Financial Planning Worksheet
CONFIDENTIAL
Name
*
First Name
Last Name
Mobile Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Monthly Budget
Housing
Rows
Amount
Mortgage/Rent
Second Mortgage/Rent
Condo/Association Fees
Insurance
Taxes
Other
*If other, please explain
Entertainment
Rows
Current
Travel
Hobbies
Membership Dues
Other
*If other, please explain
Transportation
Rows
Current
Car Payment 1
Car Payment 2
Auto Insurance
Other
*If other, please explain
Savings
Rows
Current
Taxable
Tax-Deferred
Tax-Exempt
Other
*If other, please explain
Sources of Income
Rows
Current
Salary
Social Security
Pension
Other
*If other, please explain
Assets/Liability (Personal property, businesses, debt)
Rows
What you own
Account Location
Value
Owed
Home
Personal Property
Business
Toys
Other assets
Student Loans
Credit Card
Personal Loans
Business Loans
Other Liability
*If other, please explain
Account Summary (Bank Accounts, Annuities, Life Insurance Policies)
Rows
Account Name/Owner/Number
Market (Benefit) Value
Bank Accounts
1
2
3
4
Annuities/Life Insurance
1
2
3
4
Please upload statements from investment accounts and insurance policies.
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All information is strictly confidential. Securities offered through Avantax Investment Services℠, Member FINRA,SIPC. Advisory services offered through Avantax Advisory Services℠, 408 W. Michigan Ave, Jackson, MI 49201.
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