Sample Page from the
Next-Of-Kin-Info Booklet

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7. MONEY MARKET ACCOUNTS, CERTIFICATES of DEPOSIT, etc. (Continued):

     Bank/S&L:_______________________________________________________________

     Branch:__________________________________________________________________

     Account/Certificate Number: ________________________________________________

     Address:_________________________________________________________________

                   _________________________________________________________________

     Certificates are located in:___________________________________________________

8. SAVINGS BONDS, STOCK CERTIFICATES, PERTINENT PAPERS (HOUSE DEED, CAR TITLE, TAX RECORDS, BIRTH & MARRIAGE CERTIFICATES, ETC.).

These items are located in:_____________________________________________________

9. BROKERAGE ACCOUNT. My stockbroker is:

     Name:___________________________________________________________________

     Address:_________________________________________________________________

     Telephone:_______________________________________________________________

10. ATTORNEY. My attorney is:

     Name:___________________________________________________________________

     Address:_________________________________________________________________

     Telephone:_______________________________________________________________

11. PASSWORD & USER ID FOR COMPUTER AND VARIOUS ACCOUNTS.

I ____ have ____ have not attached a list of user IDs and passwords to this document for my computer and various accounts.