DEBTS
SELF
SPOUSE

Final Expense
Medical and Hospital
Burial Expenses
School and Auto Loans
Installment Credit and
other debts
$
$
Shelter
Pay Off Mortgage $
Real Estate Taxes
Home Maintenance
Rent Fund:
$  for years
$  
$  
Education
College*
Four Year Undergraduate*
Education
Vocational Training
$
$
Emergency Fund
Unexpected Bills (Major
repairs to home, auto,
medical emergencies)
3-6 Months Salary
$
$

Total Debts(1)
$  
$  
*According to the U.S. Department of Education, National Center for Education Statistics (2010), in 2007 - 2008, the average cost of tuition, fees, room & board at a 4-year public institution was $13,424 per year. The average cost at a 4-year private institution was $30,393.

A traditional funeral, including a casket and vault, costs about $6,000, however, additional items such as flowers and limousines can add thousands, causing many funerals to run well over $10,000. (From the Federal Trade Commission's Facts for Consumers, Funerals: A Consumer Guide - November 2009. Source: ftc.gov - June 2010.)
ASSETS
SELF
SPOUSE
Savings Acct
$
$
Checking Acct
$
$
IRA/401K Plan
$
$

Life Insurance:
Individual
$
$
Group
$
$
Mortgage Ins.
$
$
Total Assets(2)
$
 
  • In the event of your death or the death of your spouse, would you like to provide an additional income for your family?

 
 
SELF
SPOUSE
Monthly Income
$ 
$ 
 

x 12

x12

# of Years
x 
 x 
Total Additional Income(3)

$ 

$ 

 
    SELF   SPOUSE
Total Debts(1)
  $ 
  $ 
Total Additional Income(3)

 
+   $ 

 
+   $ 
Total Assets(2)

 
-    $ 

 
-    $ 
Life Insurance Needed:
$ 
$