Individual Financial Assessment

Personal Financial Assessment
This questionnaire is designed to help you highlight personal financial planning areas that may need attention. Please complete, checking all that apply for each statement. Thank you.
General Planning

Have you recently experienced a major life event?

Do you have a formal financial/retirement plan? If so, has it been reviewed in the last year?

	Yes	No	Let's Discuss
Do I have it?
Has it been reviewed?

Do you have an alternate source of income to pay your mortgage if you become disabled and are unable to work for a prolonged period of time?

	Yes	No	Let's Discuss
Response

Have you established college-funding plans for children or grandchildren? Are they on track?

	Yes	No	Let's Discuss
Response

Do you anticipate that your parents will need to your financial support in retirement?

	Yes	No	Let's Discuss
Response

Do you maximize your annual retirement plan contributions?

	Yes	No	Let's Discuss
Response

Have you established any non-taxable sources of retirement income (ex: Roth IRA, Permanent Life Insurance)?

	Yes	No	Let's Discuss
Response

Have you calculated how much you need to save for retirement and the sources of that income?

	Yes	No	Let's Discuss
Response

Do you know when you will be able to maximize your Social Security benefits?

	Yes	No	Let's Discuss
Response

Do you have an up-to-date will that details how your assets should be distributed?

	Yes	No	Let's Discuss
Response

Does your will name a guardian for your minor children?

	Yes	No	Let's Discuss
Response

Do you have a durable power of attorney and written health care directives?

	Yes	No	Let's Discuss
Response

Have you considered a living trust to avoid probate?

	Yes	No	Let's Discuss
Response

Have you made plans to minimize the amount of tax that your heirs or charities will need to pay on your estate?

	Yes	No	Let's Discuss
Response

Will your family be able to maintain its lifestyle in the event of you or your spouse's death?

	Yes	No	Let's Discuss
Response

Will your life insurance be sufficient to cover the debts, taxes, and estate settlement costs that may be due on your estate?

	Yes	No	Let's Discuss
Response

Would you like to set-up time to review your complete financial situation?

	Yes	No	Let's Discuss
Response

I'd like to discuss:

Savings and accumulation strategiesRetirement PlanningInvestment analysisEducation funding strategiesWealth transfer strategiesRisk management (death, disability, health, long-term care)Life insuranceOther
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Personal Financial Assessment