Determine your Assets

A simple and easy way to determining your assets! Fill out this form as if it is owned by you alone, owned by your spouse and/or owned jointly (or in community). After submitting this form, contact BCA Insurance Group at 609-645-1700 or bbalsley@bca-insurance.com for further assistance to ensure that your wishes are carried out after your lifetime.

First Name *

Last Name *

ZIP / Postal Code *

Primary Phone Number *

E-Mail Address *

Assets: Residence *

Other real estate *

Bank accounts, certificates of deposit, money market funds *

Stocks, bonds, mutual funds *

Closely held business interests *

Partnership ventures *

Notes, mortgages owed to you *

Retirement funds *

Life insurance face value *

Furniture, jewelry, collections, etc. *

Automobiles, boats, etc. *

Annuities, revocable trusts *

Other assets *

Total assets *

Liabilities: Mortgages *

Loans, installment debts *

Current bills *

Taxes owed *

All other liabilities *

Total liabilities *

NET ESTATE (subtract total liabilities from total assets) *

Submission Validation

Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

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Main Office
330 Tilton Road
Northfield, NJ 08225

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Northfield: 609.645.1700
Marlton: 609.645.1700