JUST-IN-CASE INSTRUCTIONS

For laurie lee coots of springfield, Missouri

Created on _____________________

Signature _____________________

This document is intended to make it easier for anyone to manage my affairs in the event I become
incapacitated or to manage my estate when death occurs. I created it for my family and anyone I have
appointed as a representative, agent, or executor.

This document is not intended to be interpreted as a Last Will and Testament or Living Will. These
guidelines are only intended to help family and caregivers manage my affairs.

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 Residence

Address

1. Address: 2710 n. farm road 137 lot#90 ,springfield, mo 65803

Access

2. Keyholders:

a. Name: marcella laree donson

Relationship: daughter
Phone: (417) 523-3472

b. Name: dean lee goodman

Relationship: cousin
Phone: (417) 733-1759

Alarm System

3. I do not have an alarm system.

Mail

4. Delivered to: Community mailbox

Number: 90
Key Location: on my key chain

Mortgage

5. Mortgage Lender: ____________________

Contact Name: ______________________
Phone: ____________________
Email: ____________________

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6. Payments:

Ownership and Insurance

7. I do not have homeowners insurance.

8. My mortgage is paid off, but should you need to review the mortgage documents, they can be
found here: my safe

Real Estate

1. I do not own any additional real estate.

Vehicle

1. I do not own or lease a motor vehicle.

Employment

1. I am not currently employed.

Dependent

Dependent

1. Name: marcella laree donson

Birth Date: 02/09/2009

Dependent Documents

2. Important documents, such as birth certificates and passports, for my dependents are in the
following location: my safe.

Emergency and Medical Care

3. In the event of an emergency, the following people have agreed to care for my dependents:

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 a. Full Name: charmin chereese carroll
Phone: (417) 828-8103

b. Full Name: dixie lea devoe

Phone: (909) 386-8622

4. I am not including information about medical care for my dependents.

Pet

1. I have the following pet:

a. Name: bubby
Description: black cat
Special Instructions: raerae will go crazy if she doesnt have bubby with her

Caretaker

2. In the event of an emergency, the following person has agreed to care for my pet:

Name: charmin chereese carroll

Phone: (417) 828-8103

Health

Insurance

1. I hold the following insurance policy:

a. Type: medical
Company: triwest military insurance
Broker Name: NA
Phone: ____________________
Email: ____________________

Copies of my insurance policy are kept in the following location: safe.

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Medications and Pharmacy

2. I have not included information about medication I may be taking.

Financial Information

Banking

1. I have the following account:

a. rush prepaid card

____________________
Account Type: checking and savings
Location of Statements: filing cabnet

Investment

2. I have not included information about investments.

Bill

3. I have the following bill:

a. Payee: lakewood mobile home park

Frequency: first of month as long as my trailer i there
Payment Method: online portal
Statement Delivered By: email

Taxes

4. I keep my previous year’s tax returns in my filing cabnets.

Debt

5. Debt
Type: medical bills
Amount: $$0.00

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 Creditor: cox
Location of Loan Documents: filing cabnets

Debtor

6. I am not owed any money.

Estate Documents

1. I currently have the following estate documents in place:

- Last Will and Testament

- Living Will

- Power of Attorney

- End-of-Life Plan

- Personal Care Profile

2. I keep my estate documents in my safe and copy n filinf cabnet.

Important Documents

1. My birth certificate is kept in safe.

2. My social security card is kept in my billfold in purse.

3. I do not have a passport.

4. My educational records are kept in filing cabnet.

5. My marriage records are kept in filing cabnets.

6. My military records are kept in filing cabnet.

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 Secure Storage

1. I do not have any secure storage such as a safe, or storage outside of my residence, such as a
storage unit or safe deposit box.

Devices and Online Accounts

Personal Devices

1. It’s important you’re able to access my personal devices. A record of my personal devices and
access codes are located in a file on my computer. The document path for the file is: google
account

Online Accounts

2. It’s important you’re able to access my online accounts. My accounts and passwords are stored
in my password manager. The password manager I use is called google. marcdella laree donson
also has access to this account. They can be contacted at:
Phone: (417) 527-3472
Email: lauriecoots72@gmail.com

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