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Building Economic Confidence
THANK YOU FOR SCHEDULING YOUR COMPLIMENTARY FINANCIAL CONSULTATION
In this initial meeting together we will explore different views of money and how to make yourmoney work smarter and harder to accomplish your goals with more confidence. The First Step is thehardest; this questionnaire is intended to serve as a guide to help you gather the information we require. Ifyou already have a system to summarize your assets you may provide it. We understand some details maynot be readily available and we can still move forward, a follow up checklist will be provided. Please do thebest you can to complete what is pertinent to you and please try to securely email back to us before yourmeeting; if unable to do so, please bring all information to our first meeting.
If we were meeting here three years from now, looking back over those three years, what has happened during that period (financially, personally and professionally) which has made you feel happy about your progress?
Financial Priorities
From 1-5 (1 being most important), rank each of these financial goals in order of importance:
Retire comfortably
Children's Education
Save on Taxes
Provide for family in event of death/ disability
Other (please explain)
Are there any special or unique circumstances, goals, needs or wants that should be taken into account during this process (retirement concerns, tax planning, special needs child, potential inheritance, taking care of parents, etc.)?
Checklist
The following exercise helps us to evaluate your financial picture, highlighting how monies are being distributed and where inefficiencies may exist. Tending to this checklist with detail and accuracy will allow us to most effectively tailor our planning process to your financial needs.
Document Check List (Please Check Boxes)
Yourself
Spouse
- Paystub(s) for you and your spouse ( Most recent and final from previous year)
- Mortgage statement
- Current statements for each investment account
- Company-provided group benefits for you and your spouse (please provide a print-out of coverage details, if available)
- Wills and trust documents
- Life Insurance policy, annual statement, and illustration
- Any other types of insurance policies (auto, home, umbrella, etc)
- If applicable, other debt statements
Personal Info
BACKGROUND INFORMATION
BACKGROUND INFORMATION
NAME
DATE OF BIRTH
YOURSELF
PLACE OF BIRTH
SPOUSE
PLACE OF BIRTH
CHILD
CHILD
CHILD
CHILD
Street Address
How Long Have You Lived Here?
City
State
Zip
Phone
Email
Spouse Cell
Spouse Email
EMPLOYMENT
Yourself
Spouse
Company Name
Occupation & Job Title
Company Address
Length of Employment
INCOME
Yourself
Spouse
Base Salary
Bonus/Commission
(if any, when is it paid?)
Stock Options/RSU's Other:
Matrix
Source
Source
Matrix(1)
Amount
Amount
Assets
BANK ACCOUNTS
Account Holder (ex. John Doe), Bank Name (ex. Bank of America), Type (ex. Checking), Amount (ex. $10,000), Annual Savings (ex. $2,000), Purpose (ex. Savings, vacation, college, etc)
BANK ACCOUNTS
Account Holder
Bank Name
Type
Amount
Annual Savings
Purpose
RETIREMENT ACCOUNTS
Type (ex. 401k)
Account Holder (ex. Nancy)
% Contributing (ex. 7%)
% Match (ex. 3%)
Investment Company (ex. Fidelity)
Estimated Value (ex. $50,000)
Do you have a pension? If so, what is the estimated payout at retirement?
Assets
INVESTMENT ACCOUNTS
Account Holder (ex. John)
Account Type (ex. Brokerage)
Investment Company (ex. Fidelity)
Estimated Annual Savings (ex. $5000)
Estimated Value (ex. $10,000)
Purpose (ex. General Investing)
Are you happy with the performance of all your investments?
Are you happy with the level of risk that you are currently taking?
Real Estate
Type
Type Estimated Current Market Value
Debt
Type
Current Balance
Current Monthly Payment
Interest Rate
Months Remaining
Are you making any additional payments above the current minimum amounts? If so, how much?
Insurance
LIFE INSURANCE
Type
Name of Insurance Company
Insured
Amount of Coverage
Annual Premium
Est. Cash Value
DISABILITY INSURANCE
Type
Insured
Name of Insurance Company
Annual Premium
Amount of Coverage
How did you arrive at the amount of Life and Disability insurance that you currently have?
If you have term insurance, in what year does the coverage end?
Monthly Cash Flow
I Basic Expenses
Automobile Fuel
Automobile Loan
Cable/Internet
Child Care
Food/Groceries
Home/Auto/Umbrella Insurance Payments
Home Security
Mortgage/Rent
School (College, Private)
Phone Bill
Utilies ( Gas, Electric, Water)
Pet Care
Misc
Other
Total
II Discretionary Expense
Entertainment
Food/Dining
Gifts
Haircuts
Hobbies
Housekeeper Services
Subscriptions
Travel
Vacations
Memberships
Misc. (Charity, etc)
Totals
Grand Total
Additional Information
What would your perfect future look like, feel like, what would you be doing and with who?
What changes or improvements would you like to see with respect to your personal finances?
What are you hoping to get out of going through this process with us?
What is important about money to you?
Personal Notes
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