To Do List:
☐ Complete personal info
☐ Assign decision makers
☐ Document medical wishes
☐ Choose funeral preferences
☐ Organize finances
☐ Store documents safely
☐ Inform family where this guide is kept
PERSONAL INFORMATION
Keep this page updated. This information helps your loved ones act quickly and accurately.
Basic Information
Full Legal Name: ___________________________________________
Preferred Name/Nickname: ___________________________________
Date of Birth: ______________________
Place of Birth (City/State): _________________________________
Social Security Number (Last 4 digits only): ________
Driver’s License / ID Number: _______________________________
State Issued: ____ Expiration:_______
Home Address: _____________________________________________
City: _______________________ State: ______
Zip: ____________________
Length of Time at Address: _________________________________
Contact Information
Primary Phone: ____________________________________________
Secondary Phone: __________________________________________
Email Address: ____________________________________________
Marital & Family Information
Marital Status: ☐ Single ☐ Married ☐ Divorced ☐ Widowed ☐ Other
Spouse/Partner Full Name: _________________________________
Date of Marriage (if applicable): __________________________
Children (Names & Birthdates):
Employment Information
Current Employer: _________________________________________
Occupation/Title: _________________________________________
Employer Phone: __________________________________________
Years Employed: __________________________________________
Military Service (if applicable)
Branch: _________________________________________________
Years of Service: ________________________________________
Rank: _________________________________________________
Service Number (Last 4): ________
VA Benefits: ☐ Yes ☐ No
Important Notes
(Anything your family should know immediately)
Location of Important Documents
Birth Certificate: _________________________________________
Social Security Card: _____________________________________
Driver’s License/ID Copy: _________________________________
Other Documents: _________________________________________
Reach out with your planning needs.
