1. New Burial Exclusion & Designation Form (current as of 2/1/2010)
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2. Purpose of this training: Demonstrate the new Burial Exclusion & Designation Form
The new “Burial Asset Exclusion & Designation” form replaces the old Burial Exclusion worksheet and the Form 985, Designation Form.

3. The form tells what figure to enter on a NON paid in full contract.
Calculate the value of any burial contract.
Carry (c) from section 1 and the totals from section 2 & 3 to the back of the form.

4. List all burial assets here
Decide what to exclude & list that here.
List here anything you could NOT exclude
Have client or AREP sign if assets include a burial fund or burial contract

5. Ms. Haynes owns a burial contract with Carmichael Funeral home.
She is making payments on the contract, so far she has paid $6800.
The funeral home verifies that she has fully paid for her casket (valued at $2000) and her vault (valued at $550).
No other burial space items are paid in full.

7. Ms. Haynes also has a burial fund, it is a $2000 CD.

9. Ms. Haynes owns a whole life insurance policy with a face value of $5000 and a cash surrender value of $231.

11. Now let’s look at the back of the Burial Exclusion & Designation sheet for Ms. Haynes.

12. Section 4: List all assets
Section 5: Decide what to exclude
We exclude the burial contract and the burial fund. Can’t exclude the life insurance because a whole life policy can’t be partially excluded.
Section 6: List anything that could not be excluded.
Ms. Haynes would need to sign this form since her assets include a burial contract and a burial fund.

13. Excluded assets on RES1 INTERVIEW RESOURCES 1 - RES1 RES1 01
Month
Client Name BEATRICE CLINE Client ID
Do you have any of the following: cash, money loaned out, checking, savings,
credit union, CD's, stocks, bonds, or secured notes?
Del Type Amount V Acct Num Institution Name
CH CS BANK OF AMERICA
Do you have any of the following: life insurance, pre-paid burial contracts,
real estate, or cemetery lots?
Del Type Face Amt Cash Amt V Policy Num Company Name
BC ? OT EXCLUDED BURIAL ASSETS
More
Message
0779 SHOULD THIS AMOUNT BE ZERO?
15-lett alau 24-del
Excluded assets on RES1

14. Documentation behind RES1
UPDATE REMARKS - REMA REMA 01
(In addition to other resource documentation)
Burial Assets--Ms. Haynes owns:
a burial contract at Carmichael Funeral Home valued at $6800 which includes $2550 in paid for burial space items– value is $4250
a burial fund (CD at Bank of America #319-4) valued at $2000
Life insurance policy # with General Life—FV $5000, CSV $231
Burial contract and burial fund excluded (total exclusion $6250), cash surrender value of insurance counted ($231)
See signed Burial Exclusion & Designation Form 985 in CR
Message More
13-bott
Documentation behind RES1

15. INTERVIEW RESOURCES 3 - RES3 RES3 01
Month 11 XX XX
Client Name BEATRICE HAYNES Client ID
Do you have any of the following: safety deposit box, business holdings, non-
home consumption produce, livestock, or other valuables?
Other Property
Del Type FMV V Encumb V Annl Rate V
Return
OC OT
More
Message
15-lett del
Included assets on RES3 (If there’s a FS case these can be entered as “MO”)

16. Documentation behind RES3 (just a copy & paste from RES1)
UPDATE REMARKS - REMA REMA 01
(In addition to any other resource documentation)
Burial Assets--Ms. Haynes owns:
a burial contract at Carmichael Funeral Home valued at $6800 which includes $2550 in paid for burial space items– value is $4250
a burial fund (CD at Bank of America #319-4) valued at $2000
Life insurance policy # with General Life—FV $5000, CSV $231
Burial contract and burial fund excluded (total exclusion $6250), cash surrender value of insurance counted ($231)
See signed Burial Exclusion & Designation Form 985 in CR
Message More
13-bott
Documentation behind RES3 (just a copy & paste from RES1)

17. There are many additional examples in the “Train Track” for Burial Assets.
You can find this and many other helpful guides on our website at “gadfcs.org/ofi”

18. Thank you for completing this desk training. Have a great day!