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End of Life Planning

We offer this checklist as one way to begin the planning process. Be sure to include important decision makers as you work through the list. Let them clearly know your wishes and how to access your documents.

I. Your Story

1. What is the story of your life? Who might want or need to know it? Can you write or audiotape or video tape or draw your story? Do you have photos, letters, other documents or records that are important to your story?
2. Genealogical matters - do you have a family history or family tree?
3. Community and church - Are there important records or connections outside your immediate control?
4. Interests, accomplishments and hobbies?

II. Your Estate

1. Legal Matters:
   a. Do you have a will? Where is it?
   b. Are you a trustee, guardian or committee?
   c. Are you responsible (legally or otherwise) for other persons or property?
   d. Name of the Executor of your will
   e. Name of your Financial Power of Attorney
   f. Name of your Medical Power of Attroney ("e" and "f" are not the same!)
   g. Name of your Lawyer
   h. Name of your Estate and/or Financial planner
2. Insurance: Locate and identify policies and specific contact information
   a. Life insurance
   b. Homeowner or Renters insurance
   c. Medical insurance
   d. Accidental death insurance
   e. Business insurance
   f. Automobile insurance
   g. Disability
   h. Funeral policy
   i. Other
3. Taxes: locate and identify previously filed tax returns and documents
   a. Personal income tax
   b. Property taxes
   c. Business and other taxes
   d. Other
4. Finances: locate and identify specific account numbers, institutions, account passwords and access codes, etc.
   a. Credit cards
   b. Bank and Credit Union accounts (savings, checking, money market, other)
   c. Loans (Auto, personal etc)
   d. Stocks, Bonds, Investments, Certificates of Deposit
   e. Annuities
   f. Debts owed you
   g. Debts you owe
   h. Investment manager or Financial advisor
   i. Brokers
   j. Banker
   k. Pension plan, Retirement benefits
   l. Safety Deposit box
   m. Other
5. Documents and Certificates (locate and identify)
   a. Birth certificate
   b. Wills that affect your property and other interests
   c. Marriage certificates
   d. Social Security
   e. Deeds and leases
   f. Homeowners Association bylaws
   g. Notes and security agreements
   h. Mortgage(s)
   i. Military discharge papers
   j. Financial instruments (See Finances above)
   k. Vehicle and personal property titles

II. Personal Information

1. Organizations, Associations and Memberships: name, certificates, identification numbers, other documents that may be important
   a. Civic and Fraternal
   b. Military/Veterans
   c. Business
   d. College/School
   e. Clubs
   f. Union
   g. Boards
   h. Church
   i. Other
2. Utilities and maintenance: who is responsible for these?
   a. Electricity
   b. Gas
   c. Water
   d. Trash
   e. Phone
   f. Internet (access codes, passwords)
   g. Cable TV
   h. Auto club
   i. Lawn and home maintenance
   j. Other
3. Medical Information:
   a. Primary physician
   b. Physician specialists
   c. Dentist
   d. Pharmacy
   e. Hospital/Health clinic
   f. Living will (where)
   g. DNR/DNI orders (where)
   h. Home Health Agency/Hospice Agency
   i. Other
4. Employment Information:
   a. Employer
   b. Supervisor
   c. Date started, stopped
   d. Pension plan
   e. Other

Information Needed After Death

1. Surviving relatives and important people: contact information, phone numbers, addresses
   a. Father
   b. Mother
   c. Husband
   d. Wife
   e. Sons
   f. Daughters
   g. Brothers
   h. Sisters
   i. Grandchildren
   j. Great-grandchildren
   k. Friends and important others
2. Funeral:
   a. Funeral home
   b. Casket, vault, clothing, blanket or robe
   c. Cemetery or other location
   d. Specific instructions for body (cremation, embalming, etc)
   e. Minister
   f. Church or memorial service
   g. Graveside service
   h. Music (special selections; instruments, singer)
   i. Readings and other elements of service
   j. Active Pallbearers
   k. Honorary pallbearers
   l. Flowers
   m. Memorial donations
   n. Obituary
   o. Memorial marker
   p. Veteran (war, unit, service number)
3. Vital Statistics: information required for death certificate in Virginia. Get at least 10 sealed copies - needed for burial, insurance, all government matters
   a. Hospital (if any) of death
   b. County/city/town of death
   c. Street address of death
   d. Legal name of decedent e. Residence (non-resident give city and state)
   f. Place of death
   g. Date of death
   h. Age, Sex of decedent
   i. Name of decedent's father
   j. Maiden name of decedent's mother
   k. Citizen of what country
   l. Race/Country of origin of decedent
   m. Education (highest grade completed)
   n. Social Security number for Decedent; Spouse; dependent children
   o. Birthplace
   p. Usual or last occupation; Kind of industry
   q. Marital status (name of spouse)
   r. Name of Informant (person supplying information)

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