Use the work sheet below to determine the total life insurance needed. Do not enter any values into the fields that are already displaying a zero. These fields will be calculated for you when you click the Calculate button at the bottom of the work sheet. (Enter numeric values only into each field. Do not use commas, dollar signs, etc.). Skip those items that do not apply.

Calculation Factors	Your Estimates
1. Annual living expenses (enter the amount from the last line of the Assessing Your Life Insurance Needs work sheet)	$
2. Minus other sources of annual gross income
Surviving spouse’s salary
Investment earnings
Social Security*
Pensions/Annuities
Miscellaneous (rental income, etc.)
Total annual gross income	=$
3. Annual income shortfall (Subtract total of Item 2 from Item 1)	=$
4. Amount of death benefit needed to generate annual income in Item 3 (Divide amount in Item 3 by .04)	=$
5. Expenses
Funeral/Cremation
Final hospital stay/Illness
Estate probate costs
Federal estate taxes
State inheritance taxes
Mortgage balance (if rent/mortgage payment is not included in the Assessing Your Life Insurance Needs work sheet)
Education fund
Emergency fund
Other outstanding debts
Total expenses	=$
6. Preliminary insurance needs (Add total of Item 4 and Item 5)	=$
7. Existing assets/other insurance
Group life through employer
Personal life coverages
Lump-sum pension payable at death
Savings
Securities
IRA/Keogh plans
Employer savings plan 401(k)
Other liquid assets
Total assets/Insurance	=$
8. Total life insurance needed (Subtract total of Item 7 from Item 6)	=$

You may print this form for your convenience,
or press the Reset button to try a different set of numbers.

*The amount of Social Security benefits received depends on several factors. Consult your Social Security statement each year to determine your Social Security benefits.

Updated Thursday, January 28, 2010