• Confidential Questionnaire

  • The purpose of this financial questionnaire is to
    assemble a summary view of your financial picture which we will use to
    develop the best possible strategy for you and your goals. While you do
    not have to answer every question (you can leave anything blank that you
    choose), it is important to be as thorough as possible to ensure that
    any options we discuss are appropriate for your unique situation.

    **All information is strictly Confidential**

  • Personal and Family Information 

  • Income

    Occupation, Income, and Income Tax Rates

  • Defined Benefits (Social Security, PERs, Railroad Pension, etc.)

  • Other Future Income or Assets (Inheritance, Sale of Business, etc.)

  • Real Estate and Mortgages 

  • Qualified Retirement Accounts (IRA, Roth, 401k, SEP, Deffered Comp, Pension Balances, Etc.)

  • Savings and Investment Accounts (CD's, Securities, Bonds, Mutual Funds, ETF's, Annuities, etc.)

  • Liabilites 

    Installment Loans (Auto, Boat, RV, Student/Parent College, HELOC. Etc.)

  • Revolving Credit Lines (Credit Cards, Store Charge Cards, Checking Credit Lines, Etc.)

  • Protection

    Life Insurance (Term, Cash Value)

  • Other Insurance (Auto, Home-Owners, Renters, Umbrella, Health, Disability, Long Term Care, Etc.)

  • Expenses 

    Future Expenses (College, Weddings, Etc.)

  • Please bring the following to your first meeting: 

  • I have received the above checked documents for review and they will be kept confidential in a place of safe keeping. 

  • Clear
  • Should be Empty: