The purpose of this memorandum is to establish effective communication among family members in reference to key items that normally will be of concern in the event of death. I know at first this may seem a bit morbid, but as you read on, hopefully you will agree that it is necessary. Ideally, we will make everyone aware of our wishes before something happens to us, that way there is no questions or doubt about what our wishes are. As you are aware, when we lose someone, everyone is stressed and it gets further complicated if everyone is confused about who is or should be handling certain things. As a financial note you are probably aware that a typical funeral cost varies, starting around $6,000. Some things that should be discussed are:
Wills: Do you have a will? ____Yes
____No
If Yes, where is the location of the Will:___________________________________
Executor of Estate: Who do you want to be the executor of your estate? (Someone to make sure all of your wishes are carried out) ____________________________. Does this person know that you want them as the executor? _____Yes ______No
Life Insurance Policies: Do you have Life Insurance Policies? ____Yes ___No
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Accidental Death Policies: Do you have Accidental Death Policies _____Yes ___No
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Where is your policy located?__________________________________________
What is the name of your Insurance Company?_______________________________
Do you have a copy of the policy? _____Yes ____No
What is the amount of your Insurance Policy: _______________
Who is listed as the beneficiary? Primary:_____________Contingent:____________
Burial Policies: Do you have a Burial Policy? _____Yes _____No
Where is your policy located:_________________________________
What is the name of the Company:_____________________________
What is the amount of the policy:______________________________
Church: Do you want your funeral to be at a church? ____Yes ____No
If yes, what Church_________________________
If no, where would you like the funeral held? _________________________________
Preacher: Is
there a particular Preacher/Brother/Minister that you want to conduct the
service: ___Yes ___No, If yes, who______________________.
Mortician: Is there a particular mortician that you want to handle your remains?
___Yes ___No. If Yes, who_______________________________________.
Cremation: _____Yes _____No
Clothing: Is there certain clothing that you wish to wear? ___Yes ____No
If Yes, describe the
clothing________________________________________
Funeral : Are there any specific instructions for the funeral? A particular day/time, Order to follow. If so explain_______________________________
Wake: Do you
want a Wake: ______Yes _____No
Cards/Flowers: Do you want cards and/or flowers? _____Yes _____No
If No, would you like donations made to a specific
organization? ___________________
Songs: Are there certain songs that you want? If so, list_________________
__________________________________________________________________
Burial Location: Where do you want to be buried at: ___________________
Have you purchased a burial plot? _____Yes ____No
If yes, where is the location_______________________ Who is the Point of Contact___________
Obituary: Do you want the obituary in the newspaper? ____Yes ____No
Are there any specifics you want on/in the obituary? If Yes List__________
_______________________________________________________________
Do you want a photo on the obituary? ____Yes ___No, If yes, list/provide photo
_________________________________________________________________.
Pall Bearers: Do you have a preference for Pall Bearers? ____Yes ____No
If yes list 1.____________________ 2._____________________ 3.________________
4. ___________________ 5. _____________________ 6. _______________
Additional Information: __________________________________________________
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________________________ ______________________
Printed Name Signature
_______________________ _____________________
Witness Printed Name Witness Signature
_______________________ _____________________
Witness Printed Name Witness Signature
_______________________ ____________________
Date Location