Emergency Financial Guide
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5005 Lyndon B Johnson Frwy, Suite 750 I Dallas, Texas 75244 Direct: 972.759.3932 I Cell: 817.507.8952 I Fax: 972.774.1652 I jhicks@rockgatefinancial.com EMERGENCY FINANCIAL GUIDE www.RockgateFinancial.com Rockgate Financial Partners is independent of John Hancock and Signator Investors, Inc. Offering John Hancock insurance products. Registered Representative/Securities offered through Signator Investors, Inc., Member FINRA, SIPC. • SMAR #166-2141027-205292 How to Use This Brochure This brochure is meant to protect your loved ones in case of emergency in the event that you are not there to provide this information, such as in the case of passing away. Please fill each section out completely and store it in a safe, accessible place. Once you do, be sure to let your loved ones know exactly where they can find it or give them a copy. We are dedicated to insuring that their financial stability will remain intact. Call Justin Hicks to set up a personal meeting to disucuss your loss and how Rockgate Financial Partners can help you in these hard times. 817.507.8952 Updated: YOUR NAME Last Name____________________________________ First Name_________________________ Middle Name________________ Phone #_______________________________________Email_______________________________Date of Birth_________________ YOUR SPOUSE Last Name____________________________________ First Name______________________ Middle Name__________________ Phone #_______________________________________Email_______________________________Date of Birth_________________ EMERGENCY NOTIFICATION Who would need to be notified if something happened to you or your spouse/partner? Name_________________________________________ Relationship____________________ Phone #________________________ Name_________________________________________ Relationship____________________ Phone #________________________ CHILDREN List the names of children and other individual living in the residence Name_________________________________________ Relationship____________________ Phone #________________________ Phone #_______________________________________Email____________________________Date of Birth___________________ Name_________________________________________ Relationship____________________ Phone #________________________ Phone #_______________________________________Email____________________________Date of Birth___________________ Name_________________________________________ Relationship____________________ Phone #________________________ Phone #_______________________________________Email____________________________Date of Birth___________________ Name_________________________________________ Relationship____________________ Phone #________________________ Phone #_______________________________________Email____________________________Date of Birth___________________ Name_________________________________________ Relationship____________________ Phone #________________________ Phone #_______________________________________Email____________________________Date of Birth___________________
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Transcript of Emergency Financial Guide
5005 Lyndon B Johnson Frwy, Suite 750 I Dallas, Texas 75244Direct: 972.759.3932 I Cell: 817.507.8952 I Fax: 972.774.1652 I [email protected]
EMERGENCY FINANCIAL GUIDE
www.RockgateFinancial.comRockgate Financial Partners is independent of John Hancock and Signator Investors, Inc. Offering John Hancock insurance products.
Registered Representative/Securities offered through Signator Investors, Inc., Member FINRA, SIPC. • SMAR #166-2141027-205292
How to Use This BrochureThis brochure is meant to protect your loved ones in case of emergency in the event that you are not there to provide this information, such as in the case of passing away. Please fill each section out completely and store it in a safe, accessible place. Once you do, be sure to let your loved ones know exactly where they can find it or give them a copy. We are dedicated to insuring that their financial stability will remain intact.
Call Justin Hicksto set up a personal meeting to disucuss
your loss and how Rockgate Financial Partners can help you in these hard times.
817.507.8952
Updated:
YOUR NAME
Last Name____________________________________ First Name_________________________ Middle Name________________
Phone #_______________________________________Email_______________________________Date of Birth_________________
YOUR SPOUSE
Last Name____________________________________ First Name______________________ Middle Name__________________
Phone #_______________________________________Email_______________________________Date of Birth_________________
EMERGENCY NOTIFICATION
Who would need to be notified if something happened to you or your spouse/partner?Name_________________________________________ Relationship____________________ Phone #________________________
Name_________________________________________ Relationship____________________ Phone #________________________
CHILDREN List the names of children and other individual living in the residence
Name_________________________________________ Relationship____________________ Phone #________________________
Phone #_______________________________________Email____________________________Date of Birth___________________
Name_________________________________________ Relationship____________________ Phone #________________________
Phone #_______________________________________Email____________________________Date of Birth___________________
Name_________________________________________ Relationship____________________ Phone #________________________
Phone #_______________________________________Email____________________________Date of Birth___________________
Name_________________________________________ Relationship____________________ Phone #________________________
Phone #_______________________________________Email____________________________Date of Birth___________________
Name_________________________________________ Relationship____________________ Phone #________________________
Phone #_______________________________________Email____________________________Date of Birth___________________
EMERGENCY FINANCIAL GUIDE
PROFESSIONAL ADVISORSAccountantLast Name______________________________ First Name________________________ Middle Name______________________Company_______________________________ Phone #___________________________ Email______________________________Address_________________________________City/State/Zip Code___________________________________________________Additional Information__________________________________________________________________________________________
AttorneyLast Name______________________________ First Name________________________ Middle Name______________________Company_______________________________ Phone #___________________________ Email______________________________Address_________________________________City/State/Zip Code___________________________________________________Additional Information__________________________________________________________________________________________
Financial AdvisorLast Name______________________________ First Name________________________ Middle Name______________________Company_______________________________ Phone #___________________________ Email______________________________Address_________________________________City/State/Zip Code___________________________________________________Additional Information__________________________________________________________________________________________
IMPORTANT LEGAL DOCUMENTS THAT APPLY TO MY FAMILY STORED WHERE?1. Birth Certificate (s)/Adoptions Papers Have ____ Need ____ N/A ____ ____________________________
2. Marriage License Have ____ Need ____ N/A ____ ____________________________
3. Social Security Card (s) Have ____ Need ____ N/A ____ ____________________________
4. Will Updated__________ Have ____ Need ____ N/A ____ ____________________________
5. Trust Updated__________ Have ____ Need ____ N/A ____ ____________________________
6. Health Care Proxy Updated__________ Have ____ Need ____ N/A ____ ____________________________
7. Power (s) of Attorney Updated__________ Have ____ Need ____ N/A ____ ____________________________
8. Mortgage or Real Estate Deeds of Trust Have ____ Need ____ N/A ____ ____________________________
9. Divorce Agreement Have ____ Need ____ N/A ____ ____________________________
10. Prenuptial Agreement Have ____ Need ____ N/A ____ ____________________________
11. Home & Auto Insurance Have ____ Need ____ N/A ____ ____________________________
12. Funeral Arrangements Have ____ Need ____ N/A ____ ____________________________
13. Life Insurance Have ____ Need ____ N/A ____ ____________________________
14. Disability Insurance Have ____ Need ____ N/A ____ ____________________________
15. Long-Term Care Insurance Have ____ Need ____ N/A ____ ____________________________
16. Other________________________________________ Have ____ Need ____ N/A ____ ____________________________
PRIMARY AND CONTINGENT BENEFICIARY DESIGNATION FORM FOR: 1. IRAs Updated__________ Have ____ Need ______ N/A _____2. Retirement Plans (401(k), 403(b), etc.) Updated__________ Have ____ Need ______ N/A _____3. Annuities Updated__________ Have ____ Need ______ N/A _____4. Life Insurance Policies Updated__________ Have ____ Need ______ N/A _____5. Non-Qualified Deferred Compensation Plans Updated__________ Have ____ Need ______ N/A _____6. Qualified Pension Plan Updated__________ Have ____ Need ______ N/A _____
EMERGENCY FINANCIAL GUIDE
LIFE INSURANCE (LAST REVIEWED________________)Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________ Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________ Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________ Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________ Insured__________________________________________ Face Amount _______________ Issue Date _____________________ Type of Policy (Term or Permanent) __________________________________________ Policy # ________________________
DISABILITY INSURANCE (LAST REVIEWED________________)Insured_____________________________________ Monthly Benefit _________________Benefit Period _______________Elimination Period_________________________ Issue Date _______________________ Policy # ______________________Company ___________________________________Phone # ___________________________________________________________Insured_____________________________________ Monthly Benefit _________________ Benefit Period _______________Elimination Period_________________________ Issue Date _______________________ Policy # ______________________Company ___________________________________Phone # ___________________________________________________________
LONG-TERM CARE (LAST REVIEWED________________)Insured_____________________________________ Monthly Benefit _________________Benefit Period _______________Elimination Period_________________________ Issue Date _______________________ Policy # ______________________Company ___________________________________Phone # ___________________________________________________________Insured_____________________________________ Monthly Benefit _________________ Benefit Period _______________Elimination Period_________________________ Issue Date ________________________Policy # ______________________Company ___________________________________Phone # ___________________________________________________________
INVESTMENTS (LAST REVIEWED________________)Company ___________________________________Phone # __________________________Website _______________________Address ____________________________________ City/State/Zip____________________________________________________User Id ______________________________________Password _________________________________________________________1. Account#___________________________________________ Type ______________________________________________2. Account#___________________________________________ Type ______________________________________________3. Account#___________________________________________ Type ______________________________________________4. Account#___________________________________________ Type ______________________________________________
OTHER INVESTMENTS (LAST REVIEWED________________)Company ___________________________________Phone # _________________________ Website ________________________Address ____________________________________ City/State/Zip_____________________________________________________User Id ______________________________________Password _________________________________________________________1. Account#___________________________________________ Type ______________________________________________2. Account#___________________________________________ Type ______________________________________________3. Account#___________________________________________ Type ______________________________________________4. Account#___________________________________________ Type ______________________________________________
EMERGENCY FINANCIAL GUIDE
COLLEGE PLANS (LAST REVIEWED________________)Company ____________________________________ Phone # ____________________ Website __________________________Address ______________________________________ City/State/Zip Code____________________________________________User Id ______________________________________________________ Password ________________________________________1. Account#___________________________________________ Type ______________________________________________2. Account#___________________________________________ Type ______________________________________________3. Account#___________________________________________ Type ______________________________________________4. Account#___________________________________________ Type ______________________________________________5. Account#___________________________________________ Type ______________________________________________
BANK (AGENT NAME ___________________________)
Company ____________________________________ Phone # ____________________ Website __________________________
Address ______________________________________ City/State/Zip Code____________________________________________
User Id _______________________________________ Password _______________________________________________________
1. Account#_____________________________Type _____________________________________________________________
2. Account#_____________________________Type _____________________________________________________________
MORTGAGE (AGENT NAME ___________________________)
Company ____________________________________ Phone # _________________________ Website ______________________
Address ______________________________________City/State/Zip Code_____________________________________________
User Id _______________________________________Password ________________________________________________________
1. Loan #________________________________Term __________Interest Rate____ Date Purchased ______________
Address ______________________________________City/State/Zip___________________________________________________
2. Loan #________________________________Term _________ Interest Rate____Date Purchased ______________
Address ______________________________________City/State/Zip___________________________________________________
AUTO & HOME OWNER INSURANCE (AGENT NAME ___________________________)
Company _____________________________________Phone # ________________________ Website _______________________
Address ______________________________________ City/State/Zip___________________________________________________
User Id _______________________________________ Password________________________Policy # _______________________
OTHER (AGENT NAME ___________________________)
Company _____________________________________Phone # ________________________ Website _______________________
Address ______________________________________ City/State/Zip___________________________________________________
User Id _______________________________________ Password________________________Policy # _______________________
Notes: __________________________________________________________________________________________________________
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