To have lived, loved, laughed and learned that is my legacy.

To those I leave behind

Because you care enough to plan ahead for those youll leave behind
Using this booklet to record your funeral wishes and to organize lifes many details assures that, when the time comes, those closest to you will have the necessary information to handle your affairs and celebrate your life. Your preparation now means greater peace of mind for loved ones later. As you complete this record, know that you are giving your family a most thoughtful gift. This simple, caring gesture will help ensure a meaningful funeral experience and comfort them in their time of loss. And they wont have to worry if they made the right choices. Please make your loved ones aware that this document exists and keep it in a safe place, where they may easily access it. You may also want to provide a photocopy to a loved one who lives outside your home.

Personal record
Its out of pure and simple love that I leave you with this gift to guide and protect you at this most difficult time. My wish is to spare you any unnecessary expense and the burden of having to make decisions under pressures of time and emotion. Thats why I have expressed my wishes and provided the information youll need to answer the many questions youll be asked. I have also shared my personal thoughts and memories. May you find as much comfort and meaning within these pages as I found in preparing them. Signed Date

Full name
First Last Street address City Years at address State residence since Previous address State / Province ZIP Middle

Years at previous address Place of birth Date of birth Social Security number Country of citizenship
2

Personal record
Marital status q Single q Married q Divorced q Widowed Maiden name Spouses name Name

Date and place of marriage

Education School(s) Degree(s)

Occupation Employer

Military service Branch Date and place of induction Rank Serial number Date and place of discharge

Fathers name Birthplace

Mothers maiden name Birthplace

Family record
Spouse / loved one Parents

Children

Siblings

Family record
Grandchildren

Great Grandchildren

Additional family members

My life and memories

Life is a succession of moments. To

live

each one is to succeed.

Corita Kent

Milestones
First job

First car

High school graduation

College graduation

Wedding

First home

Becoming a parent

Becoming a grandparent

Other milestones

My life and memories

To

love

and be loved is to feel the sun from both sides.

David Viscott

Favorites
Color

Flower

Season

Song

Poem

Scripture

Book

Saying

Other favorites

My life and memories

Laughter
is wine for the soul ... the hilarious declaration made by man that life is worth living.
Sean OCasey

Recollections
Close friends

Mentors / role models

Pets

Family traditions

Great inspirations

Fond memories

Special achievements

My life and memories

In youth we

learn;

in age we understand.

Marie Ebner Von Eschenbach

Cherished mementos

Family heirlooms

Hobbies / interests

Special talents

Community service

Clubs / organizations

Military experience

Important documents
Please specify the location of each item.
Birth certificate Childrens birth certificate(s) Marriage license Veterans discharge papers / military records Last will and testament Funeral and cemetery arrangement documents Life insurance policies Health and accident policies Property insurance policies Real estate deeds Mortgages / notes Bank records Stocks / bonds / CDs Pension / retirement plans Income tax records Auto registration / title Safe deposit box
Location Box number Key(s)

Other documents

10

Important information
Insurance
Life
Insurance Company Policy number Agent Benefit amount Phone Beneficiary

Insurance Company Policy number

Agent Benefit amount

Phone Beneficiary

Insurance Company Policy number

Agent Benefit amount

Phone Beneficiary

Health and accident

Insurance Company Policy number and details Agent Phone

Insurance Company Policy number and details

Agent

Phone

Property (homeowners, auto, other)

Insurance Company Property insured Agent Type of insurance Phone Policy number

11

Important information
Insurance
Property (homeowners, auto, other)
Insurance Company Property insured Agent Type of insurance Phone Policy number

Insurance Company Property insured

Agent Type of insurance

Phone Policy number

Banking, investments and credit accounts

Banking
Institution Account type Phone Account number

Institution Account type

Phone Account number

Institution Account type

Phone Account number

Institution Account type

Phone Account number

12

Important information
Investments
Investment type Investment type Investment type Investment type Investment type Company Company Company Company Company Acct. / Cert. number Acct. / Cert. number Acct. / Cert. number Acct. / Cert. number Acct. / Cert. number

Credit accounts
Creditor Creditor Creditor Creditor Creditor Address Address Address Address Address Phone Phone Phone Phone Phone Acct. number Acct. number Acct. number Acct. number Acct. number

Personal Advisors
Accountant Attorney Clergy Investment Advisor Physician Address Address Address Address Address Phone Phone Phone Phone Phone

13

Final wishes
First person to be notified upon my death
Name Relationship Address Phone Email

Funeral Home to contact

Name Address Phone Counselor / Advisor
Your funeral professional can help plan a meaningful, personalized celebration of your life.

Funeral preferences
Place of service q Church q Funeral Home q Cemetery q Other Person to officiate Name Name Name Name

14

Final wishes
Special instructions Music selections

Readings

Flowers

Personal touches / items to display

Special services / Ceremonies

(fraternal, military, spiritual, etc.)

Personal instructions Clothing Glasses Jewelry Other

15

Final wishes
Suggested memorial contributions Pallbearers Honorary pallbearers

Other requests

16

Final wishes
Final disposition
q Earth burial q Mausoleum entombment q Cremation / Inurnment q Other (please specify) Name of Cemetery / Mausoleum Address Description of burial property Phone

Casket selection

Urn selection

Vault selection

Personalization choices

Permanent memorial Type Inscription

17

Special people
Please be sure to notify these people of my passing:
Name Relationship Address Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email
18

Phone Email

Special people
Name Relationship Address Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email

Phone Email

Name Relationship Address

Name Relationship Address

Phone Email
19

Phone Email

In loving memory
... My stories are my wealth.
Angela Sidney

How I wish to be remembered

20

M8472-03

2012 Forethought 0112