Page 1 of 12

My Planning Guide

HOW I WANT TO BE REMEMBERED

Legacy Tree Funeral Planning

Personal History

My Planning Guide is designed to guide you and those close to you through the funeral planning process. By recording vital information and personal preferences now, you ease the burden for your loved ones. If you have questions regarding any aspect of funeral planning, ask your funeral planning professional.

Vital Statistics

Name:

Date:

Sex:

Male

Female

SSN:

Race:

Address:

In city since:

Moved from:

Year:

Phone:

Email:

Date of birth:

Age:

Place of birth:

Father's name:

Father's place of birth:

Mother's name:

Mother's place of birth:

Marital status:

Married

Never married

Widowed

Divorced

Place:

Date:

Name of Spouse/Partner (maiden name, if applicable):

Education (highest grade completed):

Elementary/Secondary College

School(s) attended/degree(s) earned:

Church/Lodges/Memberships:

Occupation:

Business/Industry:

Employer:

Years in occupation:

Hobbies:

Armed Forces

Branch of service:

Service number:

Date entered:

Place of entry:

Type of separation or discharge:

Date:

Place of discharge:

Location of discharge papers (DD214):

Do you have a will or living trust?

Yes

Attorney who wrote the will or trust:

Executor of Estate:

Do you have a living will?

Yes

Location:

Financial Information

Banking

Bank name/branch:

Type of account:

Checking

Savings

Username:

Password:

Bank name/branch:

Type of account:

Checking

Savings

Username:

Password:

Bank name/branch:

Type of account:

Checking

Savings

Username:

Password:

Credit Cards

Type:

Visa

Mastercard

American Express

Discover

Other:

Account number:

Exp. date:

Username:

Password:

Type:

Visa

Mastercard

American Express

Discover

Other:

Account number:

Exp. date:

Username:

Password:

Mortgage

Lender:

Account number:

Phone:

Location:

Lender:

Account number:

Phone:

Location:

Pension/Retirement Plans

Company:

Account number:

Phone:

Location:

Company:

Account number:

Phone:

Location:

Company:

Account number:

Phone:

Location:

Insurance (Homeowners, Health, Life, Auto, etc.)

Company:

Agent:

Phone:

Policy number:

Beneficiary:

Company:

Agent:

Phone:

Policy number:

Beneficiary:

Company:

Agent:

Phone:

Policy number:

Beneficiary:

Company:

Agent:

Phone:

Policy number:

Beneficiary:

Social Media Profiles

Account name:

Website/URL:

Username:

Password:

Account name:

Website/URL:

Username:

Password:

Account name:

Website/URL:

Username:

Password:

Location of Important Documents

Safe deposit box:

Box number:

Key(s) location:

Birth certificate:

Children's birth certificate(s):

Last will and testament:

Funeral and cemetery arrangement documents:

Real estate deeds:

Income tax records:

Auto registration/title(s):

My Preferences

This section enables you and your family to keep track of which arrangements have been made and which remain to be determined.

Memorial Instructions

Funeral home:

Phone:

Church:

Phone:

Officiant:

Phone:

Disposition preference:

Burial

Mausoleum

Cremation

Memorial service to be held at:

Funeral home

Church

Graveside

Other:

Visitation/Friends calling:

Yes

Casket:

Opened

Closed

Participating fraternal, military, or service organization:

Obituary:

Yes

Photo

Newspaper(s):

Pallbearers:

Flowers (describe):

Favorite religious passages, quotations, or poems:

Favorite musical selections:

Specific requests to be performed at service:

Contributions (name of charity):

Flag (if veteran):

Folded

Draped

Given to:

Specific clothing (describe):

Glasses to be worn:

Yes

After viewing, removed and given to:

Jewelry to be worn:

Yes

After viewing, removed and given to:

Specific jewelry (describe):

Cemetery Instructions

Cemetery property owned:

Yes

Cemetery:

Address:

City:

State:

Phone:

Location, Section/Garden:

Lot:

Space:

Marker owned:

Yes

Cremation memorialization:

Niche

Burial

Other:

Additional instructions:

The preceding information represents my desires for my funeral and burial arrangements. As of this date, I prefer that my family only spend $ for these plans.

Signature:

Date:

Funeral planning professional:

Cost Estimate Sheet

I understand that this estimate sheet does not represent items bought or sold and is not a contract to do so. These figures represent only an estimate of the costs of my funeral preferences at today's prices.

Name:

Signature:

Date:

Section I: Services

Funeral package, describe:
For details, please refer to a copy of the General Price List.
Basic services of funeral director and staff
Transfer of deceased to funeral home	miles @ $ per mile
Embalming
Other preparation of the body
Use of facilities and staff for viewing	days @ $
Use of facilities and staff for ceremony
Use of equipment and staff for ceremony
Funeral coach
Family car	no @ $ each
Other, please specify
Subtotal: Section I	$

Section II: Merchandise

Casket
Name
Description
Interior fabric and color
Exterior material and color
Gauge weight (where applicable)
Outer Burial Container
Name
Description
Other Merchandise
Alternative container
Urn
Marker
Memorial package
Subtotal: Section II	$

Section III: Miscellaneous Items

Memorial package
Obituary notices
Death certificates	copies @ $ per copy
Flowers
Clergy honorarium
Musician honorarium
Reception
Grave opening and closing
Setting fees
Sales tax
Other
Subtotal: Section III	$
Subtotal: Sections I and II	$
Total: Sections I, II, and III	$

Payment Options:

Single Premium	$
One-Year	$ per month
Three-Year	$ per month
Five-Year	$ per month

Important Information

Social Security

If you are working and paying into Social Security, some of the Social Security taxes you pay are applied toward survivor benefits. The amount of these benefits will be determined by Social Security.

To file a claim or for answers to your specific questions, contact the nearest Social Security office or call (800) 772-1213 between the hours of 7 a.m. and 7 p.m., Monday-Friday. Free informative publications are available at your local office or on the internet at www.ssa.gov.

Veterans Administration

If you are an honorably discharged veteran, your survivors may be eligible for a range of benefits, such as burial flag, presidential memorial certificate, marker for the grave or niche, and burial allowances. Information on a variety of topics may be obtained by calling (800) 827-1000 or by visiting www.va.gov.

Federal Employees

Survivors of employees of the federal government may be eligible for a wide range of benefits, including group life insurance, annuities, and health insurance continuation. For answers to specific questions, you can contact the Office of Personnel Management at (888) 767-6738 or visit www.opm.gov.

Will

This document specifies what is to be done with your property when you die and names your executor or personal representative. You can also use your will to name a guardian for your children. Wills must be handled through a process known as "probate."

Probate

Simply stated, probate is the court process following a person's death that includes:

Proving the authenticity of the deceased person's will
Appointing someone to handle the deceased person's affairs
Identifying the deceased person's property
Paying debts and taxes
Identifying heirs
Distributing the deceased person's property according to the will, or state law if there is no will.

Living Trust

This form of a trust can be set up during your life. Living trusts are an excellent way to avoid the cost and hassle of probate because the property you transfer into the trust passes directly to the beneficiaries after you die. The successor trustee - the person you appoint to handle the trust after your death - simply transfers ownership to the beneficiaries.

Power of Attorney

This document gives another person legal authority to act on your behalf. If you create such a document, you are called the "principle," and the person to whom you give this authority is called your "attorney-in-fact." If you make a durable power of attorney, the document will remain in effect if you become incapacitated.

Living Will

This legal document states your wishes about medical treatments and life-prolonging procedures. It takes effect if you are unable to communicate your healthcare decisions. A living will may also be called a healthcare directive, advanced directive, or directive to physicians. Laws vary from state to state, check with your state's authorities.

Life Insurance

This contract states that an insurance company agrees to pay money to a designated beneficiary upon the death of the policy holder. In exchange, the policyholder pays a regularly scheduled fee, known as a premium. The purpose of life insurance is to provide financial support to those who survive the policyholder, such as family members or business partners. When the policyholder dies, the insurance proceeds pass to the beneficiaries free of probate, although they may be counted for federal estate tax purposes.

Prearranged Funeral Plan

This is a contract in which a funeral establishment agrees to provide merchandise and services upon the death of the contract beneficiary. The plan provides not only the funding for the funeral, but also allows individuals the opportunity to specify their wishes for the funeral ceremony and merchandise.

Funeral or Memorial Service

Whether you or your loved one have chosen burial or cremation, the funeral or memorial service fills an important role by:

Celebrating, honoring, and recognizing the life of the deceased
Giving family and friends the chance to say goodbye
Providing closure after the loss of a loved one
Presenting an opportunity for friends and family to console each other

Many details and decisions must be made when a death occurs. When you arrange them in advance, you can plan what you want and minimize stress on your loved ones. For example, you can plan where your funeral will be held and the style of the ceremony. You can indicate whether you prefer friends and family to gather informally and share their feelings and memories. Favorite music and photographs can be selected.

Obituary

An obituary is not only a notice of a death, but it also can tell the life story of the deceased, provide funeral information, and request memorial donations.

An obituary can paint an expansive picture of the deceased's life, but at a minimum it should list:

Full name and age
Place of residence
Time and place of death
Cause of death (optional)
Date and place of birth
Parents' names, including mother's maiden name
Date and place of marriage
Birth name of spouse
Education and occupation
Military service
Social organizations (optional)
List of surviving family, starting with closest relations. Place spouses' names inside brackets.
Service details
Special message or requests for memorials
Photo (optional)

Your funeral home can help you write, format, and publish an obituary.

Personal Thoughts for My Obituary

Additional Notes

For more information on prepaid funeral benefit contracts in Texas, visit prepaidfuneralstexas.gov.

4311449610779 US