Personal & Business Priority Review

Personal & Business Planning Review

completing this form will accomplish two key objectives:
1) The nature of the questions will help you understand the type of work we do.

2) Your responses will help both of us determine how we should proceed.

NO PERSONAL or FINANCIAL DATA IS REQUIRED

Name & Age
E-mail
Name & Age (2)
Address Personal or Business

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone (Res)
Phone (Cell)
Company Name | Position
Year Business Established | Entity Type (C, S, LLC, PC)
Number of Shareholders | Number of Employees
Approximate Revenue & Taxes Paid Last year
Your information will be kept strictly confidential in accordance with privacy regulations.

My Views

Rows	Essential	Fairly Important	Of Little Value	Does Not Apply
1. Developing a higher level of wealth is
2. The involvement of my spouse/partner in our financial affairs Is
3. Exchanging some of today's lifestyle for future financial security is
4. Understanding the risks of tax-deferred savings and investments is
5. Investing in the stock market or mutual funds Is
6. Having an investment portfolio that offers high-growth potential is
7. In my investments, a low risk factor is
8. Understanding how taxes affect my retirement lifestyle is
9. Having a worry-free retirement plan for the future is
10. If I became disabled, a replacement income would be
11. In my opinion, will planning and having a current will is
12. Paying off loans and mortgages upon my death is
13. My family's ability to maintain their current standard of living upon my death is
14. Protecting the value of my estate from tax erosion is
15. Knowing I won't outlive my retirement income is
16. Creating a guaranteed lifetime income is
17. Knowing that my financial professional has a complete understanding of my financial objectives is
18. Assistance from a qualified financial advisor in planning my financial affairs is

Financial Development

Rows	Yes	No	Unsure	Does Not Apply
1. I know how much I need in retirement to support my lifestyle
2. My spouse/partner actively participates in our financial affairs,
3. My spouse/partner has a clear understanding of our financial situation.
4. I have fully outlined my financial objectives.
5. My financial plans Include education funding for my children.
6. I am skilled at managing my income and expense flow.
7. I accumulate and build wealth systematically.
8. I have prepared a Retirement Income Plan.
9. My spouse/partner and I each have our own long-term retirement plans.
10. I allocate a specific percentage of my earnings for wealth accumulation.
11. I understand the benefits of integrating my retirement plan, long term care planning and family protection into one plan
12. I am satisfied with the rate of return on my current retirement savings program.
13. I understand how taxes affect my retirement lifestyle.
14. I know how life insurance integrates with my financial plan.
15. I am satisfied with the quality of financial advice and service I currently receive.
16. I would like assistance with reviewing my financial development.

Investment Strategy

Rows	Yes	No	Unsure	Does Not Apply
1. My investment strategy includes taxable, tax-deferred and tax-free assets.
2. My investment portfolio is properly diversified in terms of risk versus return.
3. I have a current asset allocation formula as part of my investment strategy.
4. My investment strategy takes advantage of dollar-cost averaging.
5. My investment portfolio has a good balance between short-term liquidity and long-term growth.
6. Stability in the value of my investments is critical.
7. I value performance over fees.
8. My investment portfolio is optomized to reduce taxes
9. I am currently taking maximum advantage of tax-deferred retirement plans.
10. I have accurately projected my retirement income needs and sources of income.
11. I recognize the importance of having a qualified financial advisor.
12. I am satisfied with the advice and service I receive from my financial advisor.
13. I am accustomed to paying fees for sound financial advice.
14. I would like assistance in reviewing my investment strategy

Lifestyle Protection

Rows	Yes	No	Unsure	Does Not Apply
1. I know the income I will receive if I am unable to work due to an accident or severe illness.
2. My disability protection continues if I leave my employer.
3. My spouse/partner has adequate income protection coverage.
4. My disability income program covers debt repayments.
5. My current standard of living will continue if I have a severe accident or illness.
6. My income protection coverage has been Increased to keep pace with my earnings.
7. I have adequate long-term care insurance.
8. My spouse/partner has adequate long-term care insurance.
9. I understand the value of critical Illness coverage.
10. My insurance program will maintain my family's lifestyle.
11. My spouse/partner has sufficient life insurance to maintain our family's lifestyle.
12. I have an adequate pension plan.
13. My spouse/partner has an adequate pension plan.
14. Our retirement income will meet the demands of our desired lifestyle.
15. I am prepared to alter today's lifestyle to guarantee future financial security.
16. l am satisfied with my current lifestyle and Income protection.
17. I would like assistance in reviewing my lifestyle protection needs.

Estate Organization

Rows	Yes	No	Unsure	Does Not Apply
1. I am well informed about the organization of my estate.
2. My will is current and consistent with my estate plans.
3. My spouse/partner has a valid, up-to-date will or trust.
5. A guardian has been appointed for our minor children.
6. I maintain a current list of important personal papers and their location.
7. My beneficiary designations are current.
8. My executor understands my will and estate plan.
9. My executor knows the location of important personal papers
10. I have made specific plans to distribute my estate upon my death.
11. I understand how taxes will be applied to my estate.
12. The value of my estate is protected from the effects of "tax erosion".
13. I know what income my family will receive from the after-tax proceeds of my estate.
14. My life insurance program is consistent with the needs of my estate plan.
15. I understand how life insurance can protect my estate from the effects taxation.
16. I understand how taxes will be applied to the beneficiaries of my retirement benefits.
17. I would like assistance In organizing my estate.

Rows	Yes	No	Unsure	Does Not Apply
1. I take time to work on strategic planning for my business
2. My family is involved in the business.
3. I know the fair market value of my business.
4. I could easily find people to purchase and run my business.
5. My business is ready for others to step in and manage should I leave due to death, disability, or retirement.
6. In my opinion the business provides adequate compensation for the owners.
7. I have a plan to diversity my wealth and accumulate tax-advantaged wealth outside the business.
8. Our current buy-sell agreement is up to date and covers death, disability, retirement, and divorce.
9. There is adequate life insurance for all owners of the business
10. I have a program in place to recruit, reward and retain employees who are key to business ongoing success.
11. My CPA is proactive in helping us save money on taxes each year.
12. I have a plan to create guaranteed income when I retire.
13. I have a plan in place to regularly evaluate ongoing business expenses
14. I understand how life insurance can be used to become my own bank.
15. I understand how taxes could significantly reduce the value of my qualified retirement accounts
16. I would like assistance with my issues as a business owner

Review Status

Rows	More than three years ago	One to Three Years Ago	Less Than One Year Ago
1. My last retirement planning review was
2. My last investment strategy review was
3. My last life insurance policy review was
4. My last estate organization review was
5. My last Buy-Sell Agreement review was

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Note: Tax and legal matters should be discussed with a qualified advisor.
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