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What is your current total life insurance value?

Self: Spouse:

How much will be needed at death to meet your immediate obligations?

Funeral Expenses

Self: Spouse:

Loans (e.g. Car, School)

Self: Spouse:

Credit Cards/Lines of Credit

Self: Spouse:

Mortgage Debt?

Self: Spouse:

Education Funding

Self: Spouse:

Emergencies

Self: Spouse:

How much income is needed to sustain your survivors?

Annual Income Needed After Tax?

Self: Spouse:

For How Many Years?

Self: Spouse:

Current Financial Assets to Assist in Loss of Income:

What is your home value?

What is the value of your RRSP?

Self: Spouse:

What is the value of your pension?

Self: Spouse:

What is the value of any other investments?

Self: Spouse: