Love Letter to My Family

Dear Loved Ones,

In an attempt to simplify matters for you, I have written this letter to provide
you with information that may be helpful to you when the time arises.
__________________________________________
(Printed) Full Legal Name
__________________________________________
Date Written
Here is a list of the people you may need to contact
Attorney/Lawyer
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Employer
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Accountant/CPA
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Financial Planner
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Pension Benefits
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Insurance
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Compliments of North Florida Wealth Advisors 352.225.3132

Insurance (2)
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Mortgage Holder
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Stockbroker
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Bank
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Church
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Bank (2)
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Other ________________________
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Other _______________________
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Other __________________________
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Other ________________________
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Fax: ________________________________________
Note: _______________________________________
_____________________________________________

Compliments of North Florida Wealth Advisors 352.225.3132

Assets
Here is a list of all my stocks, bonds property and other investments. A financial statement
for each one should be attached.
Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct #_______________________________________
Note: _______________________________________
_____________________________________________

Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct # ______________________________________
Note: _______________________________________
_____________________________________________

Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct #_______________________________________
Note: _______________________________________
_____________________________________________

Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct #_______________________________________
Note: _______________________________________
_____________________________________________

Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct#_______________________________________
Note: _______________________________________
_____________________________________________

Investment
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Acct#_______________________________________
Note: _______________________________________
_____________________________________________

Money Owed to Us
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Amount______________________________________
Note: _______________________________________
_____________________________________________

Money Owed to Us
Name: ______________________________________
Address: ____________________________________
____________________________________
Telephone: __________________________________
Amount______________________________________
Note: _______________________________________
_____________________________________________

Deposits:
I Have ____ Have Not ___ made any substantial deposits on certain accounts. If applicable
the accounts are:
_________________________________________________________________________________________________________
________________________________________________________________________________________________________
Compliments of North Florida Wealth Advisors 352.225.3132

________________________________________________________________________________________________________
LIABILITIES
Here is a list of our liabilities, including a contact name and phone number of each, as well
as the location of any related documents.
This also includes any debts I am the guarantor (as noted)
Telephone: __________________________________
Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Liability
Telephone: __________________________________
Amount______________________________________
Name: ______________________________________
Located:_____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Telephone: __________________________________
Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Liability
Telephone: __________________________________
Amount______________________________________
Name: ______________________________________
Located:_____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Telephone: __________________________________
Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Liability
Telephone: __________________________________
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Telephone: __________________________________
Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Liability
Telephone: __________________________________
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Telephone: __________________________________
Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Compliments of North Florida Wealth Advisors 352.225.3132

Liability
Amount______________________________________
Name: ______________________________________
Located: _____________________________________
Address: ____________________________________
_____________________________________________
____________________________________
Telephone: __________________________________
INSURANCE COVERAGE
I have the following polices (including company owed) and where they can be found
LIFE INSURANCE
Type Owner Beneficiary
Face Amount $ Existing Loans$
Cash Value $
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Any of the polices can be found at__________________________________________________________________
DIABILITY INSURANCE
Company
Policy Located at:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
LONG TERM CARE INSURANCE
Company
Policy Located at:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
HEALTH INSURANCE
Company
Policy Located at:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
OTHER POLCIES (Auto, Umbrella, Home, etc.)
Type
Company
Policy Located at:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
IF I BECOME DISABLED
Please make sure to pay the premiums on the policies which will provide me or my family benefits.
My Life Insurance policy If I become disabled
____ Allows _____Does Not Allow
for pre-payment of death benefits to support me
____ Allows _____Does Not Allow
you to stop making premium payments

Compliments of North Florida Wealth Advisors 352.225.3132

My Disability Insurance policy If I become disabled

____ Allows _____Does Not Allow
you to stop making premium payments
Special Notes:
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
EMPLOYMENT
I have the following disability and/or death benefits where I work or worked (describe briefly)
Retirement Plan(s)____________________________________________________________________________________________
Life Insurance__________________________________________________________________________________________________
Health Insurance ______________________________________________________________________________________________
Long Term Care Insurance ___________________________________________________________________________________
Disability Insurance ___________________________________________________________________________________________
Deferred Compensation ______________________________________________________________________________________
Stock Ownership ______________________________________________________________________________________________
Stock Options __________________________________________________________________________________________________
Cafeteria Plan __________________________________________________________________________________________________
Other ___________________________________________________________________________________________________________
DOCUMENTS
I have executed each of the following documents and you can find them where noted.
Document
Date Signed
Location_________________________
Will _____________________________________________________________________________________________________________
Living Will _____________________________________________________________________________________________________
Medical Power of Attorney ___________________________________________________________________________________
Medical Directive ______________________________________________________________________________________________
General Power of Attorney ___________________________________________________________________________________
Living Trust ____________________________________________________________________________________________________
Insurance Trust _______________________________________________________________________________________________
Charitable Trust _______________________________________________________________________________________________
Minors Trust __________________________________________________________________________________________________
Custodial Account _____________________________________________________________________________________________
Organ Donation _______________________________________________________________________________________________
Prenuptial Agreement ________________________________________________________________________________________
Divorce Decree ________________________________________________________________________________________________
Citizenship Papers / Passports ______________________________________________________________________________
Burial Agreement _____________________________________________________________________________________________
Retirement Plan Beneficiary Designation ___________________________________________________________________
Insurance Beneficiary Designation __________________________________________________________________________
Other ___________________________________________________________________________________________________________
I have appointed (in the above documents) the following persons to act on my behalf if I become disabled:

Power of Attorney over my Assets

Power of Attorney of Medical Decisions

Guardian over My Property
Guardian over My Person

1st ____________________________________________________
2nd____________________________________________________
1st ____________________________________________________
2nd____________________________________________________
1st ____________________________________________________
2nd____________________________________________________
1st ____________________________________________________
2nd____________________________________________________

Compliments of North Florida Wealth Advisors 352.225.3132

It is my desire that the persons having the above powers of attorney act on my behalf rather than a
guardian being appointed, unless my family believes guardianship is necessary.
In the event of my incapacity, I DO ____ DO NOT _____ want to be kept home as long as possible,
taking into account the cost.
I, HAVE _____ NOT DO HAVE _____ a divorce decree which may require that certain payments be
made after I am disabled or after my death.
GENERAL INFORMATION

Location / Combination / Number

_____ Safety Deposit Box __________________________________________________________________________
_____ Personal Safe _________________________________________________________________________________
_____ Social Security # ______________________________________________________________________________
_____ Drivers License #/ Expiration _______________________________________________________________
_____ Date of Birth What City/State ______________________________________________________________
_____ Passport # _____________________________________________________________________________________
_____ I AM _____ AM NOT currently the Trustee for a trust. If so, document located
________________________________________________________________________________________________________
_____ I AM _____ AM NOT
a beneficiary of a trust. Is so, document located
________________________________________________________________________________________________________
_____ I AM _____ AM NOT
entitled to military benefits. Benefits are:
________________________________________________________________________________________________________
_____ I AM _____ AM NOT
a member of a religious group . If so, name below
________________________________________________________________________________________________________
_____ I AM _____ AM NOT
a member of the following fraternal group(s). If so, listed here
________________________________________________________________________________________________________
I currently carry the following credit cards:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Upon my death, my heirs _____ WILL _____ WILL NOT receive a distribution or benefits
from a trust. If will, the trust instrument was created by :
____________________________________________
and can be found ____________________________________________________________________________________
I may receive an inheritance from:
_________________________________________________________________________________________________________
I have listed here or attached a list of persons and what I want each to receive of my
personal property when I die.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Compliments of North Florida Wealth Advisors 352.225.3132

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

IN THE EVENT OF MY DEATH

I have the following final wishes
Funeral Home: ______________________________________________________________________________________
Cemetery: ___________________________________________ Plot/Drawer: ________________________________
_____ I HAVE _____ HAVE NOT prepaid the following:
_____ Burial costs _____ Burial Plot _____ Casket _____ Crematory ______ Other _________
Information for the above
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_____ I DO _____ DO NOT wish to be cremated

Crematory: ____________________________________

Minister / Rabbi to perform service: _______________________________________________________________

Pallbearers:
__________________________________________________
__________________________________________________
__________________________________________________

________________________________________________
________________________________________________
________________________________________________

Special Requests:
Obituary Reading, Tombstone Engraving, Organ Donation, In Lieu of flowers/charitable
donations, special songs, scriptures, or any other special requests:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
I Have signed this family love letter this _____ day of _____________________, in the year __________.
This document is not intended to replace my will or other estate planning documents
signed by me. However, it is my express desire that each family member, Executor,
Trustee, and Guardian will use this love letter and the other documents signed by me in
making any discretionary decisions for me and my family.
Compliments of North Florida Wealth Advisors 352.225.3132

______________________________________________
Print: Full Legal Name

________________________________________________
Sign: Full Legal Name

Copies of this Document were delivered to:

_______________________________________________
_______________________________________________

________________________________________________
________________________________________________

Compliments of North Florida Wealth Advisors 352.225.3132