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Back to Forms for 'Husband and Wife'.


ASSET INVENTORY

ASSET INVENTORY

 

    Bank Name and Address                        Form of Account

Account Number                       (Joint, Tentative Trust, etc.)               Amount

                                                               Names of Account

_________________________       ____________________        $_____________

_________________________       ____________________        $_____________

_________________________       ____________________        $_____________

_________________________       ____________________        $_____________

_________________________       ____________________        $_____________

 

  Total:  $_____________

 

Enter here information pertinent to estate planning decisions:

______________________________________________________________________

______________________________________________________________________

 

Are these permanent savings accounts or suspense accounts pending use of funds for other purposes?

 

______________________________________________________________________

______________________________________________________________________

 

U.S. SAVINGS BONDS

 

 Registration of Bonds                    Total Redemption Value of                Issue Dates

   (Form and Names)                          Bonds So Registered

___________________                   _________________              ______________

___________________                   _________________              ______________

___________________                   _________________              ______________

Total:  __________________

 

Enter here information pertinent to estate planning decisions:

 

______________________________________________________________________

______________________________________________________________________

 

What amounts were contributed by each co-owner?

 

______________________________________________________________________

______________________________________________________________________

 

OTHER BONDS

 

   Description                                                                   Cost

      (Issuer                                                             or

   Series, Rate,            Registration of Bonds          Face             Other                Current

  Date Acquired)          (form and Names)          Amount           Basis                  Value

______________     __________________     $__________     ________     $_____________

______________     __________________     $__________     ________     $_____________

______________     __________________     $__________     ________     $_____________

______________     __________________     $__________     ________     $_____________

______________     __________________     $__________     ________     $_____________

______________     __________________     $__________     ________     $_____________

 

                                          BOND TOTAL:  $_________         TOTAL: $_____________

 

Enter here information pertinent to estate planning decisions:

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

What amounts were contributed by each joint owner?

 

____________________________________________________________________________

____________________________________________________________________________

 

Any U.S. Treasury bonds redeemable at par to pay Federal Estate tax?

 

____________________________________________________________________________

____________________________________________________________________________

 

STOCKS

 

Name of Company and Type of Stock:  ___________________________________________

 

Number of Shares:  ___________________________________________________________

 

Registration of Stock (Form and Names):  _________________________________________

 

Date Acquired:  ______________________________________________________________

 

Cost or Other Basis:  __________________________________________________________

 

Current Value:  ______________________________________________________________

 

Enter here information pertinent to estate planning decisions: 

 

____________________________________________________________________________

____________________________________________________________________________

 

Is portfolio active or stable?

 

____________________________________________________________________________

Is purpose of investment program primarily current income or capital appreciation?

 

____________________________________________________________________________

____________________________________________________________________________

 

Do you have margin account?  Cash account?

 

____________________________________________________________________________

____________________________________________________________________________

 

What amounts were contributed by each joint owner of jointly held stock?

 

____________________________________________________________________________

 

List also other property interests in this area such as warrants, etc.

 

____________________________________________________________________________

 

List all brokers with whom you have account or do business.

 

____________________________________________________________________________

 

REAL ESTATE RESIDENCES

 

Location Description, Date Acquired:  _____________________________________________

 

Owners¾Form of Ownership-Interest of Each Owner:  _______________________________

____________________________________________________________________________

 

Cost or Other Basis:  ___________________________________________________________

 

Fair Market Value:  ____________________________________________________________

Mortgages and Other Liens:  _____________________________________________________

 

Your Equity:  _________________________________________________________________

 

TOTAL:  __________________________

 

INSURANCE ON  HOMES

 

Type of Insurance        Name of Company      Policy Number      Expiration          Name of

       Dates                Broker

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

_______________   ________________    ______________    __________   ___________

 

Enter here information pertinent to estate planning decisions:

 

____________________________________________________________________________

____________________________________________________________________________

 

What amounts were contributes by each joint owner?

 

____________________________________________________________________________

____________________________________________________________________________

 

Do you contemplate any sales of above homes in near future?

 

____________________________________________________________________________

 

REAL ESTATE-INVESTMENTS

 

                         Owners-Form of                                                      Mortgages

    Location      Ownership-Inter-       Cost or              Fair                    and

  Description      est of Each                Other             Market                Other                 Your

  Date Acq’d           Owner                  Basis               Value                 Liens                Equity

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

 

TOTAL:  _________________

 

INSURANCE ON INVESTMENT REALTY

 

Type of Insurance          Name of                  Policy                 Expiration          Name of Broker

                                      Company                Number                   Dates

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

______________     _____________     _____________     _____________     _____________

 

Enter here all information pertinent to estate planning decisions: 

 

____________________________________________________________________________

 

Is investment realty owned by corporation in which you hold stock?

 

______________________________________________________________________

 

If so, give details concerning corporation and stockholders.

 

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

 

NON BUSINESS RECEIVABLES

 

    Debtor          Nature of Debt      Security             Date Due        Face Amount   Current Value

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

___________    ___________    ___________    ___________    ___________    ___________

 

                                                                                                         TOTAL:  ___________

 

Enter here other pertinent information:

 

____________________________________________________________________________

 

List any surety or accommodation parties regarding any of the above debts; how payable; names of associates holding interests in receivables, etc.

____________________________________________________________________________

 

LIFE INSURANCE

 

List all policies under which you are the insured.

 

                                                                   Present                                       How will

    Name of         Type of         Policy           Cash           Face                      Proceeds

    Company        Policy         Number        Value       Amount   Owner       Be Paid   Beneficiary

__________   _________   _________   _______   ________   _______   _______   _________

__________   _________   _________   _______   ________   _______   _______   _________

__________   _________   _________   _______   ________   _______   _______   _________

__________   _________   _________   _______   ________   _______   _______   _________

__________   _________   _________   _______   ________   _______   _______   _________

__________   _________   _________   _______   ________   _______   _______   _________

 

                                                         _________   _________

TOTALS

 

Enter here information pertinent to estate planning decisions:

 

____________________________________________________________________________

 

Are there any loans under policies?

 

____________________________________________________________________________

 

Have any policies been assigned?

 

____________________________________________________________________________

 

Should you reconsider settlement chosen?

 

___________________________________________________________________________

Do you own life insurance on lives of others?  If so, give details here including name of insured, face amount of policy, and present cash value.

 

____________________________________________________________________________

____________________________________________________________________________

 

Who are insurance agents with whom you deal with ?

 

____________________________________________________________________________

 

 

BUSINESS INTERESTS

 

Name of Business:  ____________________________________________________________

 

Address of Business:  __________________________________________________________

 

Sole proprietorship:  _______ Partnership:  _______ Close Corporation:  __________

 

Nature of Business enterprise:  ___________________________________________________

 

Names of Partners           Number of Shares or                 Office Held                 Duties

 or Stockholders                Percentage Interest

__________________     _________________      ________________    ___________

__________________     _________________      ________________    ___________

__________________     _________________      ________________    ___________

__________________     _________________      ________________    ___________

__________________     _________________      ________________    ___________

__________________     _________________      ________________    ___________

 

Value of  interest in business:  _____________________________________

 

Have you entered in to any partnership, stockholders’, cross-purchase, or stock redemption agreement?  If so, describe briefly on this page.

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Are there IRC Sec. 303 stock redemption considerations?

 

____________________________________________________________________________

 

Have you retained voting rights in transferred stock?  [IRC Sec. 2036 (b)].

 

____________________________________________________________________________

 

If no agreement presently exists, what are your wishes with regard to business interests?

 

____________________________________________________________________________

 

Enter on this page information on family members and key men who can operate business in the event of your death or disability and other facts relating to plans for retention or disposition of business interest?

 

____________________________________________________________________________

 

List facts relating to capital structure of corporation.  Does corporation hold treasury stock?  Has all authorized stock been issued, etc.?

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

EMPLOYEE AND RETIREMENT BENEFITS

 

Employer’s Pension, Profit-sharing or Stock Bonus Plans

 

                                 Plan 1                              Plan 2                                     Plan 3

Name of Plan   _________________                  _________________        _________________

 

Trustee, Insurance

Company, or

Administrator   _________________                  _________________        _________________

 

Amount Contributed

by Employee  _________________        _________________        _________________

 

Amount Contributed

by Employer  _________________         _________________        _________________

 

Retirement

Benefit          _________________        _________________        _________________

 

Death Benefit  _________________                  _________________        _________________

 

Present Value of Total

Contributions    _________________                  _________________        _________________

 

Amount Vested  ________________                  _________________        _________________

 

What are the options available to you?  Enter here information pertinent to selection of options offering you maximum advantage for your  situation, e.g., payment of lump sum, payment in installments, payment in company stock, payment in the form of an annuity.

 

____________________________________________________________________________

Can you borrow from plan?  What amounts can you presently withdraw?

 

___________________________________________________________________________

 

Retirement Benefit Plans

 

Are you contributing to an IRA?  If self-employed -- to a Keogh plan?

 

____________________________________________________________________________

____________________________________________________________________________

 

Group Life, Accident, Health, Death Benefit, and Disability Plans

 

                                             Plan 1                           Plan 2                           Plan 3

Name of Plan             __________________            ___________________          ________________

 

Insurer of Trustee      __________________            ___________________          ________________

 

Policy Number           __________________            ___________________          ________________

 

Benefits                     __________________            ___________________          ________________

 

Beneficiary                __________________            ___________________          ________________

 

Options Elected          __________________            ___________________          ________________

 

What other options are available to you?

 

____________________________________________________________________________

 

Split-Dollar Life Insurance

 

Enter here all information relating to split-dollar life insurance, e.g., name of company, policy number, form of agreement, face amount, net amount payable to beneficiary.

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Stock Options

 

Enter her all pertinent information relating to stock options held by you, e.g., option price, number of shares to which options extends, number of shares already purchased, price at which purchased, present market value per share, etc.

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Deferred Compensation Contract

 

Date of execution; provisions for retirement and death benefits.

 

____________________________________________________________________________

 

TOTAL DEATH BENEFITS FROM ALL PLANS  ___________________

 

RIGHTS UNDER ESTATES AND TRUSTS INCLUDING

POWERS OF APPOINTMENT

 

Rights and interest of trusts set up by yourself

 

Date trust executed:  ___________________________________________________________

 

Name and address of trustee:  ____________________________________________________

 

Duration of trust:  _____________________________________________________________

 

Value of initial corpus on date of transfer to trustee:  _________________________________

 

Present market value of total corpus:  ______________________________________________

 

Rights and interests held by settlor (if none, so state):  ________________________________

____________________________________________________________________________

 

Is trust revocable?

____________________________________________________________________________

 

Rights and interests of other beneficiaries (describe briefly; examine copy of trust instrument):

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Details on your powers of appointment:

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Rights and interest of your trusts set up by others:  ___________________________________

____________________________________________________________________________

 

Type of trust:             Inter vivos ______________    Testamentary _____________________

 

Name of settlor:  ______________________________________________________________

 

Name and address of trustee:  ____________________________________________________

 

Date trust executed if inter vivos:  ________________________________________________

 

Date will probated if testamentary:  _______________________________________________

 

Court having supervision of trust:  ________________________________________________

 

Duration of trust:  _____________________________________________________________

 

Present market value of trust corpus:  ______________________________________________

 

Rights and interest held by you:  _________________________________________________

 

Is trust revocable?  ____________________________________________________________

 

Rights and interests of other beneficiaries:  _________________________________________

____________________________________________________________________________

 

Details on your  power of appointment:  ___________________________________________

____________________________________________________________________________

 

MISCELLANEOUS ASSETS

 

Personal Property

(Automobiles, boats, jewelry, furs, silverware, china, art works, books, stamp collections, coin collections, household furniture, etc.)

 

      Description              Location         Current Value             Costs or                   Insurance

    Date Acquired                                                                   Other Basis               Information

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

______________     ____________   ____________        ___________         _______________

 

                                 SUBTOTAL:  ____________

 

Patents, Copyrights, Trademarks

 

Enter here information pertinent to estate planning decisions, e.g.,

annual income over last few years, anticipated income to expiration date, etc.

 

____________________________________________________________________________

____________________________________________________________________________

 

Oil and Gas Interest

 

List all transfers that might be included in gross estate (gifts where donor retained some control, transfers for inadequate consideration, etc.).  Examine copies of all gift tax returns:

How much unified credit remains for you and your spouse?

 

____________________________________________________________________________

____________________________________________________________________________

 

Rights Under Estates Being Administered and Anticipated Inheritances

Enter here all pertinent information:

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Safe Deposit Boxes

 

Name of safe deposit company, address, box number, names and addresses of persons having access, form of registration.  Is property of any person in box?

 

____________________________________________________________________________

____________________________________________________________________________

 

Cemetery Plots

 

Enter here all information relating to ownership of family burial plots, location of deed.

 

____________________________________________________________________________

____________________________________________________________________________

 

Other Assets Not Previously Listed

 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

TOTAL - MISCELLANEOUS ASSETS:  ____________

LIABILITIES

 

   Nature of                    Creditor          Amount         Security                  Location of

       Debt                                                                                                    Security

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

__________             __________    __________    ________        _______________

 

                                             TOTAL  _____________

 

SUMMARY SHEET

 

Assets

 

Bank Accounts:                                                           ________________________________

 

Bonds (Total U.S. Savings Bonds and others): ________________________________

 

Stocks:                                                                       ________________________________

 

Real Estate - Residences:                                           ________________________________

 

Real Estate - Investments:                                          ________________________________

 

Non Business receivables:                                           ________________________________

 

Life Insurance on your life:                                         ________________________________

Life insurance on lives of others:                                 ________________________________

 

Business interests:                                                      ________________________________

 

Death Benefits - Employee and Retirement plans:        ________________________________

 

Rights under estates and trusts including powers

of appointment:                                                           ________________________________

 

Miscellaneous assets:                                      ________________________________

 

ESTIMATED GROSS ESTATE                     TOTAL:  ______________________________

 

***DOCUMENTS CHECKLIST (to be examined by attorney as required) AND LOCATION-OTHER REQUIRED INFORMATION***

 

Document                                                                  Location

 

Previous will or wills:                                      ________________________________

 

Spouse’s will:                                                             ________________________________

 

Antenuptial agreement:                                               ________________________________

 

Copies of income and gift tax returns:              ________________________________

 

Birth Certificates:                                                       ________________________________

 

Marriage Certificates:                                                 ________________________________

 

Divorce Decree:                                                         ________________________________

 

Separation Agreement:                                               ________________________________

 

Family Tree:                                                               ________________________________

 

Military service discharge certificate and

benefits records:                                                         ________________________________

 

Social Security number:                                               ________________________________

 

Person holding safe deposit keys:                                 ________________________________

 

Cemetery deed:                                                          ________________________________

 

Name and address of insurance agent:                         ________________________________

 

Name and address of stockbroker:                               ________________________________

 

Leases:                                                                      ________________________________

 

Deeds of residence and business property:                   ________________________________

 

Tax receipts:                                                              ________________________________

 

Maps, surveys:                                                           ________________________________

 

Mortgages and notes owned:                                       ________________________________

 

Mortgages and notes owed:                                         ________________________________

 

Stock and bond certificates:                                         ________________________________

 

Bankbooks and bank statements:                                 ________________________________

Records of securities purchased and sold:                    ________________________________

 

Life insurance and annuity policies:                              ________________________________

 

Fire and other casualty insurance policies:                    ________________________________

 

Health and accident policies:                                       ________________________________

 

Partnership agreement:                                               ________________________________

 

Stockholders’ agreement:                                            ________________________________

 

Stock redemption agreement:                                      ________________________________

 

Business continuation agreement:                                ________________________________

 

Business legal and accounting records:                         ________________________________

 

Employee benefit plan booklets, records

agreements, certificates, account books:                       ________________________________

 

Deferred compensation agreement:                             ________________________________

 

Copies of trust agreements and wills under which

you have power of appointment and other rights:          ________________________________

 

Trust instruments in which you are settlor:                    ________________________________

 

Bills of sale and other evidences of ownership:             ________________________________

 

The Asset Inventory Form needs to be used with the Estate Analysis Form found in the Financial Planning Category

 



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