SURVIVOR CHECKLIST FOR RYAN B.

JAGGER
The following personal, financial, and legal information has been gathered to assist with the handling of the estate procedures for Ryan B. Jagger (the "Decedent"). This Survivor Checklist provides information about the Decedent's address and personal items, heirs and beneficiaries, and financial information. It includes most (if not all) of the information needed to decide whether or not formal estate procedures are required. Further, information regarding the Decedent's legal and financial advisors and other important contacts is included so that further details can be obtained from the appropriate parties. 1. PERSONAL INFORMATION: The following personal information is provided about the Decedent: Decedent's name: Address: SSN: Date of birth: Date of death: Ryan B. Jagger 35 Palm Circle Dr. Corte Madera, California 123-45-6789 January 04, 1976 March 01, 2012

2. CIRCUMSTANCES OF DEATH: The following information is provided about the circumstances of the Decedent's death: Mr. Jagger drowned at sea in the gulf of Mexico, during a tropical storm caused by Hurricane Jane. 3. SAFE DEPOSIT BOX: The Decedent did not own or have access to a safe deposit box. 4. LEGAL AND FINANCIAL ADVISORS: The Decedent's financial advisors included the following: None. 5. ESTATE DOCUMENTS: The Decedent's estate planning included the following documents: Document: Date: Will for Married Person with Children September 25, 2005

6. RESPONSIBLE PERSONS: The following persons or entities are the most knowledgeable about the Decedent's financial and personal matters, and are the most likely to be involved in handling the Decedent's estate: Name: Address: Peter R. Olsen 123 Main St. Mill Valley, California 94941

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Phone: Relationship: Tax ID No.:

(415) 443-1234 Executor 123456789

7. MARITAL STATUS: The Decedent was married at the time of death, and the following information is provided regarding the surviving spouse: Name: Address: Phone: SSN: Birth Date: Mary H. Jagger 35 Palm Circle Dr. Corte Madera, California 95422 (415) 774-5543 333-44-5555 July 09, 1982

The Decedent and the surviving spouse had not entered into a premarital agreement. 8. PRIOR MARRIAGES: The Decedent had not entered into any prior marriages that terminated prior to the Decedent's death as a result of divorce, annulment, death of the spouse, or other reasons. 9. CHILDREN: The Decedent had children as follows: Name: Address: Phone: Birth Date: SSN: Name: Address: Phone: Birth Date: SSN: _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________

10. CHILDREN \ OTHER PARENT: All of the Decedent's children are also the children of the surviving spouse. 11. OTHER BENEFICIARIES: The Decedent did not have heirs or beneficiaries who are not either a spouse or child of the Decedent. 12. LIFE INSURANCE: The Decedent owned life insurance as follows: Company: Policy No.: Amount: Fairchild Insurance Company G123456789 $250,000.00
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Beneficiary: Insured: Contact:

Mary H. Jagger Ryan B. Jagger (415) 887-5432

13. RETIREMENT PLANS: The Decedent did not own any retirement plan accounts such as IRA, 401K, or other retirement accounts. 14. EMPLOYMENT: The Decedent did not have a current or past employer who should be contacted for possible unpaid wages or other benefits. 15. REAL ESTATE: The Decedent owned real estate as follows: Description: Value: Joint Owner: Jagger Ranch $3,900,000.00 Mary H. Jagger

16. OTHER PROPERTY: The Decedent owned other property as follows: Description: Value: Joint Owner: Description: Value: Joint Owner: 2002 Chevrolet Corvette $55,000.00 _________________ Dunn & Prince 35 ft. Schooner $82,000.00 _________________

17. DEBTS: The Decedent had debts as follows: Description: Amount: Contact: Description: Amount: Contact: Property Mortgage $1,000,000.00 Redwood National Bank, (415) 456-0099 Boat Loan $50,000.00 Scottish Lending Partners, LLC, (415) 834-8845

18. EXPENSES AND BILLS: The Decedent did not have any monthly living expenses and bills, outstanding medical expenses, or funeral expenses. 19. TAX RETURNS: The Decedent did not file income tax returns for the most recently completed calendar year.

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Final Instructions for the Survivor Checklist for Ryan B. Jagger

May 16, 2012 Make It Legal * The Survivor Checklist is not a legal document and does not need to be signed.

Other Information * Certain information may not be available at the time the checklist is first prepared. Blank lines have been printed for questions where you answered "yes" and then provided no information or incomplete information. To update the Survivor Checklist, open the saved copy and enter the new or additional information.

Attachments If possible, obtain and attach copies of the following documents: * * * * * * * Death Certificate Will for Married Person with Children, dated September 25, 2005 Family tree Life insurance policies or other information about life insurance Deeds, abstracts, title insurance policies and other real estate information Statements and documentation that show asset values and/or contact information Statements and documentation that show amounts of debts and/or contact information

Reasons to Update * This checklist should be updated one or more times as new or additional information regarding the personal and financial information of Ryan B. Jagger becomes available.

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