Life Needs Analysis

Down load or print out this work sheet to help you determine what your life insurance needs are.

Needs

$________Final Expenses
Funeral, Medical, Taxes, Probate, Attorney Fees.

$________Debts
Vehicle Loans, Personal Loans, Credit Cards, etc.

$________Speical Needs
Education Fund, Child care, etc.

$________Housing
Mortgage or Rent Payment Fund

$________Income Replacement Fund
5, 7 or 10 Times Annual Income

Assets

$________Cash
Savings Accounts, CDs, etc

$________Stocks and Bonds

$________Present Life Insurance Death Benefit

$________Retirement Death Benefit
Pensions, 401K, IRAs, etc

$________Other Assets

Balance Sheet

$ _______Total Needs
$-_______Total Assets
$ _______Additional Life Insurance Dollars Needed

Return to the Life Insurance Form

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