Financial Questionnaire

1
Marital Status* This field is required.
Single
Married
2
Legal Name* This field is required.
First Name
Middle Name
Last Name
3
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / 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
4
Email* This field is required.
example@example.com
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Estimated Net Worth* This field is required.
< $250,000
$1,000,000 - $5,000,000
$250,000 - $1,000,000
> $5,000,000
7
Estimated Annual Gross Income* This field is required.
< $100,000
$250,000 - $1,000,000
$100,000 - $250,000
> $1,000,000
8
Spouse's Legal Name* This field is required.
First Name
Middle Name
Last Name
9
Spouse's Email* This field is required.
example@example.com
10
Spouse's Phone Number* This field is required.
Please enter a valid phone number.
11
Estimated Household Liquid Net Worth* This field is required.
< $250,000
$1,000,000 - $5,000,000
$250,000 - $1,000,000
> $5,000,000
12
Estimated Household Annual Gross Income* This field is required.
< $100,000
$250,000 - $1,000,000
$100,000 - $250,000
> $1,000,000
13
How did you hear about us?* This field is required.
Google/Search Engine
Facebook
YouTube
Blog
Referral
14
Who referred you?* This field is required.
15
Paint a picture of what your ideal retirement life looks like.* This field is required.How are you spending your time? Who are you spending it with? What emotions are you feeling? Are you traveling? What hobbies are you enjoying? What organizations are you volunteering for?
16
What are three things you feel are most important to accomplish in order to give a level of comfort you desire in retirement?* This field is required.
17
What emotions come up when you think about your current financial situation, and what do you think is driving those feelings?* This field is required.
18
What actions have you taken to ensure a successful retirement? What's been your experience with financial planning?* This field is required.
19
What's missing or holding you back right now in your financial life?* This field is required.Select all that resonate with you.
Not Enough Time (to understand and manage finances)
Lack Of Financial Clarity (not knowing exactly what I have or need)
Limited Financial Knowledge (uncertainty about investing, taxes, retirement)
No Clear Retirement Plan (unsure how and when I can retire comfortably)
Insufficient Liquidity (difficulty accessing cash without penalties)
Not Enough Saved In An Emergency Fund (fearful of unexpected expenses)
Lack Of Trusted Guidance (not having someone I trust to help with decisions)
Anxiety About Market Volatility (worried about protecting my assets)
Unclear Tax Strategies (concerned I'm paying too much tax)
No Reliable Retirement Income Plan (unsure how to create steady cash flow)
Debt Concerns (carrying debts that impact retirement confidence)
Difficulty Transitioning From Saving To Spending (not sure how to comfortably start using my savings)
Unsure About Insurance Coverage (worried I don't have the right protection in place)
Lack Of Intentionality With Monthly Spending (unclear where my money goes month-to-month)
Missing Or Outdated Legal Documents (no clear wills, powers of attorney, or estate plan in place)
20
When thinking about retirement planning, which concerns or uncertainties resonate most with you?* This field is required.Select all that apply.
I'm not sure if I have enough saved to retire comfortably.
I fear outliving my retirement savings.
I don't have a clear retirement plan - it's causing anxiety.
I'm unsure how to maximize my Social Security benefits.
I worry unexpected healthcare costs will drain my savings.
I want a clear roadmap to confidently transition into retirement.
I need clarity on whether I'm on track to meet my retirement goals.
21
When it comes to managing your investments, which concerns resonate most with you?* This field is required.Select all that apply.
I'm not confident my investments align with my retirement goals.
Market volatility makes me anxious - I worry about protecting my assets.
I need someone to help me better understand my investments.
I feel my investments aren't growing enough to fund my retirement.
I'm unsure if I have the right investment strategy in place.
I worry my investments won't outperform rising costs and inflation.
22
When it comes to managing your cash flow in retirement, which concerns resonate most with you?* This field is required.Select all that apply.
I'm concerned about maintaining my current lifestyle in retirement.
I'm uncertain how to turn my savings into regular retirement income.
I need help creating a reliable monthly income stream.
I'm worried about managing expenses on a fixed income.
I fear unexpected costs might disrupt my financial stability.
I want a clear spending strategy to ensure my money lasts.
I feel I have too much debt going into retirement and worry about the impact on my financial security.
23
When it comes to estate planning, which concerns or uncertainties resonate most with you?* This field is required.Select all that apply.
I don't have clear or up-to-date legal documents (wills, trusts, power of attorney).
I worry about leaving my family with confusion or financial burdens after I'm gone.
I'm uncertain if my estate plan aligns with my current wishes.
I'm concerned about the tax implications my family might face when inheriting assets.
I want to ensure my wealth transfers smoothly to the next generation.
I haven't clearly communicated my estate wishes to my loved ones.
I want guidance to organize my estate plan so nothing important is overlooked.
24
When it comes to tax planning, what concerns or needs resonate most with you?* This field is required.Select all that apply.
I'm worried I'm paying more taxes than necessary.
I'm unsure how taxes will affect my retirement income.
I need strategies to minimize taxes on my investments.
I'm concerned about tax consequences when withdrawing from retirement accounts.
I want to optimize my tax situation but don't know how.
25
When thinking about factors outside of your control, which concerns resonate most with you?* This field is required.Select all that apply.
Government of policy changes impacting my financial plans.
Family members needing financial assistance.
Becoming a target of scams or financial fraud.
Current or potential health issues creating unexpected expenses.
26
When working with our team to develop a financial plan, what do you most hope to achieve or gain from the process?* This field is required.Select all that resonate with you.
Holistic Financial Clarity (seeing entire financial picture clearly, with everything working together)
Personalized Guidance (advice specifically designed around your unique goals, circumstances, and priorities)
Adaptive Financial Roadmap (a flexible plan that adjusts with your changing life and evolving needs)
Proactive Wealth Protection (strategies put in place ahead of time to protect your assets and financial security)
Tax Minimization Strategies (integrated planning designed to reduce your tax burden, now and in the future)
Reliable Lifetime Income (detailed planning to ensure consistent and reliable income throughout retirement)
Estate And Legacy Planning (comprehensive plans to smoothly pass on wealth, minimize burdens, and maximize your legacy)
Ongoing Monitoring And Adjustments (regular reviews to proactively adjust your financial plan as life and circumstances change)
Other
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