Full Financial Plan Client Information
Client #1 Important Basic Information
Name
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First Name
Last Name
What is the most important thing for you/your family to accomplish in the next 5 years?
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E-mail
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Age
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Desired retirement age
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are You Retired?
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Yes
No
Employer
Job Title
Co-Client Basic Information, if applicable
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
Desired retirement age
Address (leave blank if same as above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are You Retired?
Yes
No
Employer
Job Title
Family Information
Marital Status
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Single
Married
Divorced
Widow/Widower
Separated
Life Partner
Prefer Not To Answer
Dependents, with ages
Concerns, if any.
Financial details
If you are looking to invest with our firm, how much?
Please Select
Under $250,000
$250,000 to $499,999
$500,000 to $749,999
$750,000 to $999,999
$1 million to $2 million
$2 million to $3 million
$3 million to $5 million
$5 million and up
Balances for checking, savings, and CDs.
List all sources of income, including W2, self employment, rental, royalties, etc.
List details for all life insurance policies. Example: 20 year term with $1 million death benefit on "Jim," in year 10 of term.
Please list all debt and terms. Example: 30-year mortgage with 20 years left, $2,000 monthly payment. Include credit cards, vehicles, student loans, personal loans.
Please list real estate assets (primary residence first, if applicable), and approximate value.
List other marketable assets you own and their estimated value (if you plan to sell at some point; example is a classic car collection).
For business owners only. If you own a business and plan to use the sale to fund your lifestyle in retirement, please give approximate value of business, including any property that would be included. Also list outstanding business debts.
Other important information
I have (check if true):
Wills for both spouses (if relevant)
Buy sell agreement (if business owner)
Revokable Trust
Financial Power of Attorney
Irrevokable Trust
Health Care Proxy /Medical PoA
HIPAA release
Home, auto, renters insurance
Umbrella insurance
Health Insurance for all family members
Disability insurance for all employed adults
Loved ones who do or will rely on my care, financial or otherwise.
Other
Miscellaneous notes for your financial planner.
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