DEBTS SELF SPOUSE
Final Expenses
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:
$/year 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 Account $ $
Checking Account $ $
IRA/401(K) 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

x 12

# of Years x x
Total Additional Income(3) $ $
     
    SELF   SPOUSE
Total Debts(1)   $   $
Total Additional Income(3)   + $   + $
Total Assets(2)   — $   — $
Life Insurance Needed:   $   $