Retirement Planning Questionnaire (RN)

Retirement Planning Questionnaire

RetireNow Insurance & Financial Services
Date

MonthDayYear
Date
Personal Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Gender
Marital Status
Spouse Contact Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Situation
Are you already retired?
If not, what is your current income? (annual, $)
When are you planning to retire? (how many years from now)
Include your spouse in your retirement plan?
Is your spouse already retired?
What is your spouse's current income? (annual, $)
When is your spouse planning to retire? (how many years)
Considering all of your retirement accounts: (Pension, 401k, TSA, 403b, 457b), will that amount be enough to support your retirement lifestyle?
Finance
How much income will support your retirement lifestyle? ($)
How much are you currently contributing a month to your retirement accounts? ($)
Considering all bills at home, what is an estimated monthly amount of all bills? ($)
Considering all credit cards, what is the total amount of all credit cards? ($)
What is your consolidated total ($) of all of your retirement accounts?
What is your desired income in retirement? (monthly)
Do you currently have Life Insurance, what type?
Legal
Do you have a Will or Living Trust?
Lifestyle
Where do you plan to live during retirement?
Do you plan to finish life in your home or at a professional assisted living facility?
Should be Empty:

Retirement Planning Questionnaire

Personal Information

Spouse Contact Information

Current Situation

Finance

Legal

Lifestyle