Wealth Assessment

OPENING QUESTIONS
1. How did you hear about us and what do you know about our company?
2. What are you currently doing in preparation for your financial future?
3. What do you like most about what you are doing?
4. What don’t you like about your current financial position?
5. What would you like to see enhanced or improved?
6. What has been your past experience with preparing for your financial future?
7. What would you “ideally” like to accomplish with your financial strategy?
8. Tell me about your decision-making process.
9. What keeps you up at night?
10. Complete this sentence: “When it comes to my money and financial situation, the one thing I REALLY care about is .

LIFE INSURANCE

VIII. QUALIFIED ACCOUNTS
(401k), 403b, 457, Defined Benefit Plan, IRA, Roth IRA, SEP, Stocks, Options etc.)

QUALIFIED ACCOUNTS

	Client/Spouse	Institution	Type	Current Balance $	Your Annual Contribution $	%	Employer Annual Contribution$	%	Average Return	Repositionable	In-force Distribution
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IX. NON-QUALIFIED ACCOUNTS
(CD’s, Annuities, Mutual Funds, Money Markets, Stocks, Bonds, Listed Securities, etc.)

NON-QUALIFIED ACCOUNTS

CURRENT LIABILITIES

	Liability	Remaining Balance $	Monthly Payments Regular $	Monthly	Remaining Payments $	Interest %	Payoff and Reposition Monthly Payments?
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FUTURE EXPENSES IN THE NEXT 1-5 YEARS

XII. ADDITIONAL COMMENTS
ACCOUNTANT INFORMATION
Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax
LAWYER INFORMATION
Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax
What are the most important financial goals that you would like to accomplish? Please prioritize.
If you were going to change anything in your financial situation, what would it be?
If we were meeting here three years from today, what has to have happened for you to feel happy with your progress?
We have been able to grow substantially through the power of referrals. If we fulfill your expectations, what method of communication may we talk to you about obtaining referrals that is most comfortable for you? (Leave blank if you are not comfortable with discussing referrals)
Will there be any other advisors involved in the decision making process? (Accountants, Lawyers, Brokers, Relatives, Friends, etc.)
This assessment is confidential and intended solely for creating a comprehensive, wealth-building strategy
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Your Personal Wealth Assessment