personal financial information

8/8/2019 Personal Financial Information

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PERSONAL FINANCIAL INFORMATION

FOR

____________________________


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Personal Financial InformationTable of Contents

1. Introduction

2. Personal Information

3. Personal Finances

4. Insurance Checklist

5. Pension and Investment Checklist

6. Tangible Assets Checklist

7. Tax Information

8. Wills/Trusts/Estate Planning

9. Professional Contacts

10. Important Papers


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Introduction

Developing and maintaining a personal financial plan is essential foryou in achieving financial security.

Your personal financial plan is composed of many elements, whichinter-relate in a dynamic way as you progress through the variousstages of your life.

This information is offered to you with the hope that it may behelpful to you in developing and maintaining your personal financialplan by:

Suggesting a variety of financial planning

elements that might be helpful.

Providing a centralized place where your financialplanning information can be maintained.

In the event of an emergency or at death, information can beextremely important. Thus, having everything listed in anorganized planner makes things simpler.

When you have completed the information, place this binder in asafe location. Make sure that its location is known by at least two

other family members or close friends. Do not place it in a safedeposit box because of the limited access to it in time of need.

This information is intended for your general use only. You maywant to obtain professional advice from either a lawyer or acertified financial planner regarding your specific financial planning.


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Personal Information

Check if information is included


Parents Information

Siblings or Other Relatives Information

Employment History

Salary History

Instructions to the Family


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Legal

Name___________________________________________________

_______

SSN ______________________________ Birthdate

________________________

Maiden Name (if

applicable)________________________________________

Place of Birth

______________________________________________________

Spouses Name ______________________ Maiden Name

________________

SSN ______________________________ Birthdate

_______________________

Place of Birth

______________________________________________________

Parents

Name and Address

Relationship

Birthdate

Living Deceased_______________________________________


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__________________

_____________

_______________________________________

__________________

____________________________________________________

Name and Address

Relationship

Birthdate

Living Deceased_______________________________________

__________________

____________________________________________________

__________________

____________________________________________________

Name and Address

Relationship

Birthdate

Living Deceased


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_______________________________________

__________________

____________________________________________________

__________________

____________________________________________________


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Siblings or Other Relatives

Name_________________________________________

SSN____________________________________

Birthdate_______________________Gender ______ MaritalStatus_________________________

Address_______________________________________

Phone_______________________________

Name_________________________________________

SSN____________________________________


Address_______________________________________

Phone_______________________________

Name_________________________________________

SSN____________________________________


Address_______________________________________

Phone_______________________________

Name__________________________________________

SSN____________________________________


Address_______________________________________

Phone_______________________________


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Name__________________________________________SSN____________________________________


Address_______________________________________

Phone_______________________________

Name__________________________________________SSN____________________________________


Address_______________________________________Phone_______________________________

Employment History

Present Employer UC RiversideDepartment ______________________________ Phone

___________________Title_______________________________________________________________Supervisor _______________________________ Phone____________________Hire Date___________________________________________________________

Retirement Benefits Yes No

Contact the UCR Benefits Office Phone: (909) 787-4766E-mail:


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Former Employer__________________________________________________

Address __________________________________ Phone__________________

Employment Date: From:_________________ To:______________________

Retirement Benefits Yes NoContact person for benefits_________________________________________Phone______________________________________________________________

Former Employer__________________________________________________Address __________________________________ Phone__________________Employment Date: From: _______________ To:

______________________

Retirement Benefits Yes NoContact person for benefits

_______________________________________Phone_____________________________________________________________


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Salary History

Employer:

___________________________________________________________Employment Dates:

_________________________________________________

Year Annual Salary

__________ ____________________

__________ ____________________

__________ ______________________________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________

__________ ____________________


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__________ ____________________

* Enter the amount from your annual W2 form


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Instructions to My Family

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

__________________________________________________________________________________________________

_________________________________________________


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Personal Finance

If information is included

Budget

Cash Flow Analysis

Net Worth Analysis

Other


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Financial Institutions


Bank Credit Union

Checking Checking

Savings Savings

Certificate of

Deposit

Certificate of

Deposit

Money Market Money Market

Credit Cards Credit Cards

Loan Information Loan Information

Other Other


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Name of Financial

Institution______________________________________

Address

___________________________________________________________

Phone

_____________________________________________________________

Contact Person

___________________________________________________Account Number(s) PIN Number

Checking ________________________

_________________________

Savings ________________________

________________________

Certificates ________________________________________________

of Deposit ________________________

________________________

Money Market________________________

________________________

Credit Card(s)________________________

________________________

(Lost or stolen card call ________________________)

Credit Card(s)________________________


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________________________


Credit Card(s)________________________

________________________



(Continued)

Name of Financial

Institution______________________________________

Address

___________________________________________________________

Phone

_____________________________________________________________

Contact Person

___________________________________________________

Account Number(s) PIN Number


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Checking ________________________

________________________

Savings ________________________

________________________

Certificates ________________________________________________

of Deposit ________________________

_________________________

Money Market________________________

________________________

Credit Card(s)________________________

________________________


Credit Card(s)________________________

________________________


Credit Card(s)________________________

________________________



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Location of Safe Deposit Box(es)

Name of Bank ______________________________________________ Box No.

_______________

Address ____________________________________________ Phone

________________________

Contact Person

____________________________________________________________________

Location of Key

____________________________________________________________________

Contents/Inventory:

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________


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Loan Information

Name of Bank/Credit Union

__________________________________________________________

Address ________________________________________________ Phone_____________________

Account Number

____________________________________________________________________

Contact Person

_____________________________________________________________________

Collateral

___________________________________________________________________________

Loan Term ______________________ Payoff Date

_____________________________________

Credit Life/Disability Insurance Yes No


__________________________________________________________

Address ________________________________________________ Phone

_______________________

Account Number

_____________________________________________________________________

Contact Person

_____________________________________________________________________

Collateral

____________________________________________________________________________


______________________________________




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_________________________________________________________

Address ________________________________________________ Phone

______________________

Account Number

_____________________________________________________________________

Contact Person

_____________________________________________________________________

Collateral

_____________________________________________________________________________


_______________________________________


Other Financial Information

_______________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________


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Insurance Checklist


Medical

Dental

Vision

Life

Disability

Auto

Recreational Vehicles

Homeowners/Renters

Umbrella ( General Liability Policy)

Long-Term Care

Other Insurance Plans


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Health Insurance Medical, Dental and Vision

Medical Insurance Company

_______________________________________________________

Group Individual

Phone Number

_____________________________________________________________________

Policy or Certificate Number

______________________________________________________

Plan Name and Type

_______________________________________________________________

Hospitalization

Physician Visits

Prescriptions

Dental Insurance Company

_________________________________________________________

Group Individual

Phone Number

_____________________________________________________________________


_______________________________________________________

Plan Name and

Type________________________________________________________________

Vision Insurance Company

_________________________________________________________

Group Individual

Phone Number

______________________________________________________________________


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_______________________________________________________

Plan Name and Type

_______________________________________________________________

Other Insurance Company

_________________________________________________________

Group Individual

Phone Number

______________________________________________________________________


________________________________________________________

Plan Name and Type

________________________________________________________________


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Prescription Information

Patient Name

Medication

Dosage/Frequenc

ies Doctor


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Life Insurance

Insurance Company

___________________________________________________________________

Group Individual

Phone Number

_______________________________________________________________________


_________________________________________________________

Type of Coverage____________________________________________________________________

Amount of Coverage

_________________________________________________________________

Beneficiaries

________________________________________________________________________

Insurance Company

__________________________________________________________________

Group Individual

Phone Number

________________________________________________________________________


_________________________________________________________

Type of Coverage

____________________________________________________________________

Beneficiaries

________________________________________________________________________


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Disability/Accident Insurance

Insurance Company

__________________________________________________________________ Group Individual

Phone Number

_________________________________________________________________________


_________________________________________________________

Type of Coverage

_____________________________________________________________________

Beneficiaries

___________________________________________________________________________


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Auto Insurance

Insurance Company

____________________________________________________________________

Group Individual

Agent

_________________________________________________________________________________

Phone Number

_______________________________________________________________________


________________________________________________________

Type of Coverage

____________________________________________________________________

Vehicle 1 _________________________________ VIN _________________________________

Vehicle 2 _________________________________ VIN _________________________________

Vehicle 3 _________________________________ VIN _________________________________

Vehicle 4 _________________________________ VIN _________________________________

Recreational Vehicle Insurance

Insurance Company

___________________________________________________________________

Group Individual

Agent

__________________________________________________________________________________

Phone Number

_______________________________________________________________________



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________________________________________________________

Type of Coverage

_____________________________________________________________________

Vehicle 1 __________________________________ VIN _________________________________

Vehicle 2 __________________________________ VIN _________________________________

Vehicle 3 __________________________________ VIN _________________________________

Motorcycle ________________________________ VIN _________________________________


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Homeown ers/Renters Insurance

Insurance Company

____________________________________________________________________ Group Individual

Agent

_________________________________________________________________________________

Phone Number

_______________________________________________________________________


________________________________________________________

Type of Coverage

____________________________________________________________________

Umbrella Policy (General Liability Policy)

Insurance Company

__________________________________________________________________

Group Individual

Agent

________________________________________________________________________________

Phone Number

______________________________________________________________________


________________________________________________________

Type of Coverage

_____________________________________________________________________

Long-Term Care Insurance

Insurance Company

__________________________________________________________________


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Group Individual

Agent

_________________________________________________________________________________

Phone Number

______________________________________________________________________


________________________________________________________

Type of Coverage

____________________________________________________________________

Other Insurance Information

___________________________________________________

___________________________________________________


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Pension & Investment Checklist


UCRP Basic Retirement Plan & Other

Pension Plans

Savings Account (see financial institutions

section)

Certificates of Deposit (see financial

institutions section)

UC Savings Plans & Other Employer

Savings Plans

IRA

Mutual Funds U.S. Savings Bonds

Stocks & Bonds

Social Security Information


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UCRP Basic Retirement Plan

Contact: UC Riverside Benefits Office

Phone: (909) 787-4766 E-mail:

Retirement estimate can be obtained at:

www.ucop.edu/bencom

Retirement Estimate Enclosed: Yes No

Payout option

______________________________________________________

Beneficiary_________________________________________________________

Other Pension Plan(s)

Company

___________________________________________________________

Address

____________________________________________________________

Phone _____________________ Contact Person

________________________

Amount

_____________________________________________________________

Company

___________________________________________________________

Address


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____________________________________________________________

Phone _____________________ Contact Person

________________________

Amount

_____________________________________________________________

Other Pertinent Information:

________________________________________

____________________________________________________________________

__

____________________________________________________________________

__

____________________________________________________________________

_


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UC Savings Programs & Other Savings Plans

1. Tax Deferred 403(b) Plan Plan Balances can be found at:

www.ucop.edu/bencom or call (800)888-8267

Account Number (Social Security

Number)_________________________

Location of Semi-Annual

Statements________________________________

PIN Number

________________________________________________________

Outstanding loans against 403(b) plan

_____________________________

Date of Loan

________________________________________________________

Term of Loan________________________________________________________

Final Payment Due

__________________________________________________

2. After-Tax Plan 401(a) Plan Balances can be found at:

www.ucop.edu/bencom or call (800)888-8267

Account Number (Social Security

Number)_________________________

Location of Semi-Annual Statements
http://www.ucop.edu/bencomhttp://www.ucop.edu/bencomhttp://www.ucop.edu/bencomhttp://www.ucop.edu/bencom


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________________________________

PIN Number

______________________________

__________________________

3. Defined Contribution Plan (DCP 401(a) plan) Plan

Balances can be found at : www.ucop.edu/bencom or call

(800)888-8267

Account Number (Social Security Number)

________________________


_______________________________

PIN Number

________________________________________________________

4. Capital Accumulation Plan (CAP account) Plan Balance can

be found at www.ucop.edu/bencom or call (800)888-8267


_________________________


________________________________PIN Number

________________________________________________________

5. Other Employer Savings Plans Plan Balance can be found
http://www.ucop.edu/bencomhttp://www.ucop.edu/bencomhttp://www.ucop.edu/bencomhttp://www.ucop.edu/bencom


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at:

____________________________________________________________________

_


_________________________


________________________________

PIN Number________________________________________________________

6. Other Employer Savings Plan Plan Balance can be found

at:

____________________________________________________________________

_


_________________________


________________________________

PIN Number________________________________________________________

7. Other Employer Savings Plan Plan Balance can be found at:

_____________________________________________________________________


_________________________



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________________________________

PIN Number________________________________________________________


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IRA Accounts

Traditional

Rollov

er

ROTH

Educat

ion

Company

____________________________________________________________

Address ________________________________________Phone

______________

Contact Person

_____________________________________________________

Account Number & Type

____________________________________________

Company

____________________________________________________________

Address ________________________________________Phone

______________

Contact Person


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_____________________________________________________

Account Number &

Type_____________________________________________

Company

____________________________________________________________

Address ________________________________________Phone

_______________

Contact Person

_______________________________________________________

Account Number & Type

_____________________________________________

Company

_____________________________________________________________

Address ________________________________________Phone

_______________

Contact Person

_______________________________________________________

Account Number & Type____________________________________________


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Mutual Funds

Company

____________________________________________________________

Address ________________________________________Phone

_______________

Contact Person

______________________________________________________

Account Number____________________________________________________

Company

____________________________________________________________

Address ________________________________________Phone

______________Contact Person

_____________________________________________________

Account Number

____________________________________________________

Stocks and Bonds

Brokerage Firm

______________________________________________________

Address _______________________________________Phone


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_______________

Contact Person

______________________________________________________

Account Number

_____________________________________________________

Other Investment Information

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Social Security Information

Beginning in 2000 the Social Security Administration sends out annual

statements to all wage earners. This Personal Earnings and Benefit

Estimate Statement shows your Social Security earnings history and

estimates how much you have paid in Social Security taxes. It also

estimates your future benefits and tells you how you can qualify for

benefits. It is a good idea to review these statements for accuracy and it is

important to keep these statements in your records.

Local Social Security Office: Hours 9 am to 4 pm

1860 Chicago Ave.

Riverside, CA

(909) 276-6041


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General Information and Services: Hours 7am to 7pm

(800) 772-1213 http://www.ssa.gov


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Tangible Assets Checklist


Primary Residence

Secondary Residence

Automobile(s)

Recreational Vehicle

Personal Property

Business Interests


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Residential Property

Primary Residence

__________________________________________________

Mortgage Holder

____________________________________________________

Address __________________________________________Phone

_____________

Location of papers (deed, insurance,

etc.)________________________________________________________________________________________________

_

Secondary Residence

________________________________________________

Mortgage Holder____________________________________________________

Address __________________________________________Phone

____________

Location of papers (deed, insurance,

etc.)____________________________

_____________________________________________________________________

__

Other Real Property

_______________________________________________


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_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Automobile(s)

Make/Model

__________________________________________________________

Lien holder__________________________________________________________

Address _____________________________________Phone

___________________

Insurance Company

_________________________________________________

Location of Title

_____________________________________________________

License Plate # ____________________ VIN

_____________________________


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Make/Model

_________________________________________________________

Lien holder

___________________________________________________________

Address _____________________________________Phone

_________________

Insurance Company

_________________________________________________

Location of Title

_____________________________________________________

License Plate # _____________________VIN

______________________________

Make/Model

__________________________________________________________

Lien holder

_________________________________________________________

Address _____________________________________Phone

_________________

Insurance Company

_________________________________________________Location of Title

_____________________________________________________

License Plate # _____________________VIN

______________________________


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Recreational Vehicle(s)

Make/Model

_________________________________________________________

Lien holder

___________________________________________________________

Address _____________________________________Phone

__________________

Insurance Company________________________________________________

Location of Title

_____________________________________________________

License Plate # _________________________ VIN

________________________

Make/Model

_________________________________________________________

Lien holder

___________________________________________________________

Address _____________________________________Phone

_________________

Insurance Company

__________________________________________________

Location of Title

_____________________________________________________


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License Plate # ________________________ VIN

________________________


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Personal Property

List all possessions that are valuable, tangible property.

Examples: Jewelry, Furniture, Collectibles/Antiques, HomeOffice Equipment, Electronics, Other Equipment, Books,CDs, Artwork, Musical Instruments, etc.

Item

1. ____________________

2. ____________________

3. ____________________

4. ____________________

5. ____________________

6. ____________________

7. ____________________

8. ____________________

9. ____________________

10. ____________________

11. ____________________

12. ____________________

13. ____________________

14. ____________________

15. ____________________

Location

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

______________________________________________

_______________________

_______________

Value

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

_________

Insured

Y or N________

________

________

________

________

________

________

________

________

________

________

________

________________

________


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Tax Information


Federal Tax Return

State Tax Return

Flexible Spending Account (FSA)

Charitable Contributions

Premium Only Plan (POP)

Tax Service Used Yes No

Name of Service

_______________________________________________________

Address ____________________________________ Phone

____________________

Contact Person _____________________________________________________

Location of Tax Records

_______________________________________________________________________

_______________________________________________________________________


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_______________________________________________________________________

___

Charitable Contributions

Name of Organization

________________________________________________

Annual Donation Amount

_____________________________________________

Instructions for FutureDonations_____________________________________

______________________________________________________________________

_

Name of Organization_________________________________________________


_____________________________________________

Instructions for Future

Donations_____________________________________

______________________________________________________________________

_


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Name of Organization

_________________________________________________


____________________________________________

Instructions for Future Donations

____________________________________

______________________________________________________________________

_


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Wills/Trusts/Estate Planning

Wills and living trusts are legal documents that determine how your estate wi

be distributed following your death. In the absence of such documents, you

property will be distributed among your heirs as prescribed by statut

Because this distribution is unlikely to match your own preferences, yo

should carefully consider creating a will, a trust or both. Because estat

planning is a complex issue, you should seek appropriate legal counsel t

determine how best to meet your individual estate planning requirements.

Attorney for Will ______________________________

Phone__________________

Date of Wi

___________________________________________________________

Location of Wi

_______________________________________________________

Location of Additional Copie

_________________________________________

Executor

_______________________________________________________________

Address ________________________________________ Phon

________________

Attorney for Trust ____________________________

Phone________________

Name of Trus

_________________________________________________________


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Date of Trus

__________________________________________________________

Trustees

_________________________________________________________________

Location of Trus

Documents__________________________________________

Location of Additional Copie

__________________________________________

Trustee Bank (

applicable)___________________________________________

Address _______________________________________ Phon

___________________

Contact Perso

________________________________________________________

Professional ContactsCheck if information is included

Accountant

Attorney

Insurance Agent

Physician(s)

Dentist

Clergy

Certified Financial Planner

Benefits Office


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Auto Mechanic

Plumber

Roofer

Other


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Important Papers

Check if records are included

Birth Certificate(s)

Citizenship Papers

Passport

Marriage Certificate

Military Service Papers

Divorce Papers

Death Certificate(s)

Living Will

Power of Attorney

Real Estate Papers

Prepaid Funeral Plan


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Location of Important Documents

Birth Certificate(s

____________________________________________________

Citizenship Paper

____________________________________________________

Military ServicPapers________________________________________________

Marriage Certificat

___________________________________________________

Divorce Paper_________________________________________________________

Power of Attorne

______________________________________________________

Real Estate Paper

____________________________________________________

Living Wi


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____________________________________________________________


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You can throw those papers out!

At least most of them. The table below indicates the

documents you need to keep and how long you should keep

them.

DOCUMENT

HOW LONG

Bank Statements 6 years*

Birth Certificates

Indefinitely

Canceled checks 6 years*

Contracts

Updated

Credit card account numbers Updated

Divorce papers

Indefinitely

Home purchase & improvement records As long as you own th

property

Household inventory Updated

Insurance, life

Indefinitely

Insurance, car, home, etc. Updated

Investment records 6 yearafter tax deadline forthe year of sale**

Investment certificates Until cashe

or sold

Loan agreements Until pai

in full


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Military service records Indefinitely

Real estate deeds Until

transfer

Receipts for large purchases Until sale odiscard

Service contracts & warranties Until expiration

Social Security number Indefinitely

Tax returns 6

years from filing date

Vehicle titles Unt

sale or disposal

Will

Updated

**The IRS audits returns up to three years after filing; however, large underpaymenmay be

investigated as far back as six years.


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Prepaid Funeral PlanYes

No

Funeral Home_________________________________________________________Address ______________________________________ Phone_________________Name of Contac______________________________________________________

Pre-Purchased Burial Plot Yes No

Location of Cemetery_________________________________________________Plot No. and Location_________________________________________________MonumentInformation____________________________________________________________

_________________________________________________________________________

Obituary Yes No

Photo Yes No Burial Instructions to My Family______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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_______________________________________________________________________


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People to be contacted at time of death

Name ________________________________________________________________

Phone # ________________________________________________________

Name ________________________________________________________________

Phone # ________________________________________________________

Name ________________________________________________________________

Phone # ________________________________________________________

Name ________________________________________________________________

Phone # ________________________________________________________

Name ________________________________________________________________

Phone # ________________________________________________________

Name ________________________________________________________________

Phone # ________________________________________________________