The following items would be helpful to have at the time of our visit:
1. All brokerage firm statements
Contact Information
First Name
Last Name
Nickname
Date of Birth
Working At/Retired From:
Current/Former Occupation:
Spouse First Name
Spouse Last Name
Spouse Nickname
Spouse Date of Birth
Spouse Working At/Retired From:
Spouse Current/Former Occupation:
Home Phone:
Cell Phone:
Email Address:
Address:
Street Address:
Address Line 2:
City:
State:
Zip / Postal Code:
Country:
Number of Children
Number of Grandchildren
Do any of your children or grandchildren have special needs?
Are any of your children or grandchildren listed as joint owners on any of your accounts/assets?
Family Notes:
LEGAL ITEMS
Which of the following legal documents do you have in place?
Power of Attorney (POA) Assets
Power of Attorney (POA) Health
LEGAL ITEMS
Which of the following do you have in place?
Death Benefit Life Insurance
CASH FLOW
Please list monthly income from each source.
You
Your Spouse
You
Your Spouse
You
Your Spouse
You
Your Spouse
Source(s)
Total
Source(s)
Total
Are these amounts net or gross?
How much are your monthly expenses?
Here are some common expenses:
Mortgage, Food, Gas, Car Loan, Insurance, Utilities, Gifts/Donations, Medical, Taxes, Social Security, etc
Total
Is your current cash flow sufficient and comfortable?
Do you live off interest your investment dollars earn?
Do you anticipate any significant changes in cash flow?
Are you planning any major lifestyle changes?
Do you foresee any large purchases greater than $5,000 within the next 3 years?
Do you contribute to charity?
ASSETS
Please go through the accounts you currently hold and list the total amounts in the boxes below, and bring the latest statement in for your visit (Optional). Leave box blank if not applicable.
Bank / Credit Union Accounts $
Mutual Funds / Stocks / Bonds $
Brokerage Accounts $
Retirement Accounts from Work $
CDs $
Business Interest $
Annuities $
IRAs / 401K / 401B / Keoghs / TSAs $
Life Insurance $
Long Term Care Insurance $
Promissory Notes / Contract for Deed $
Other Assets $
Home Value $
Autos and Personal Property $
Rental/Additional Properties $
Description
Balance Owed
Pay Off Date
Description
Balance Owed
Pay Off Date
Description
Balance Owed
Pay Off Date
If you are not already retired, when do you want to retire?
How did you acquire your wealth?
How involved would you like to be with your investments?
What is most important about your money to you?
Are you more concerned about growing your assets or protecting what you already have?
Which of the following describes your risk tolerance when it comes to retirement assets?
Conservative
Moderate
Aggressive
SEND
