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Full Name
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First Name
Last Name
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Email
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Phone Number
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Address
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street, city, state, and zip code
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Your age
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Gender
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Marital Status
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Life Partner
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What is your occupation?
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10
When is/was your retirement date?
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Date
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Day
Year
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How did you hear about us?
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Online search
Referral from a client
Dinner Seminar
Radio Ad
Internet Ad
Library Seminar
Other
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If Other, please specify:
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13
If referred, who were you referred by?
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14
What is the most important thing that you want to accomplish in our initial meeting?
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15
What are your primary financial planning goals? (check all that apply)
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Determine when I can retire
Saving for retirement
Coordinating investments with tax planning
Maximize employer benefits
Ensure my estate plan is up to date
Understanding and managing my investments
Reducing my taxes
Align my finances towards specific goals
Prepare for health care costs in retirement
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16
In order for us to be better prepared for our meeting, please indicate your total investment liquid assets (not including real estate).
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Under $250,000
$250,000 to $500,000
$500,000 to $1,000,000
Above $1,000,000
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17
What is your primary investment objective? (Check all that apply)
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Preserve my money
Aggressively grow my money
Create income now
Conservatively grow my money
Income for future (retirement)
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18
Are you currently working with a financial advisor?
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Yes, but I would like a second opinion
Yes, but they don't offer what I need
Sort of, but they mostly sell products
No, I'm not working with a financial advisor
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19
On a scale of 1 - 10, with 10 being the MOST concerned, how concerned are you about having enough money to last through retirement?
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1
2
3
4
5
6
7
8
9
10
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20
How confident are you that you're in a position to retire the way that you want to?
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21
What are your 3 most important financial goals?
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