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Estate Planning

InventoryBNC Wealth Management Services

Bismarck, ND • Minneapolis, MN • Glendale, AZ1-800-BNC-BANK

08/10

2BNC National Bank Estate Planning Inventory

Many people have a will which states how their property will be managed and administered after their death, but provision for the proper administration of property during the remainder of their lifetime is often neglected. Estate planning is valuable protection for you and your family in the event of an illness or death. Your property will be managed as you choose with strong consideration given to:

1) avoiding a taxable event, and

2) income maximization for your heirs.

Using the valuable information you have compiled, we can assist you in meeting the major objectives of estate planning.

For a free initial consultation today, call 701-222-2200 or 1-800-BNC-BANK.


1. Name Birth Date Security #

Husband ____________________________________________ ___________ ______________

Wife ________________________________________________ ___________ ______________

2. Address County

City _____________________________________________________________ ________________

Farm ____________________________________________________________ ________________

3. Telephone Number _____________________________________________________________________

4. Children Name Birth Date Married Occupation

________________________________________________ _________ ________ _______________

________________________________________________ _________ ________ _______________

________________________________________________ _________ ________ _______________

________________________________________________ _________ ________ _______________

________________________________________________ _________ ________ _______________

________________________________________________ _________ ________ _______________

5. Other Dependents Name Birth Date Relationship

_______________________________________________________ ___________ _____________

_______________________________________________________ ___________ _____________

_______________________________________________________ ___________ _____________

6. Special Family Circumstances (explain)

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Personal Information


Checklist of Documentsand other Information Needed

Advisors Name Address Phone No.

Attorney _____________________________ ______________________________ _______________

Accountant ___________________________ ______________________________ _______________

Trust Officer __________________________ ______________________________ _______________

Financial Advisor ______________________ ______________________________ _______________

Life Insurance _________________________ ______________________________ _______________

Copies of your latest investment statements:

This would include retirement plans, investment accounts, IRAs, annuities, CDs (which should include rates and maturities), etc.

Copies of any insurance policies.

Details of any debt such as mortgage, student loans, credit cards, hospital bills, vehicle loans, personal loans, etc.

Copies of existing wills.

Copies of existing trusts.

Copies of last year’s tax return, preferable 2 to 3 years.


Goals & Objectives

Income NeedsWhat monthly income will your family need after you retire?Enter amount in today’s dollars.

At what age would you like to retire? Your Spouse?

Is there any other source of income that you expect beyond those already mentioned?

Tax AssumptionsWhat tax bracket do you want used to tax effect growth on assets before and after retirement?

Retirement Funding

$__________________monthly amount

Client Age ______Spouse Age ______$_______________

monthly amount

Before ret ________%After ret _________%

Disability Income NeedsWhat total monthly income will your family need in the event of your total disability? Today’s dollars, pre-tax.

What total monthly income will your family need in the event of your spouse’s total disability? Today’s dollars, pre-tax.

Do you expect any other income at disability other than from insurance, social security or spouse’s continuing salary? If so, enter amount here. Source? _____________________________

Survivor Income NeedsIn the event of your death, what total amount of monthly income will your family need? Today’s dollars, pre-tax. While your children are still at home: __________________ No children (or after they are independent): _____________

In the event of your spouse’s death, what total amount of monthly income will your family need? Enter the amount in today’s dollars, pre-tax. While your children are still at home: __________________ No children (or after they are independent): _____________

What amount of emergency funds, aside from insurance, would you like to have available in the event of your death?

Do you expect any other income at your death other than from insurance, social security and spouse’s continuing salary?Enter amount here. Source? _____________________________Date of Will: _____________________ Type: ______________

Risk Protection

$_______________CLmonthly amount


* Joint Tenancy (JT), Client (CL), Spouse (SP)


$_______________SPmonthly amount





$_______________lump sum




Checking and Savings Accounts, CDs, Money Markets

Assets

Description(Please be as complete as possible)

CurrentBalance

CurrentRate

MaturityDateOwner*

Cash Equivalents

Description(Please be as complete as possible)

CurrentOwner*

PurchaseValue

PurchaseCost Date

Business Interests



AssetsReal Estate

Description(Please be as complete as possible) Owner* Current

ValuePurchase

CostPurchase

Date

Personal PropertyDescription

(Please be as complete as possible) Owner* CurrentValue

PurchaseCost

PurchaseDate



Policy #

Life InsuranceInsurance

Carrier Type Insured Owner* FaceAmt

CashValue Prem Prem

FreqIssue Date

Fixed AnnuitiesDescription

(Please be as complete as possible)Owner* Current

ValuePurchase

CostPurchase

DateInt

RateMaturity

DateAnnuitant, if

other than owner

Disability

Policy # Carrier Type Insured Prem PremFreq

EffDate

WaitingPeriod Payor



Description(Please be as specific as possible)

Mortgages/LoansLiabilities

Mortgagee/Owner*

Original Mortgage/ Loan Amt

OriginationDate

IntRate

PmtFreq

# ofPmts

Fixed AnnuitiesDescription

(Please be as specific as possible)Mortgagee/

Owner*Original Mortgage/

Loan AmtOrigination

DateInt

RatePmtFreq

# ofPmts