Expected Average Future Rate of Return from Your Investments %

Immediate Obligations and Death Expenses  
Funeral Expenses (average shoule be around $5000 to $6000) $
Immediate Home and Car Mortgage Payment (next 5 months) $
Total Family Expenses within 4 Months of Your death
(because spouse can't work for a few months; business can't be run for a few months, etc)
$
Medical Bill Immediately Due After Your Death $
Attorney's and Estate Executor's Fee $
Other Immediate Debt Payment (credit cards and bills) $

Long-term Debt and Obligations  
Unpaid Value of Home Mortgage Loan (the real estate property used by your family) $
Unpaid Value of Car Loan $
Other Long-term Debts (other bank loans, private business debt, etc) $

Medium-term/Long-term Family Expenses  
Spouse's age
Spouse's spending per year $ /year
Number of Years Before Child #1 Becomes Independent
Child #1's spending per year (average for the future years) $ /year
Number of Years Before Child #2 Becomes Independent
Child #2's spending per year (average for the future years) $ /year
Number of Years Before Child #3 Becomes Independent
Child #3's spending per year (average for the future years) $ /year
Number of Years Before Child #4 Becomes Independent
Child #4's spending per year (average for the future years) $ /year
Number of Years Before Child #5 Becomes Independent
Child #5's spending per year (average for the future years) $ /year

Liquid Assets  
Checking Accounts $
Savings Accounts $
Money Market Funds $
Corporate and Government Bonds $

Fixed/Non-liquid Assets (Do Not Include the House and Cars that your family members are currently using)  
CDs $
Current Value of Stock Options (actual market value of stocks - execution value of stocks) $
IRA, 401k, 403b or other retirement accounts $
Value of Houses and Land Not Used by Your Family Members (less any unpaid mortage) $
Value of Other Assets (business assets, jewelry, paintings loan to other people etc) $

Post-death Family Income  
After-tax Income Brought in by Your Spouse Before the Spouse Retires $ /year
Yearly After-tax Retirement Income from Social Security or Pensions for Your Spouse $ /year

 

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