FINANCIAL EVALUATION FORM

COMPLEMENTARY FINANCIAL EVALUATION

(Confidential) Fill out the form carefully for proper follow up
Today’s Date

MonthDayYear
Date
How Do You Spell Your Name?

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Would you consider it to be ________ to provide financial security for your financial future:
Do you have an updated will/trust?
Do you currently have life insurance?
If we can save you money on your policy, and/or give you a free upgrade, would that be something you would be open to?
If you qualify for the upgrade:
Does your company provide you with a retirement plan?
If Yes, What Kind?
401K,403B,457 ect..
Are you currently participating in it?
Are you contributing to any retirement plans outside of work?
If we lower your fees to your retirement plan, would that be something you would be open to?
Do you already have a Financial Advisor?
Are you open to a 2nd Opinion if it would improve your Financial Strategy?
Outside of tomorrow, at what age would you like to retire?
When will money work for you, so you no longer work for money
What is your current age?
When will money work for you, so you no longer work for money
How much money do you think you would need per month to retire comfortably, and stay retired?
When will money work for you, so you no longer work for money
Are you on track to reach that goal?
If we, can show you a surefire way to be on track, would you be open to it?
If we could improve your financial situation, which of the following would you like to learn more about? Please Check all That Apply
What Day & Time Can We Contact You To Schedule A Financial Check Up?
(Date & Time, Location, Within 24-48 Hrs.) Office, Home, Other
Should be Empty:

COMPLEMENTARY FINANCIAL EVALUATION