UPDATED 07252021 OMH PARTNER GROUP COLLEGE PLANNING NEW CLIENT FORM

OMH PARTNER GROUP COLLEGE PLANNING NEW CLIENT DATA SHEET

PLEASE FILL OUT AS COMPLETELY AS POSSIBLE, IF THERE IS ANY MISSING INFORMATION WE CAN GO OVER THAT DURING OUR MEETING.

IT IS ALSO VERY HELPFUL TO SUBMIT THIS BEFORE YOUR FIRST MEETING SO I CAN GET YOUR FILE SET UP.

ANY QUESTIONS CONTACT ME BY EMAIL OR PHONE. PAUL@OMHPARTNERGROUP.COM OR OFFICE: 630-510-3126.
CONSULTATION SERVICES

New Client Consultation One Time Set up Fee: $185.00

Once on board as a client:
- College Planning, Retirement Planning, Income Planning, Protecting Assets, and Managing Risk, Old 401K Transfers, How does it all relate?
- A thorough analysis of your financial situation as it applies to the financial aid process, retirement and your overall financial picture.
- Make any recommendations and implement any strategies to maximize need based financial aid eligibility
- Learn how to bulletproof your assets and your retirement.
- Year round resource for all your financial planning needs, no recurring costs.
Our fees are not for the completion of the financial forms, but rather for our expert advice and consultation services. Not all clients will be eligible for aid. If you are eligible for financial aid and/or we implement strategies to increase your aid eligibility we don’t and cannot guarantee any financial aid. This is because each college determines their own award packages.

If you don't have a professional to work with to complete any financial aid forms, we can provide several resources to you as referals. They will have their own pricing and fees for form preparation. OMH Partner Group is not affiliated or receives any compensation from any outside referrals we would suggest. OMH Partner Group does not complete or file any financial aid forms on behalf of our clients.

I would like to thank you for the opportunity to work with you and your family!

Paul Daly, President OMH Partner Group, Inc.

PARENT #1
PARENT #1 FULL NAME

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
MARITAL STATUS
SELECT ONE
DATE OF MARITAL STATUS

Month Day Year
Date
STATE OF LEGAL RESIDENCE
EMPLOYER/OCCUPATION
PLEASE TYPE IN BOTH
YEARS AT CURRENT EMPLOYER
HIGHEST GRADE COMPLETED
SELECT ONE
Military Service

YES NO
Email
example@example.com
BEST CONTACT PHONE

Area Code Phone Number

PARENT #2
PARENT #2 FULL NAME

First Name Middle Name Last Name
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
EMPLOYER/OCCUPATION
PLEASE TYPE IN BOTH
YEARS AT CURRENT EMPLOYER
HIGHEST GRADE COMPLETED
SELECT ONE
Military Service

YES NO
Email
example@example.com
BEST CONTACT PHONE

Area Code Phone Number

FEDERAL STUDENT AID ID (FSAID) NEEDED TO FILE FAFSA
FAFSA OPENS UP AFTER OCTOBER 1ST IN THE YEAR PRIOR TO GOING TO COLLEGE, SO TYPICALLY OCTOBER OF YOUR HIGH SCHOOL SENIOR YEAR.

YOU WILL NEED A FSAID (FEDERAL STUDENT AID ID) TO FILE FAFSA. ONE WILL BE NEEDED FOR EACH STUDENT FILING AND ONE FOR EITHER OR THE PARENTS. IF THE PARENTS ARE SINGLE, REMARRIED, WIDOWED, OR DIVORCED USE THE CUSTODIAL PARENT INFORMATION TO GET THE FSAID.

Go to WWW.FAFSA.ED.GOV to create one, manage existing, or update your existing FSAID. We cannot help in anyway establishing the FSAID for either the student or the parent.

CSS COLLEGE BOARD PROFILE INSTRUCTIONS
CSS PROFILE OPENS UP AFTER OCTOBER 1ST IN THE YEAR PRIOR TO GOING TO COLLEGE, SO TYPICALLY OCTOBER OF YOUR HIGH SCHOOL SENIOR YEAR.

PROVIDE COLLEGE BOARD USER NAME AND PASSWORD IF YOUR COLLEGES REQUIRE THE CSS PROFILE FORM.

TO CHECK TO SEE IF YOU COLLEGES REQUIRE THE PROFILE GO TO WWW.COLLEGEBOARD.ORG OR CHECK WITH YOUR COLLEGES WEBSITES UNDER FINANCIAL AID FORM REQUIREMENTS.

STUDENT #1 PERSONAL DATA
SPACE HAS BEEN PROVIDED FOR 4 STUDENTS, IF YOU HAVE LESS JUST FILL OUT FOR HOW MANY YOU HAVE, IF MORE WRITE IN ADDITIONAL INFORMATION IN THE COMMENTS SECTIONS BEFORE SUBMITTING.
STUDENT #1 FULL NAME

First Name Middle Name Last Name
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
HIGH SCHOOL GRADUATION YEAR
TYPE IN YEAR
HIGH SCHOOL ATTENDING OR ATTENDED
DRIVERS LICENSE NUMBER AND STATE
IF KNOWN DEGREE AND/OR MAJOR SOUGHT
CITIZENSHIP, IF NOT USA THEN PROVIDE ELIGIBLE # IF APPLICABLE

STUDENT #1 COLLEGES
COLLEGE #1

COLLEGE NAME CITY STATE
COLLEGE #2

COLLEGE NAME CITY STATE
COLLEGE #3

COLLEGE NAME CITY STATE
COLLEGE #4

COLLEGE NAME CITY STATE
COLLEGE #5

COLLEGE NAME CITY STATE
COLLEGE #6

COLLEGE NAME CITY STATE
COLLEGE #7

COLLEGE NAME CITY STATE
COLLEGE #8

COLLEGE NAME CITY STATE
COLLEGE #9

COLLEGE NAME CITY STATE
COLLEGE #10

COLLEGE NAME CITY STATE

STUDENT #2 PERSONAL DATA
STUDENT #2 FULL NAME

First Name Middle Name Last Name
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
HIGH SCHOOL GRADUATION YEAR
TYPE IN YEAR
HIGH SCHOOL ATTENDING OR ATTENDED
DRIVERS LICENSE NUMBER AND STATE
IF KNOWN DEGREE AND/OR MAJOR SOUGHT
CITIZENSHIP, IF NOT USA THEN PROVIDE ELIGIBLE # IF APPLICABLE

STUDENT #2 COLLEGES
COLLEGE #1

COLLEGE NAME CITY STATE
COLLEGE #2

COLLEGE NAME CITY STATE
COLLEGE #3

COLLEGE NAME CITY STATE
COLLEGE #4

COLLEGE NAME CITY STATE
COLLEGE #5

COLLEGE NAME CITY STATE
COLLEGE #6

COLLEGE NAME CITY STATE
COLLEGE #7

COLLEGE NAME CITY STATE
COLLEGE #8

COLLEGE NAME CITY STATE
COLLEGE #9

COLLEGE NAME CITY STATE
COLLEGE #10

COLLEGE NAME CITY STATE

STUDENT #3 PERSONAL DATA
STUDENT #3 FULL NAME

First Name Middle Name Last Name
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
HIGH SCHOOL GRADUATION YEAR
TYPE IN YEAR
HIGH SCHOOL ATTENDING OR ATTENDED
DRIVERS LICENSE NUMBER AND STATE
IF KNOWN DEGREE AND/OR MAJOR SOUGHT
CITIZENSHIP, IF NOT USA THEN PROVIDE ELIGIBLE # IF APPLICABLE

STUDENT #3 COLLEGES
COLLEGE #1

COLLEGE NAME CITY STATE
COLLEGE #2

COLLEGE NAME CITY STATE
COLLEGE #3

COLLEGE NAME CITY STATE
COLLEGE #4

COLLEGE NAME CITY STATE
COLLEGE #5

COLLEGE NAME CITY STATE
COLLEGE #6

COLLEGE NAME CITY STATE
COLLEGE #7

COLLEGE NAME CITY STATE
COLLEGE #8

COLLEGE NAME CITY STATE
COLLEGE #9

COLLEGE NAME CITY STATE
COLLEGE #10

COLLEGE NAME CITY STATE

STUDENT #4 PERSONAL DATA
STUDENT #4 FULL NAME

First Name Middle Name Last Name
DATE OF BIRTH

Month Day Year
Date
SOCIAL SECURITY NUMBER
HIGH SCHOOL GRADUATION YEAR
TYPE IN YEAR
HIGH SCHOOL ATTENDING OR ATTENDED
DRIVERS LICENSE NUMBER AND STATE
IF KNOWN DEGREE AND/OR MAJOR SOUGHT
CITIZENSHIP, IF NOT USA THEN PROVIDE ELIGIBLE # IF APPLICABLE

STUDENT #4 COLLEGES
COLLEGE #1

COLLEGE NAME CITY STATE
COLLEGE #2

COLLEGE NAME CITY STATE
COLLEGE #3

COLLEGE NAME CITY STATE
COLLEGE #4

COLLEGE NAME CITY STATE
COLLEGE #5

COLLEGE NAME CITY STATE
COLLEGE #6

COLLEGE NAME CITY STATE
COLLEGE #7

COLLEGE NAME CITY STATE
COLLEGE #8

COLLEGE NAME CITY STATE
COLLEGE #9

COLLEGE NAME CITY STATE
COLLEGE #10

COLLEGE NAME CITY STATE

COMMENTS, NOTES, ADDITIONAL FAMILY MEMBERS
COMMENTS, NOTES OR ADDITIONAL FAMILY MEMBERS, PLEASE PROVIDE FULL NAME, DATE OF BIRTH, RELATIONSHIP TO STUDENT, AND HIGH SCHOOL GRADUATION YEAR

WHAT SHOULD I BRING TO MY APPOINTMENT?
“What Should I Bring to My Appointment”

Please try to bring as many as the pertinent items from the following list below to your meeting.
1. List of family members, including full legal names, social security numbers, birthdates, schools attending, costs of schools attending, receiving any financial aid, year in school, & graduation year.
2. Driver’s license number of the student applying for aid.
3. Most recent complete Federal Tax return and W-2’s for both parents and student.
4. Most recent statements or amounts of all checking, savings, CD’s or money market accounts for both parents and student. Basically any types of “cash” accounts.
5. Most recent statements or amounts of all stocks, bonds, mutual funds, 529 Plans, cash value of life insurance, value of any annuities, or any other type of investment that is not included in your retirement plans for both the parents and the student.
6. Any trusts or court agreements, please try to bring a copy of the documents if applicable.
7. Most recent statements or amounts of all IRA’s, Simple Plans, Roth IRA’s, 401K, 403B, SEP IRA, etc types of retirement accounts for both the parents and the student.
8. Any child support paid or received for all children or social security received for all children.
9. Deductible contributions to any retirement plans or pensions received both taxable and non-taxable.
10. Out of pocket medical or dental expenses.
11. Private elementary, junior high, high school, or homeschool tuition paid for other siblings.
12. If separated or divorced, please provide some basic information regarding the “non” custodial parent. We might need, name, address, occupation, employer, is support paid, is there an agreement with regards to college, or any other court orders.
13. If you own a business, how many employees and is there debt against the business. Also please bring your most recent completed corporate Federal Tax return if you had one.
14. If own a home, year purchased, purchased price, mortgage amounts, and monthly payment including taxes and insurance.
15. If you own other property than your home, year purchased, purchased price, mortgage amounts, percentage you own, monthly payment including taxes and insurance.

TERMS AND CONDITIONS
Payment is expected at time of our first appointment.

Our fees are not for the completion of the financial forms, but rather for our expert financial planning and consultation services. All of our form preparations are done through one of our partners.

Not all clients will be eligible for aid. If you are eligible for financial aid and/or we implement strategies to increase your aid eligibility we don’t and cannot guarantee any financial aid. This is because each college determines their own award packages; however we do unconditionally guarantee your satisfaction of our services and professional approach.

Client is to provide material that is complete, accurate, and timely as to all requests. OMH does not accept any liability due to inaccurate, false, or fraudulent material. At any point we retain to right to verify information that is being provided. It is the client’s responsibilities to provide all required statements, tax returns, docs, etc. It is the client’s burden to provide verification if required either by OMH, College/University, the Department of Education (FAFSA), or the Internal Revenue Service.

Client is solely responsible for getting both a student FSAID and one Parental FSAID. You can go to www.fsaid.ed.gov to apply and register for the Federal Student Aid ID. FSAID’s are specific for the student and either parent and not to be disclosed per FSAID disclaimer. OMH does not help in any way to set up those FSAID’s, or receive them from the client.

Privacy Policy: All material and conversations are strictly confidential. We do not sell any lists or distribute any contact information to anyone without your written approval and consent outside our normal partner group. If you choose a form preparation package, that form preparation can be outsourced and done by our strategic partner CPA firm who is local. Your information will be provided to them for the those services if needed.

We hold privacy and your personal information to the highest level possible and all of our database information is stored and backed up off site in a secure location. We do everything we can to protect ourselves and our clients, but we do not accept any liability for loss of data that is beyond our control.

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CONTACT US AND DISCLOSURE
CONTACT US

OMH PARTNER GROUP | Paul Daly, Financial Advisor | 999 North Main Street, Suite 106 D, Glen Ellyn, IL. 60137 | paul@omhpartnergroup.com | Office: 630-510-3126 | Fax: 630-403-6105 | www.omhpartnergroup.com
Investment Advisory Services provided by Brookstone Capital Management, LLC. (BCM a Registered Investment Advisor). BCM, OMH Partner Group, Inc., and OMH College Planners, Inc., are independent of each other. Insurance and Annuity products are sold separately through OMH Partner Group, Inc. Nothing contained in our website, or any correspondence is intended to provide tax or legal advice. Consult with your tax advisor and/or legal counsel for suitability regarding your specific situation. Hypothetical or historical rates of return are not a guarantee of future results.
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