My Personal, Charitable, and Financial Record - lovegr.orglovegr.org/images/PersonalandCharitableFinancialRecordEditable.pdf · THE PERSONAL INFORMATION RECORD OF: _____ My Personal,

THE PERSONAL INFORMATION RECORD OF:

_______________________________________________

My Personal, Charitable, and Financial Record

Your estate plan is a testament that affirms not only how your estate will be distributed, but also what kind of a legacy you will leave behind and the impact it will have for future generations. By completing this booklet you provide a central source of important information that will simplify the distribution of your assets upon the culmination of your estate plan.If you have a question about estate planning, would like proper will language, or have questions about planned giving options, we hope you’ll give us a call at 616-454-1751. We’re happy to help!

GRAND RAPIDS COMMUNITY FOUNDATION

A) Vital StatisticsB) Employment and Business Interests The Charitable Gift Annuity

C) Financial Information A Gift of Retirement-Plan Benefits

D) Insurance Utilizing Life Insurance

E) Property A Gift of Your Home

F) ObligationsG) Location of Important PapersH) Personal AdvisorsI) Philanthropic Interests Notes to Executor

J) Last Will and TestamentK) Funeral and Burial Instructions

CONTENTS

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part a | Vital Statistics

VITAL STATISTIC S | Personal Information, Marital Information and Family Information

First Name Middle Initial Last Name

Date of Birth month / day / year Place of Birth

Social Security No. Military Service No. Taxpayer Identification No.

PERMANENT ADDRESS

NW NE SW SE

Address Apartment Number

City, State Zip Code Phone


SUMMER/WINTER ADDRESS

NW NE SW SE

Address Apartment Number


BUSINESS ADDRESS

Business Name

NW NE SW SE

Address


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Current Marital/Relationship Status Single Married Signficant Other

Widowed Divorced

FAMILY INFORMATION

Children’s Information Names, birth dates, contact information:

Sibling’s Information Names, birth dates, contact information: if a family member is deceased, list names followed by (deceased)

Grandchildren’s Information Names, birth dates, contact information:

part a | Vital Statistics continued

RELATIONSHIP INFORMATION

Name of Spouse or Significant Other Date and Place Married

Marriage Certificate Location

Formerly Married To Date and Place Married

Marriage Terminated by: Death Divorce Annulment

Date and Place Terminated Termination Papers Located

Father’s Name Year of Birth Address

Mother’s Name Year of Birth Address

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part b | Employment and Business Interests

EMPLOYMENT AND BUSINESS INTERESTS

Employer Position Date Employed

Address Phone

OTHER BUSINESS INTEREST ( 1 )

Sole Proprietorship Partnership Closely Held Corporation LLC

Name of Business Value of Interest


OTHER BUSINESS INTEREST (2)

Sole Proprietorship Partnership Closely Held Corporation LLC

Name of Business Value of Interest

DISPOSITION OF BUSINESS INTERESTS AFTER DEATH

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A TIP FROM US TO YOU.CHARITABLE PLANNING POINTER: The charitable gift annuity is the oldest, simplest, and most popular of the charitable life-income plans. In exchange for a transfer of cash or marketable securities, we contractually agree to make specified annuity payments to you and/or another beneficiary for life, the payout rate depending on the age and number of beneficiaries.

IMMEDIATE PAYMENT: You can claim a current charitable deduction for the portion of the transfer that represents the charitable gift element--the amount by which the present value of the property transferred to us exceeds the fair-market value of the annuity received. Note: Income from a gift annuity receives favorable tax treatment in that a portion of each income payment is considered a tax-free return of principal over the donor’s life expectancy.

DEFERRED PAYMENT:Payments begin at a designated time in the future, such as at retirement. A deferred gift annuity is particularly attractive if you have a high current income, can benefit from a current tax deduction, and are interested in augmenting future retirement income on a tax-favored basis. We’re happy to prepare an illustration for you.

COMMENTS

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part c | Financial Information

FINANCIAL INFORMATION

Type of Account: Joint Individual

Bank

Address City, State Zip

Account No. In Name(s) Of


Type of Account: Joint Individual

Bank

Address City, State Zip

Account No. In Name(s) Of

SAFE DEPOSIT BOX

Box Location Box No.

Key Location

CERTIFICATES OF DEPOSIT/MONEY MARKET CERTIFICATES

Bank ___________________________________ Amount $_____________________________ Type____________________________________ Maturity Date_____________________

Bank ___________________________________ Amount $_____________________________ Type____________________________________ Maturity Date_____________________

Bank ___________________________________ Amount $____________________________ Type____________________________________ Maturity Date_____________________

Bank ___________________________________ Amount $____________________________ Type____________________________________ Maturity Date_____________________

tip: put passwords to online accounts in safety deposit box or other secure location.

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RETIREMENT BENEFITS

Pension Plan/ Profit Sharing Company Name/Contact Description

Deferred-Compensation Plan Company Name/Contact

Payable as lump sum $ ________________________ OR @ $ _______________________ per _______________________ for ________ years

Stock Option, Type Type ________________________________________________________________ Restrictions _________________________________________________

IRA/401(K)/403(B)

Other __________________

Where Held___________________________________ Account No. ______________________________________ Amount Invested ______________________

Types of Investments _______________________________________________ Options Available _______________________________________________________

IRA/401(K)/403(B),

Other __________________

Where Held __________________________________ Account No. _______________________________________ Amount Invested ______________________


IRA/401(K)/403(B),

Other __________________

Where Held __________________________________ Account No. _______________________________________ Amount Invested ______________________


Annuities

Source ___________________________________________________________________________________________________________________________________________

Investment $ ____________________________________________________ Payment terms____________________________________________

Source ________________________________________________________________________________________________________________________________________

Investment $ ____________________________________________________ Payment terms_____________________________________________

Other Retirement Benefits ________________________________________________________________________________________________________________________________________________________________________

Other Retirement Benefits ________________________________________________________________________________________________________________________________________________________________________

Comments

part c | Financial Information continued

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IDEAS FOR DOING GOOD THROUGH YOUR RETIREMENT PLANYou’ve worked hard and planned for retirement. Now, with a little creativity, you can leverage your retirement assets to benefit you and your family, reduce Uncle Sam’s cut, and support the nonprofits that matter most to you.

BENEFITS: • Continue to take regular lifetime withdrawals.• Maintain flexibility to change beneficiaries if your family’s needs change during

your lifetime.• Your heirs avoid the potential double taxation on the assets left in your

retirement account.

HOW IT WORKS:• Name a nonprofit as a beneficiary of your IRA, 401(k), or other qualified

retirement plan by simply contacting your IRA or retirement planadministrator and requesting a copy of the Change of Beneficiary Form.

• Pass the balance of your retirement assets to Grand Rapids CommunityFoundation by contacting your plan administrator.

• Complete the form and return it to your administrator. Provide theCommunity Foundation with a copy. Call us to discuss your intentions.

COMMENTS

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INSURANCE | Life Insurance, Health, Medical, and Other Insurance

part d | Insurance GRAND RAPIDS COMMUNITY FOUNDATION

LIFE INSURANCE ( 1)

Company Policy No. Face Amount $

Date of Issue Premium Due On

Insured Policy Owner Cash Value

Beneficiary 1 Beneficiary 2 Loan Outstanding

Description of Policy

Settlement Options

LIFE INSURANCE (2)






Settlement Options

1 1


HEALTH, MEDICAL , AND OTHER INSURANCE

Health Policy No. _______________________________________________________ Company___________________________________________________________________

Accident Policy No. _______________________________________________________ Company___________________________________________________________________

General Liability Policy No. _______________________________________________________ Company___________________________________________________________________

Homeowner’s Policy No. _______________________________________________________ Company___________________________________________________________________

Automobile Policy No. _______________________________________________________ Company___________________________________________________________________

LIFE INSURANCE (3)






part d | Insurance continued

Settlement Options

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GIFTS OF LIFE INSURANCE:Making a gift of life insurance is simple and cost-effective. To make a charitable gift from life insurance, simply add the nonprofit as a primary, secondary or contingent beneficiary to your policy. After completing and submitting the Change of Beneficiary/Ownership form, be sure to provide a copy to the Community Foundation.

You can give the nonprofit a paid-up policy which may be eligible for a tax deduction. A new policy may also be purchased specifically for charitable purposes. By naming the nonprofit as the owner and beneficiary of the policy, the premiums paid on the policy are tax deductible.

BENEFITS:• Make a gift using an asset that you and your family no longer need.• Receive an income tax deduction equal to the cash surrender value of the

policy.• You may be able to use the cash value of your policy to fund a gift that delivers

income, such as a deferred gift annuity.

COMMENTS

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PROPERTY | Residences, Investment Real Estate, Personal Property, Other Investments

part e | Property GRAND RAPIDS COMMUNITY FOUNDATION

INVESTMENT REAL ESTATE

Residence 1 Description Date Acquired Purchase Price

Mortgagee Balance

Held Jointly Community Tenants-in-common

Residence 2 Description Date Acquired Purchase Price

Mortgagee Balance


RESIDENCES

Investment Real Estate (1) Description Date Acquired Purchase Price

Mortgagee Balance


Names of Other Owners and Percent Contributed by Each

Investment Real Estate (2) Description Date Acquired Purchase Price

Mortgagee Balance


Names of Other Owners and Percent Contributed by Each

Other Information

Other Information

Other Information

Other Information

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CHARITABLE PLANNING POINTER: TIPS FOR REDUCING YOUR ESTATE TAXGifts of real estate often deliver a much larger value than gifts of other assets. Giving real estate — typically a high-value asset — remains one of the most effective ways of to give, especially if your children or heirs do not want or need the property in question. You may give your property outright or continue to use the property until the end of your life.

BENEFITS: • You receive an income tax deduction for the fair market value of the real estate.• You pay no capital gains tax on the transfer.• You can direct the proceeds from your gift to a specific program at Grand

Rapids Community Foundation.

HOW A LIFE ESTATE GIFT WORKS:• You deed your home, vacation home, undeveloped property, or commercial

building to Grand Rapids Community Foundation.• You may continue to use the property rent-free, and then ownership passes

to us when you no longer need it.• Grand Rapids Community Foundation may use the property or sell it and use

the proceeds.

COMMENTS

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PROPERTY | Residences, Investment Real Estate, Personal Property, Other Investments


OTHER INVESTMENTS

Mutual Funds, Stocks and Bonds Information

List here any information related to additional investments, including location, companies, advisors and account numbers. attaching copies of your most recent statements can be beneficial.

Signficant Tangible Assets/Collections

Descriptions photos of art, antiques and other collections are helpful

Trusts’ Information Trustees and Pertinent Information phone numbers, addresses, estimated values, revocability, types of trust, retained powers, etc.

part e | Property continued

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OBLIGATIONS | Accounts Receivable, Claims or Lawsuits, Credit Cards

part f | Obligations GRAND RAPIDS COMMUNITY FOUNDATION

ACCOUNTS RECEIVABLE ( 1 )

Due From Phone

Address City State

Amount Terms Due Date

Comments

ACCOUNTS RECEIVABLE (2)

Due From Phone

Address City State


Comments

LIABILITIES ( 1 )

Due To Phone

Address City State


Comments

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LIABILITIES (2)

Due To Phone

Address City State


Comments

part f | Obligations continued

Claims or Lawsuits Pending Claims or Lawsuits include attorney of record and phone number

CREDIT CARDS

Credit Cards Credit Card Information include company and account number or scan and attach with this document

CLAIMS AND LAWSUITS

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LOCATION OF IMPORTANT PAPERS

part g & h | Location of Papers, Personal Advisors GRAND RAPIDS COMMUNITY FOUNDATION

Trust Agreements ____________________________________________________________________________________________________________________________________________________

Last Will and Testament ____________________________________________________________________________________________________________________________________________________

Bonds and Securities ____________________________________________________________________________________________________________________________________________________

Bank Books ____________________________________________________________________________________________________________________________________________________

Insurance Policies ____________________________________________________________________________________________________________________________________________________

Business Agreements ____________________________________________________________________________________________________________________________________________________

Inventory of Personal Property ____________________________________________________________________________________________________________________________________________________

Titles and Deeds ____________________________________________________________________________________________________________________________________________________

Tax Papers ____________________________________________________________________________________________________________________________________________________

Charitable Documents ____________________________________________________________________________________________________________________________________________________

Others ____________________________________________________________________________________________________________________________________________________

Clergy Person Address Phone

Attorney Address Phone

Accountant Address Phone

Insurance Agent Address Phone

Trust Officer Address Phone

Investment Broker Address Phone

Tax Consultant Address Phone

PERSONAL ADVISORS

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part i | Philanthropic Interests

PHILANTHROPIC INTERESTS


LIFETIME AND TESTAMENTARY CHARITABLE GIFTS as specificied in my will

Nonprofit 1

Type of Gift Date Phone

Comments

Nonprofit 2


Comments

Nonprofit 3


Comments

Notes to executor Other Notes about Philanthropic Interests

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part j | Last Will and Testament

LAST WILL AND TESTAMENT

Personal Representative/Executor Under Will Phone

Address Alternative Phone/Address


COMMENTS

Guardian/Conservator Phone

Address Alternative Phone/Address

Trustee Phone

Address Date of Last Will

Attorney of Record Phone

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part k | Funeral and Burial Instructions

FUNERAL AND BURIAL INSTRUCTIONS

Funeral Director Phone

Address


Religious Affiliation Phone

Clergy Person

Designation of Memorial Gifts Location of Deed

Resting Place Location Cemetery Plot Cemetery Vault None

Phone Section No. Plot No.

OTHER INSTRUCTIONS

We hope this Personal, Financial & Charitable Record will help you keep your estate planning organized. When it is complete, save this PDF on your computer or share it with the executor of your estate or your estate planning attorney. Because it can be edited right on your computer, we hope you find it easy to update as things change.

Changes in personal and financial circumstances and revisions in the tax laws require frequent review of your plan. A year from now we’ll send you a friendly reminder email to review and update this document. We hope you find this tool beneficial.

We would also like to show you how the various forms of outright and deferred giving can be incorporated effectively into your plans. We are happy to discuss what options may be best for your personal situation confidentially and under no obligation.

THE IMPORTANCE OF ESTATE PLANNING

GRAND RAPIDS COMMUNITY FOUNDATION185 Oakes Street SW Grand Rapids, MI 49503Tel: 616.454.1751, Fax: 616.454.6455www.grfoundation.org