Commonwealth of Pennsylvania - Public School Employees' Retirement System
5 N 5th Street
Harrisburg PA 17101-1905
Toll-free: 1.888.773.7748 Vital Papers and
www.psers.pa.gov PSERS Other
HealthImportant
Insurance Program
Information
Fax: 717.772.3860
PSRS-1012 (07/2019)
Usually one or the other of a couple takes responsibility for paying bills and keeping the family paperwork in order. If
that person is suddenly removed from the picture, the confusion over these matters can add to the hardship of the
survivor. To avoid this confusion, it helps to have all your important papers organized or at least know where they are.
The following pages are designed to that end and to assist you in keeping your important papers up -to-date.
Name Social Security Number
1. WILL
a) Where is it?
(yours) ______________________________ (your spouse’s) ______________________________
b) Who has copies? ___________________________________________________________________
c) When was it last updated?
(yours) ______________________________ (your spouse’s) ______________________________
d) Who is executor or executrix?
(yours) ______________________________ (your spouse’s) ______________________________
e) Who is named as guardian of children, if any? ____________________________________________
2. LIFE INSURANCE
a)
Company Policy Number(s) On Whom Beneficiary(ies) Agent
b) Where are the policies? ______________________________________________________________
3. HEALTH INSURANCE
a)
Company Policy Number(s) Who is Covered Payment Due Agent
b) Where are the policies? ______________________________________________________________
Vital Papers and Other Important Information Page 1 of 6
4. AUTOMOBILE INSURANCE
a)
Company Policy Number(s) Payment Due Agent
b) Where are the policies? ______________________________________________________________
5. LIABILITY AND PROPERTY INSURANCE
a)
Company Property Insured Policy Number(s) Payment Due Agent
b) Where are the policies? ______________________________________________________________
6. BIRTH CERTIFICATES
Whose Where Located Who Has Copy
7. MARRIAGE LICENSE
a) Where is it located? _________________________________________________________________
b) Where are the copies kept? ___________________________________________________________
8. TITLES AND DEEDS TO PROPERTY
a) House:
1) Where is the original? ____________________________________________________________
2) Where are the copies kept? _______________________________________________________
b) Car(s):
1) Where is the original? ____________________________________________________________
2) Where are the copies kept? _______________________________________________________
Vital Papers and Other Important Information Page 2 of 6
8. TITLES AND DEEDS TO PROPERTY (continued)
c) Other Property or Real Estate:
1) List individually _________________________________________________________________
______________________________________________________________________________
2) Where is the original? ___________________________________________________________
3) Where are the copies? ___________________________________________________________
9. MILITARY RECORDS
a) Where are the originals? _____________________________________________________________
b) Where are the copies? _______________________________________________________________
10. BANK RECORDS
Name and Address of Bank Type of Account Names on Location of
or Other Institution Account Number Account Records
11. SAFE DEPOSIT BANK
Name and Address Box Number Who Has Access Location of Keys
of Institution
Vital Papers and Other Important Information Page 3 of 6
12. VALUABLES
Description Appraised Serial Location
Value Number
13. INVESTMENTS
Type ID Number In Whose Name Location of Papers
14. DEBTS
Type Owed to Whom Payments Due Date Paid Off When
Vital Papers and Other Important Information Page 4 of 6
15. CREDIT CARDS AND CHARGE ACCOUNTS
Name of Card If Card is Lost or Card is Under
ID Number
or Store Stolen, Contact Names of
16. TAX RETURNS
Where are they located? _____________________________________________________________________
17. NAMES, ADDRESSES AND PHONE NUMBERS OF PROFESSIONAL ADVISORS
a) Doctors
Name Address Phone Number
b) Dentists
Name Address Phone Number
Vital Papers and Other Important Information Page 5 of 6
17. NAMES, ADDRESSES AND PHONE NUMBERS OF PROFESSIONAL ADVISORS (continued)
c) Lawyers
Name Address Phone Number
d) Insurance Agents
Name Address Phone Number
e) Tax Consultant
Name Address Phone Number
f) Accountant
Name Address Phone Number
g) Broker
Name Address Phone Number
h) Clergy
Name Address Phone Number
Vital Papers and Other Important Information Page 6 of 6
