WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created...

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INSURANCE INFORMATION Life Insurance Name of Insured_________________________________ Face Amt ____________________ Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary _______________________________ Policy # _____________________ Location of Policy/Statement(s) _______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder) Name of Insured ________________________________ Face Amt ____________________ Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary ________________________________ Policy # ____________________ Location of Policy/Statement(s)________________________ Enclosed in Binder (Most Recent) (if not enclosed in binder) Insurance Information

Transcript of WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created...

Page 1: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

INSURANCE INFORMATION

Life Insurance

Name of Insured_________________________________ Face Amt ____________________ Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary _______________________________ Policy # _____________________

Location of Policy/Statement(s) _______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Name of Insured ________________________________ Face Amt ____________________

Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary ________________________________ Policy # ____________________

Location of Policy/Statement(s)________________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information

Page 2: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Insurance Information

Name of Insured ________________________________ Face Amt ___________________

Name of Company_______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary ________________________________ Policy # ____________________

Location of Policy/Statement(s) _______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder) Name of Insured ________________________________ Face Amt ___________________

Name of Company_______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary _______________________________ Policy # _____________________

Location of Policy/Statement(s)________________________ Enclosed in Binder (Most Recent) (if not enclosed in binder) Name of Insured ________________________________ Face Amt ___________________

Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Beneficiary ______________________________ Policy # _____________________

Location of Policy/Statement(s) _______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Page 3: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Homeowner’s Insurance

Property Insured_________________________________________________________________ Street Address City State Zip

Name of Company _____________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under______________________________ Policy # ______________

Location of Policy/Statement(s)______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Property Insured_________________________________________________________________ Street Address City State Zip

Name of Company _____________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under _____________________________ Policy # _______________

Location of Policy/Statement(s)______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information

Page 4: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Property Insured_________________________________________________________________ Street Address City State Zip

Name of Company ______________________________________________________ Name of Agent _______________________________________________________ Phone _____________________________ Name Policy is Under ______________________________ Policy # ______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Liability Insurance

Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under ______________________________ Policy # ______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information

Page 5: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Auto Insurance

Vehicle(s) Covered _______________________________________________________________

Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under _____________________________ Policy # _______________

Location of Policy/Statement(s)________________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Vehicle(s) Covered ______________________________________________________________ Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under ______________________________ Policy # _______________

Location of Policy/Statement(s) _______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information

Page 6: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Medical Insurance

MAJOR MEDICAL INSURANCE

Name of Company ______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under ______________________________ Policy # ______________

Location of Policy/Statement(s)______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

MEDICARE SUPPLEMENT MEDICAL INSURANCE

Name of Company ______________________________________________________ Name of Agent _________________________________________________________ Phone _____________________________ Name Policy is Under______________________________ Policy # _______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information

Page 7: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Insurance Information

DENTAL INSURANCE Name of Company _______________________________________________________ Name of Agent _________________________________________________________ Phone ____________________________ Name Policy is Under _____________________________ Policy # _______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

VISION INSURANCE

Name of Company ______________________________________________________ Name of Agent _________________________________________________________ Phone ____________________________ Name Policy is Under _____________________________ Policy # _______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

LONG TERM CARE INSURANCE Name of Company _______________________________________________________ Name of Agent _________________________________________________________ Phone ____________________________ Name Policy is Under _____________________________ Policy # _______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Page 8: WHAT TO DO WHEN I AM GONE BOOKLET · WHAT TO DO WHEN I AM GONE BOOKLET Author: Julie Hayes Created Date: 4/11/2012 3:21:10 PM ...

Miscellaneous Insurance

Boat Mortgage Renter’s Condo Other _______________

Name of Company _______________________________________________________ Name of Agent ________________________________________________________ Phone ____________________________ Name Policy is Under ______________________________ Policy # _______________

Location of Policy/Statement(s) _____________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Boat Mortgage Renter’s Condo Other _______________

Name of Company _______________________________________________________ Name of Agent _________________________________________________________ Phone ____________________________ Name Policy is Under______________________________ Policy # _______________

Location of Policy/Statement(s) ______________________ Enclosed in Binder (Most Recent) (if not enclosed in binder)

Insurance Information