Financial Plan Data Gathering: Retiree
Please use this secure form to enter data needed to prepare your plan. Your data is secure and not shared with anyone.
Client's Name
*
First Name
Last Name
Co-Client's Name (if applicable)
First Name
Last Name
Client's Email
*
example@example.com
Co-Client's Email (if applicable)
example@example.com
Client's Date of Birth
*
-
Month
-
Day
Year
Date
Co-Client's Date of Birth (if applicable)
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Month
-
Day
Year
Date
If you were to prioritize the top 2-3 goals for your financial life, what would they be?
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Retirement (Work Optional) Planning
The following questions relate to your retirement planning goals.
At what age or date did you retire? (or be in a position to make work optional)
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What are your current monthly expenses? (a round number estimate is fine OR feel free to upload a more detailed amount at the end of the questionnaire)
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What are your estimated Social Security benefits if you haven't begun them yet? (Client)
*
**Statement upload or XML file upload (even better!) at the end of this questionnaire**
What are your estimated Social Security benefits if you haven't begun them yet? (Co-Client if applicable)
**Statement upload or XML file upload (even better!) at the end of this questionnaire**
Do you have a pension? (Client)
*
Please Select
Yes
No
What are your pension benefits? (Client)
**Statement upload at the end of this questionnaire**
Do you have a pension? (Co-Client if applicable)
Please Select
Yes
No
What are your pension benefits? (Co-Client if applicable)
**Statement upload at the end of this questionnaire**
Balance Sheet and Income Sources
The following questions relate to your balance sheet. There is also a place at the end to upload statements for more accurate data gathering.
INCOME SOURCES: Please list your income sources by type.
*
**Statement upload at the end of this questionnaire**
ASSETS: Please list out your assets by type/account.
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**Statement upload at the end of this questionnaire**
Liabilities (Debts): Please list your assets by type/account.
*
**Statement upload at the end of this questionnaire**
Insurance Planning
The following questions relate to your current insurance plan.
Please list your insurance(s) by type/account.
*
Estate Planning
The following questions relate to your current estate plan.
What documents do you have in place currently?
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Living trust
Will
Healthcare directive
Power of attorney
A more complex trust structure (GRAT, GRUT, ILIT, Dynasty, etc.)
I need assistance with what I should have!
Tax Planning
The following questions relate to your current tax plan.
Do you work with a CPA or Accountant?
*
Please Select
Yes
No
I prepare my taxes myself
Do you currently do any Roth conversions, IRMAA planning, Net investment income tax planning, etc?
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Roth conversions
IRMAA planning
Net investment income planning
That's why I'm talking with you!
Other
Are there any other items you'd like to add that are specific to your situation?
Secure File Upload
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Please upload any relevant items here. (Tax returns, investment account statements, Social Security statements, etc.)
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