In Case of Emergency: What My Family Should Know
This document is designed to give your family easy access all your personal information in case of an emergency. There are two ways to fill out this form:
Then store it in your safety deposit box.
- Download & fill out the editable PDF.
a. Create a New Item in the password program on your computer and title it: a_ICE: For my family. Most password programs sort alphabetically. This naming structure will keep this New Item at the top of your password list.
b. Upload the completed doc to your password program.
Important follow up:
- Set a reminder on your calendar to review/update this doc every six months.
- Tell a trusted friend/family member where to find this doc.
In Case of Emergency - What My Family Should Know
Date this document was last updated: ____________________
Date I will review this document: _______________________ (Mark your calendar!)
Set a reminder on your calendar to review and update this doc. If you are using a digital calendar, make it recurring.
In case of emergency, please notify these people:
•• 1. ____________________________________
•• 2. ____________________________________
•• 3. ____________________________________
These people can be family, friends or professional advisors. Whenever you see the double dots (••), that means all contact information can be found in your contacts list. Every time you update this doc, double-check that everyone's current phone, email etc is in there.
My full legal name: ____________________ State of legal residence: ________________
Date of birth: __________________ Place of birth: ______________________________
Spouse/Partner: _______________ Location of marriage certificate: ______________
I have created a will: Yes No
My will can be found here: ______________________________________
My personal information
Social Security #: ______________ Taxpayer ID # : _______________________
Passport #: ___________________ City/State of issue: _______________________
Expiration date: _______________I am a citizen of: ______________________
Location of citizenship papers/passport: __________________________
I have a post office box at: _______________ Combination: _______________
Enter all the applicable information right here in the document.
• Medical - _________________ • Supplemental - _______________________
Medicare ID #_____________ • Life - ________________________________
• Homeowners - ____________ • Auto - ________________________________
• Mortgage - ________________ • Other insurance - ____________________
Whenever you see single dots (•), that means additional information can be found in the password program on your computer. In this document, just list the company you are using for each of the insurance provider.
In your password program, title each item as follows: “Insurance-Medical-Blue Cross” or “Insurance-Auto-Allstate”. This will keep all your insurance password items grouped together as they will be listed alphabetically in the program.
For each item, be sure and include the policy #, exact name on account and your agent's name (if any.)
•• Financial advisor: ______________ •• Accountant: __________________________
•• Attorney: ______________________ •• Power of Attorney: ____________________
I have an advanced directive Yes No
•• My health care power of attorney: _________________________
I have a will Yes No •• My Executor/Personal representative: _____________
I have a trust Yes No •• My Trust attorney: _________________________________
My old tax returns can be found at: _______________________________________
Enter the full name of each person and double-check that their contact info is current in your list of contacts.
My personal tech information
Apple ID: ___________________ Apple password: _________________
Microsoft ID: ________________ Microsoft password: _____________
The password to my computer password program is: ____________
My computer login is: ______________________________
A full computer backup (hard drive) can be found here: ______________________________________________________
My cell phone # and password: ________________________
• Email(s): ______________________________________________
• Website(s): ____________________________________________
If you have multiple emails/websites, list the emails/domains above. Create one password item titled "Email" and within that, list each email as well and login info and where the email is hosted. Create a second password item titled "Website" and within that, list each website, where it is hosted, and login info. Also include where the domain is held and login info for that account.
•• Primary care physician: ______________
•• Dentist: ______________________________
•• Eye Dr: _______________________________
•• Other Drs: ___________________________
Other important medical details:
When adding medical practitioners to your contact list, also indicate their specialty (i.e. Dr. Beth Harrison, Primary care)
Dates of service: ______________ Serial #/Grade: _______________
Location of discharge papers: ________________________________
If all your income accounts are handled by a financial advisor, do not create password items for each category listed below.
•• All my investments are handled by: ___________________
•• Retirement/401K: Yes No
•• IRA Account: Yes No
•• Pension Plan: Yes No
•• Cryptocurrencies: Yes No
•• Stocks/Bonds Yes No
•• Social Security: Yes No
•• Outstanding loans: Yes No
•• Cryptocurrencies: Yes No
If you have multiple accounts for any of the above categories, create one password item for each category and keep all the account info in one place (i.e. “Stocks/Bonds” would include ALL your stock and bond investment information.) Include account #, registered name on the account, and login information as well as the location of any loan document(s). For personal outstanding loans, also include the person you loaned the money to and the date/original amount of the loan.
Primary residence: I own the property free & clear (If yes, check the box.)
I have a mortgage with: ____________________________________
• Other real estate: _________________________________________
Hidden assets (cash, jewelry...): _____________________________
Non-hidden assets (car, boat...): _____________________________
Personal safe location: ______________
Location of key: _______ or combination: _______
If you own “Other real estate”, create a password item and include all relevant details. If it is owned outright, where the title is kept; and if there is a mortgage(s), the institutions that hold the deed(s). Include login information.
• Bank loan/mortgage - Yes No • Personal loans - Yes No
• Bank loan/HELOC - Yes No • Other loans - Yes No
• Other bank loans - Yes No • Credit cards - Yes No
Title each password item as labelled above. If you choose to have unique password items for each credit card, use additional descriptors to differentiate (i.e “Credit Card - BankName - Personal” or “Credit Card - BankName - Business.”) Each password item should include the name on account, account #, login credentials, and the location of any paper documents (if any.)
• Checking - Yes No
• Savings - Yes No
• Safety deposit box: Yes No
Bank: ____________ Key can be found here: __________________
If you have multiple checking or savings accounts, you may create unique password items for each one (i.e. “Checking - BankName - Personal” or “Checking - BankName - Business”. Include the registered name on each account, account #, and login credentials.
At the root of all great organization is "A place for everything and everything in its place." Whether your brain is strongly wired in this brain skill or not, organization of all the above details can be difficult and just about everyone puts it off. Like organizing the attic, cleaning out the shed, or maybe even updating a will, we always think there will be time to do it later.
Here's a tip to getting the above doc completed:
Get out a timer and just put in 10 minutes a day.
GoBrainGo: Our brain-based videos put you in the driver's seat of your life.
Join our mailing list to receive new blog posts.
Don't worry, your information will not be shared.
We hate SPAM. We will never sell your information, for any reason.