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Member’s Full Name |
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S.I.N. ###-###-### |
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Spouse’s Full Name |
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S.I.N. ###-###-### |
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Bank(s): |
a. |
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Personal Joint Chequing Account (PCA) |
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No. ########### |
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| (Location
& Ph. No.) |
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current PCA
cheque book located |
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(where) |
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spare
cheque books, old cheque books and recent statements are |
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(where) |
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b. |
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Member’s Savings Account |
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No. ########## |
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purpose/use of this account |
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passbook and cheques located |
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(where) |
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c. |
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Any line of credit Accounts: |
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purpose/use of account |
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statement and records are where |
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d. |
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Spouse’s Savings
Account |
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purpose/use of
this account |
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current cheque book is where. |
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spare cheque books, old cheque record books, statements . |
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(where) |
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| Safety Deposit Box (SDB): |
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Member & Spouse jointly with either having access, |
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Box No. #### at
XXX Bank |
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keys No. #### located
(where.) |
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agreement filed where |
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| Wills & Powers of Attorney |
a. |
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Member's
Details: |
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Executor is XXX XXXX and seconder is XXX XXXX |
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lawyer is XXX XXXX of XXXX & XXX, |
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Address and Phone No(s). |
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originals held by XXX XXXX and
notarized copies where |
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(where) |
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brief description of the content (intent) of each will and P of
A. |
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b. |
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Spouse
Details: |
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Executor is XXX XXXX and seconder is XXX XXXX |
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lawyer is XXX XXXX of XXXX & XXX, |
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Address and Phone No(s). |
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originals held by XXX XXXX and
notarized copies where |
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(where) |
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brief description of the content (intent) of each will and P of
A. |
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| Life Insurance:
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a. |
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Public Service Supplementary Death Benefit
(Inquiries: Ph. ) |
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1-(613) 995-8741) |
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Who is covered |
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Details of coverage and
payment |
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Files and Records
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(where) |
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b. |
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SISIP/CAR
(Inquiries: Maritime Life Insurance Co.) |
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1-(800)-565-0701 |
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Policy No. XXX, Member No. XXX |
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Who is covered |
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Details of coverage and payment, |
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Files and Records (where) |
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c. |
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CAA member’s insurance |
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see file (where) |
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Who is covered |
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Details of coverage and payment |
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d. |
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Other insurance – |
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see file (where) |
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Name of Company, Agent, Contacts and Policy No(s). |
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Who is covered |
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Details of coverage and payment |
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Files and Records |
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(where) |
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| Health Care:
(see file folder) |
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Public
Service Health Care Plan, No. |
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(where) |
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Who is covered |
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Details of coverage and payment |
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| Dental Care:
(see file folder) |
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Public Service Health Care Plan, No.
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(where) |
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Who is covered |
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Details of coverage and payment |
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| Service Pension:
(see file folder) |
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Pension No. #######
(Inquiries: Ph.) |
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1- (613)
952-9933 |
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pension slips filed where |
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(where) |
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pension amount halved to Spouse on death of Member |
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amount is indexed every January |
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Canada Pension Plan:
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Pension No. #######
(Inquiries: Ph.) |
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1-(613) 952-9933 |
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see file folder |
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(where) |
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Who is covered |
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Details of coverage and payment |
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payment amount is indexed every January |
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there is a monthly survivor amount on death of Member
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(65% of total) |
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if prior death of Spouse, all reverts to Member |
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Old Age Security
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(Inquiries Ph. ) |
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1-800-277-9914 |
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see file folder |
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(where) |
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Who is covered |
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Details of coverage and payment |
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amounts are indexed quarterly |
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Investments, or
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| Income generating assets: |
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list each
investment held jointly and separately |
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where its records
are held |
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details of each, including, .... as a
minimum: |
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managed by whom, |
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date of purchase, |
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up to date ACB |
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record of amount and type of
return, (income) |
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| Other Assets,
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each investment
held jointly and separately and where its record is held |
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| (listed for probate
purposes) |
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details of each,
including as a minimum |
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managed by whom, |
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date, price and other details
of purchase |
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details of insurance policies
if applicable |
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date, price and other details
of capital improvements since purchase, and |
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details of 1994 Capital Gain
Crystallization, if applicable |
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| Income
Taxes: |
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past returns, and
supporting documents |
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(where) |
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current
charitable donations and medical receipts and other records |
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(where) |
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other documents
currently being processed may be found |
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(where) |
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| Birth & Marriage
Certificates: |
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originals and
notarized copies found |
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(where) |
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Passports: |
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Member |
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(where) |
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Spouse |
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(where) |
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House(s), Condo(s),
Cottage(s): |
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Address and Phone
No. of each, |
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details of
ownership - where held, |
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deeds and
de-registration of mortgages - |
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(where) |
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property taxes,
records and how paid - file folder |
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(where) |
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routine
maintenance, upkeep costs, records and supporting documentation
are held, |
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(where) |
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location of all
keys, |
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access codes if
applicable |
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list of other
persons having access to each. |
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Credit and Bank
Access Cards: |
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list type and
details of each card held by Member and Spouse |
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location of
invoices and records of payment. |
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Associations/Memberships |
a. |
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For Member and Spouse |
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(Phone No.) |
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| phone numbers and
publication: |
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b. |
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Fpr Member only |
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(Phone No.) |
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c. |
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For Spouse only |
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(Phone No.) |
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| Subscriptions: |
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Newspapers |
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Magazines |
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| Physicians and Dentists
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a. |
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(names,
locations, contacts): |
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For both Member
and Spouse, |
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For Member |
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For Spouse |
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| Funerals and Burials |
a. |
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(details of
locations, prepayment details, arrangements) |
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For both Member
and Spouse, |
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For
Member |
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For Spouse |
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