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Financial Information (cont’d)

(2) CREDIT CARD
Account #:
(3) CREDIT CARD
Account #:
(1) SAFE DEPOSIT BOX:
Institution:
Address:

Location of Key:
Box #:
Items Stored:
Other Signatory:
Phone:
Email:
Address:

(2) SAFE DEPOSIT BOX:
Institution:
Address:

Location of Key:
Box #:
Items Stored:
Other Signatory:
Phone:
Email:
Address:

INSURANCE AGENTS/COVERAGE

PROFESSIONAL LIABILITY INS. CO.:
Agent:
Phone:
Email:
Address:

Policy #:

ERRORS & OMISSIONS INS. CO.:
Agent:
Phone:
Email:
Address:

Policy #:

BUSINESS PREMISES INS. CO.:
Agent:
Phone:
Email:
Address:

Policy #:

Insurance Agents/Coverage (cont’d)

HEALTH INS. CO.:
Agent:
Phone:
Email:
Address:

Policy #:
Persons Covered:




LIFE INS. CO.
Agent:
Phone:
Email:
Address:

Policy #:
Persons Covered:

Insurance Agents/Coverage (cont’d)

DISABILITY INS. CO.:
Agent:
Phone:
Email:
Address:

Policy #:

BUSINESS STORAGE INFORMATION

(1) STORAGE COMPANY:
Contact:
Phone:
Email:
Address:

Location of Key:
Unit Number(s):
Items Stored:

(2) STORAGE COMPANY:
Contact:
Phone:
Email:
Address:

Location of Key:
Unit Number(s):
Items Stored:

LEASES

(1) ITEM LEASED:
Lessor:
Contact:
Phone:
Email:
Address:

Lease Expiration:

(2) ITEM LEASED:
Lessor:
Contact:
Phone:
Email:
Address:

Lease Expiration:

(3) ITEM LEASED:
Lessor:
Contact:
Phone:
Email:
Address:

Lease Expiration:

MAINTENANCE CONTRACTS

(1) ITEM COVERED
Vendor:
Phone:
Email:
Address:

Expiration:

(2) ITEM COVERED
Vendor:
Phone:
Email:
Address:

Expiration:

1 Information and filing documents for professional corporations may be available on the website for the Ohio Secretary of State at: http://www.sos.state.oh.us/SOS/

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