Kajko, Weisman, Colasanti & Stein, LLP
430 Bedford Street, Suite 190
Lexington, MA 02420
rkeshian@massfirm.com
Personal Data Record
(Date this record was last revised __________)
Location of Important Documents
1. Adoption Papers ______________________________________________________
2. Automobile Titles ______________________________________________________
3. Bank passbooks _______________________________________________________
4. Birth Certificates ______________________________________________________
5. Business agreements ___________________________________________________
6. Deeds, mortgages, etc. _________________________________________________
7. Cemetery plot title _____________________________________________________
8. IRAs, money market, certificates of deposit, and Keogh accounts
______________________________________________________________________
9. Insurance policies _____________________________________________________
10. Marriage certificate(s) _________________________________________________
11. Military serial number and evidence of service ______________________________
______________________________________________________________________
12. Lease agreement(s) __________________________________________________
13. Naturalization papers _________________________________________________
14. Notes and obligations _________________________________________________
15. Safe deposit box(es) __________________________________________________
16. Safe deposit key(s) ___________________________________________________
17. Securities (stocks and bonds) ___________________________________________
18. Social Security number and records ______________________________________
______________________________________________________________________
19. Tax returns for prior years and receipts ___________________________________
______________________________________________________________________
20. Pension and retirement benefits data _____________________________________
______________________________________________________________________
21. Trust fund(s) records _________________________________________________
22. Veterans' Administration claim number ____________________________________
23. Will ________________________________________________________________
24. Other ______________________________________________________________
Important Names, Addresses, and Phone Numbers
1. Physician ____________________________________________________________
Address _______________________________________________________________
Phone ________________________________________________________________
2. Clergy ______________________________________________________________
Address _______________________________________________________________
Phone ________________________________________________________________
3. Funeral director _______________________________________________________
Address _______________________________________________________________
Phone ________________________________________________________________
4. Attorney ____________________________________________________________
Address _______________________________________________________________
Phone _________________________________________________________________
5. Insurance agent(s) ____________________________________________________
Address _______________________________________________________________
Phone _________________________________________________________________
6. Executor ____________________________________________________________
Address _______________________________________________________________
Phone _________________________________________________________________
7. Accountant __________________________________________________________
Address _______________________________________________________________
Phone _________________________________________________________________
8. Stockbroker __________________________________________________________
Address _______________________________________________________________
Phone _________________________________________________________________
