Financial Planning Questionnaire

1
Tell us a little about yourself.Fill out your basic information on the following pages and we can begin the discovery process.
First Name
Last Name
Email
Phone Number
Please Select
Please Select
Email
Phone
Preferred contact method
Name of the Advisor you work with
2
What is your home address?* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
What is your date of birth?* This field is required.
Date
Month
Day
Year
4
Who are the important people in your life?Add relationships to help us understand and shape your household - these can include family and other advisors
Name
Please Select
Please Select
Spouse
Partner
Dependent (Child)
Accountant
Attorney
Other
Relationship
Name
Please Select
Please Select
Spouse
Partner
Dependent (Child)
Accountant
Attorney
Other
Relationship
Name
Please Select
Please Select
Spouse
Partner
Dependent (Child)
Accountant
Attorney
Other
Relationship
Name
Please Select
Please Select
Spouse
Partner
Dependent (Child)
Accountant
Attorney
Other
Relationship
5
Tell us a little about this person
Name
Relation to you
Email Address
Phone Number
Date of Birth
6
Tell us a little about this person
Name
Relation to you
Email Address
Phone Number
Date of Birth
7
Tell us a little about this person
Name
Relation to You
Email Address
Phone Number
Date of Birth
8
Tell us a little about this person
Name
Relation to You
Email Address
Phone Number
Date of Birth
9
Let's get an idea of your financial picture.Click the items that you or members of your household currently have.
Income
Spending
Real Estate
Loans & Liabilities
Investment Accounts
Insurance
Business / Trusts
Other
10
What are your sources of income?
Please Select
Please Select
Employment
Self-Employment
Social Security
Pension
Annuity
Investment
Rental
Type of income
Who owns this?
Please Select
Please Select
Employment
Self-Employment
Social Security
Pension
Annuity
Investment
Rental
Type of income
Who owns this?
Please Select
Please Select
Employment
Self-Employment
Social Security
Pension
Annuity
Investment
Rental
Type of income
Who owns this?
Please Select
Please Select
Employment
Self-Employment
Social Security
Pension
Annuity
Investment
Rental
Type of income
Who owns this?
11
Details about this income.If you don't have the exact amount, it's okay to give a rough estimate.
Type of income
Who owns this?
Employer
Job title
Annual amount
Employer address
Years employed
12
Details about this income.If you don't have the exact amount, it's okay to give a rough estimate.
Type of income
Who owns this?
Employer
Job title
Annual amount
Employer address
Years employed
13
Details about this income.If you don't have the exact amount, it's okay to give a rough estimate.
Type of income
Who owns this?
Employer
Job title
Annual amount
Employer address
Years employed
14
Details about this income.If you don't have the exact amount, it's okay to give a rough estimate.
Type of income
Who owns this?
Employer
Job title
Annual amount
Employer address
Years employed
15
Tell us about your spending/Retirement?If you don't have an exact amount, it's okay to provide a rough estimate.
Estimated Monthly Spending
Desired Monthly Income in Retirement
Your Desired Retirement Age
Spouse Desired Retirement Age
16
What are your real estate assets?
Please Select
Please Select
Residence
Non-residence
Type of real estate
Who owns this?
Please Select
Please Select
Residence
Non-residence
Type of real estate
Who owns this?
Please Select
Please Select
Residence
Non-residence
Type of real estate
Who owns this?
Please Select
Please Select
Residence
Non-residence
Type of real estate
Who owns this?
17
Tell us about this real estate asset.If you don’t know the exact value, it’s okay to give a rough estimate.
Type of real estate
Who owns this?
Real Estate Value
Location (City/State)
18
Tell us about this real estate asset.If you don’t know the exact value, it’s okay to give a rough estimate.
Type of real estate
Who owns this?
Real Estate Value
Location (City/State)
19
Tell us about this real estate asset.If you don’t know the exact value, it’s okay to give a rough estimate.
Type of real estate
Who owns this?
Real Estate Value
Location (City/State)
20
Tell us about this real estate asset.If you don’t know the exact value, it’s okay to give a rough estimate.
Type of real estate
Who owns this?
Real Estate Value
Location (City/State)
21
What are your loans and liabilities?
Please Select
Please Select
Mortgage
Home Equity Loan
Student Loan
Auto Loan
Credit Card
Other
Type of liability
Who owns this?
Please Select
Please Select
Mortgage
Home Equity Loan
Student Loan
Auto Loan
Credit Card
Other
Type of liability
Who owns this?
Please Select
Please Select
Mortgage
Home Equity Loan
Student Loan
Auto Loan
Credit Card
Other
Type of liability
Who owns this?
Please Select
Please Select
Mortgage
Home Equity Loan
Student Loan
Auto Loan
Credit Card
Other
Type of liability
Who owns this?
22
Tell us about this loan/liability.If you don’t know the exact balance, it’s okay to give a rough estimate.
Type of liability
Who owns this?
Lender / Bank
Original Balance
Current Balance
Rate %
Term
Date of origination
23
Tell us about this loan/liability.If you don’t know the exact balance, it’s okay to give a rough estimate.
Type of liability
Who owns this?
Lender / Bank
Original Balance
Current Balance
Rate %
Term
Date of origination
24
Tell us about this loan/liability.If you don’t know the exact balance, it’s okay to give a rough estimate.
Type of liability
Who owns this?
Lender / Bank
Original Balance
Current Balance
Rate %
Term
Date of origination
25
Tell us about this loan/liability.If you don’t know the exact balance, it’s okay to give a rough estimate.
Type of liability
Who owns this?
Lender / Bank
Original Balance
Current Balance
Rate %
Term
Date of origination
26
What type of investment accounts do you have?You will have the opportunity to provide additional details after this page.
Please Select
Please Select
Pre-tax retirement (Trad. 401k, IRA, etc.)
Post-tax retirement (Roth 401k, IRA, etc.)
Non-retirement (Brokerage, Trust, etc.)
Education (529)
Cash (Checking, Savings, etc.)
CD
Annuity
Other (HSA, Stock options, Deferred comp.)
Account Type
Who owns this?
Please Select
Please Select
Pre-tax retirement (Trad. 401k, IRA, etc.)
Post-tax retirement (Roth 401k, IRA, etc.)
Non-retirement (Brokerage, Trust, etc.)
Education (529)
Cash (Checking, Savings, etc.)
CD
Annuity
Other (HSA, Stock options, Deferred comp.)
Account Type
Who owns this?
Please Select
Please Select
Pre-tax retirement (Trad. 401k, IRA, etc.)
Post-tax retirement (Roth 401k, IRA, etc.)
Non-retirement (Brokerage, Trust, etc.)
Education (529)
Cash (Checking, Savings, etc.)
CD
Annuity
Other (HSA, Stock options, Deferred comp.)
Account Type
Who owns this?
Please Select
Please Select
Pre-tax retirement (Trad. 401k, IRA, etc.)
Post-tax retirement (Roth 401k, IRA, etc.)
Non-retirement (Brokerage, Trust, etc.)
Education (529)
Cash (Checking, Savings, etc.)
CD
Annuity
Other (HSA, Stock options, Deferred comp.)
Account Type
Who owns this?
27
Tell us a little about these investmentsIf the owner has multiple accounts of this type (Example: 'Pre-Tax 401k/IRA', total the values and include under 'Total Value') and provide a breakdown of accounts under 'Additional Information'.
Account Type
Who owns this?
Firm (Fidelity, etc.)
Total Value
Your contribution (% or $)
Employer cont. (% or $)
Additional Information
28
Tell us a little about these investmentsIf the owner has multiple accounts of this type (Example: 'Pre-Tax 401k/IRA', total the values and include under 'Total Value') and provide a breakdown of accounts under 'Additional Information'.
Account Type
Who owns this?
Firm (Fidelity, etc.)
Total Value
Your contribution (% or $)
Employer cont. (% or $)
Additional Information
29
Tell us a little about these investmentsIf the owner has multiple accounts of this type (Example: 'Pre-Tax 401k/IRA', total the values and include under 'Total Value') and provide a breakdown of accounts under 'Additional Information'.
Account Type
Who Owns This?
Firm (Fidelity, etc.)
Total Value
Your contribution (% or $)
Employer cont. (% or $)
Additional Information
30
Tell us a little about these investmentsIf the owner has multiple accounts of this type (Example: 'Pre-Tax 401k/IRA', total the values and include under 'Total Value') and provide a breakdown of accounts under 'Additional Information'.
Account Type
Who owns this?
Firm (Fidelity, etc.)
Total Value
Your contribution (% or $)
Employer cont. (% or $)
Additional Information
31
What are your insurance policies?
Please Select
Please Select
Life
Disability
Long-Term Care
Other
Type of insurance
People insured by this.
Please Select
Please Select
Life
Disability
Long-Term Care
Other
Type of insurance
People insured by this.
Please Select
Please Select
Life
Disability
Long-Term Care
Other
Type of insurance
People insured by this.
Please Select
Please Select
Life
Disability
Long-Term Care
Other
Type of insurance
People insured by this.
32
Tell us about this insurance policy.If you don't have the exact benefit, it's okay to give a rough estimate.
Type of insurance
People insured by this policy.
Amount Benefit / Coverage
Company
33
Tell us about this insurance policy.If you don't have the exact benefit, it's okay to give a rough estimate.
Type of insurance
People insured by this policy.
Amount Benefit / Coverage
Company
34
Tell us about this insurance policy.If you don't have the exact benefit, it's okay to give a rough estimate.
Type of insurance
People insured by this policy.
Amount Benefit / Coverage
Company
35
Tell us about this insurance policy.If you don't have the exact benefit, it's okay to give a rough estimate.
Type of insurance
People insured by this policy.
Amount Benefit / Coverage
Company
36
What are your Business and/or Trust assets?
Please Select
Please Select
Business
Trust
Other
Type
Who owns this?
Please Select
Please Select
Business
Trust
Other
Type
Who owns this?
Please Select
Please Select
Business
Trust
Other
Type
Who owns this?
Please Select
Please Select
Business
Trust
Other
Type
Who owns this?
37
Tell us about this business / trust.Feel free to provide more details under 'Additional Information'.
Type
People associated with this business or trust.
Name
Value
Additional Information
38
Tell us about this business / trust.Feel free to provide more details under 'Additional Information'.
Type
People associated with this business or trust.
Name
Value
Additional Information
39
Tell us about this business / trust.Feel free to provide more details under 'Additional Information'.
Type
People associated with this business or trust.
Name
Value
Additional Information
40
Tell us about this business / trust.Feel free to provide more details under 'Additional Information'.
Type
People associated with this business or trust.
Name
Value
Additional Information
41
Doesn’t fit into a category listed? We still want to know about it.
Description
Who owns this?
Description
Who owns this?
Description
Who owns this?
Description
Who owns this?
42
Tell us a little more about this.Feel free to provide more details under 'Additional Information'.
Account description
People associated with this.
Value
Additional Information
43
Tell us a little more about this.Feel free to provide more details under 'Additional Information'.
Account description
People associated with this.
Value
Additional Information
44
Tell us a little more about this.Feel free to provide more details under 'Additional Information'.
Account description
People associated with this.
Value
Additional Information
45
Tell us a little more about this.Feel free to provide more details under 'Additional Information'.
Account description
People associated with this.
Value
Additional Information
46
File UploadsPlease upload the latest STATEMENTS for any of the accounts and policies you detailed on the previous pages.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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47
What else is on your mind?* This field is required.Select the topics that you'd like to cover with us.
Retirement Planning
Caring for a Parent
Saving for College
Providing a Legacy
Contributing to Charity
Saving for Major Purchases
Minimizing Taxes
Small Business Savings Strategy
Life Insurance/Protection Planning
Other
48
Anything else is on your mind?If there are any other topics you'd like to cover with us, feel free to note them below.
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