-sharing, IRAs, Keogh plans, etc., including face
amounts of life insurance owned in the retirement plan)
Value of Interest
Owned by Owned by
Description Beneficiary you alone your spouse
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
_____________________________________ _______________________ $___________ $___________
9. Business interests owned (proprietorship, partnership, corporation)
Value of Interest
Owned
Cost Owned by Owned by jointly or
Business name and address basis you alone your spouse community
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
10. Other assets potentially includable in estate because of your interest in them
(interest in a trust or estate, royalties, patents, copyrights, trademarks, etc.)
Current Value
Owned
Cost Owned by Owned by jointly or
Description basis you alone your spouse community
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
_____________________________________ $___________ $___________ $___________ $___________
Owned
Owned by Owned by jointly or
you alone your spouse community
TOTAL OF ALL ASSETS $___________ $___________ $___________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
______________________
______________________
______________________
______________________
______________________
______________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
______________________
______________________
______________________
______________________
______________________
______________________
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List Your Liabilities (approximate balances owed)
1. Mortgages
Owed by Owed by Owed
Description of property Name of creditor you alone your spouse jointly
__________________________ ______________________ $___________ $___________ $___________
__________________________ ______________________ $___________ $___________ $___________
__________________________ ______________________ $___________ $___________ $___________
__________________________ ______________________ $___________ $___________ $___________
__________________________ ______________________ $___________ $___________ $___________
2. Loans, installment debts (bank, auto and personal loans, insurance loans, etc.)
Description Name of creditor
Owed by Owed by Owed
you alone your spouse jointly
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
3. Current bills (department store and other charges, credit cards, etc.)
Description Name of creditor
Owed by Owed by Owed
you alone your spouse jointly
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
$___________ $___________ $___________
4. Taxes owed (estimated state and federal income tax, property tax, etc.)
Owed by Owed by Owed
Description you alone your spouse jointly
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
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List Your Liabilities (approximate balances owed)
5. All other liabilities
Owed by Owed by Owed
Description you alone your spouse jointly
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
__________________________________________________ $___________ $___________ $___________
Owed by Owed by Owed
you alone your spouse jointly
TOTAL OF ALL LIABILITIES
$___________ $___________ $___________
You Your spouse Joint
Total of all assets
$___________ $___________ $___________
Minus total of all liabilities
(___________) (___________) (___________)
NET ESTATE (estimated)
$___________ $___________ $___________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
__________________________________________________ _____________________________________
__________________________________________________ _____________________________________
__________________________________________________ _____________________________________
__________________________________________________ _____________________________________
__________________________________________________ _____________________________________
:: dispositionofestate
Who Gets What?
Now that you’ve determined which assets comprise your estate and their values, you need to
indicate who you want to inherit your assets.
1. Gifts to spouse
(indicate a contingent beneficiary in case your spouse does not survive you)
Description of asset or percentage of estate Name/Relationship/Address
2. To other beneficiaries
Description of asset or percentage of estate Name of Beneficiary/Relationship/Address
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
_____________________________________ ___________________________________________________
3. To charitable organizations
Percentage
Name and address of charitable organization of net estate Dollar amount
______________________________________________________ _____________% OR $_____________
______________________________________________________ _____________% OR $_____________
______________________________________________________ _____________% OR $_____________
______________________________________________________ _____________% OR $_____________
Description of
Name and address of charitable organization specific asset
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:: dispositionofestate
Who Gets What?
4. Residue of estate
Name and address of charitable organization Percent of residuary estate
__________________________________________________________________ ____________________%
__________________________________________________________________ ____________________%
__________________________________________________________________ ____________________%
Name and address of other beneficiaries Percent of residuary estate
__________________________________________________________________ ____________________%
__________________________________________________________________ ____________________%
__________________________________________________________________ ____________________%
PEPC-E • The information in this publication is not intended as legal or tax advice. For such advice, please consult an attorney or tax advisor.
considercharitablechoices
How You, Your Family and Your Favorite Causes Can Benefit
Once you have completed this record
book, you are ready to meet with your
attorney and other professional advisors
for their important counsel and the
drafting of necessary documents.
We hope that as part of your planning
you consider making a gift to us in
your will or through some other form
of gift planning. A gift to us, however,
should never come before your personal
or family needs. That’s the beauty of
a planned gift—you come first.
Depending on the type of gift you
choose, you may potentially reap
benefits from your philanthropy
that have very practical and desirable
outcomes, such as the following:
• Ability to leave a legacy
• Income tax benefits
• A life income
• Reduce or eliminate capital
gains taxes
• Personal satisfaction
Whatever your objective, we can help
match your needs with the right giving
tool to provide the most benefits for you,
your family and us.
Please contact us and we’ll be happy
to explain the choices available to you—
without obligation.
!
Gifts That
Give Back!
::
A generous gift to us
should not supplant
your personal and family
concerns, of course.
However, you will reap
benefits from your
philanthropy that have
practical consequences.
Income tax benefits. A
gift to a qualified charitable
organization may entitle
you to an income tax
charitable deduction when
you itemize.
Capital gains tax savings.
When you donate
appreciated property you
have held for more than
one year to a qualified
charitable organization,
you can reduce or even
eliminate capital gains
taxes on the transfer.
You may also qualify for
an income tax charitable
deduction based on the
fair market value of the
securities at the time of
the transfer.
Lifetime income. If you
desire, you can receive
an assured income for life
through a planned gift.