Expenses to be Covered Upon Death IF ______________ Died Today: IF ______________ Died Today: Funeral costs Estate taxes and administration Final medical expenses Mortgage pay-off Other debts Readjustment period income Income replacement during child dependency period Income replacement for surviving spouse after dependency period and before retirement Retirement period income for surviving spouse Extra expense fund Special Goals: Education funding Support of dependents with special needs Charitable contributions Care of pets Other Total Need $- $- Less available assets Total Need to be Funded with Life Insurance $- $- Amount to be funded with term insurance Less existing term insurance Additional term insurance needed $- $- Amount to be funded with permanent insurance Less existing permanent insurance Additional permanent insurance needed $- $-