Eclectic Client Questionnaire

Welcome to Eclectic Associates.

We're excited to begin working together and look forward to helping you achieve your financial goals. If you have any questions or need anything at all as we get started, please don't hesitate to reach out at 714.738.0220 or send us an email.

Getting Organized.

We understand that everyone has a different way of getting organized, so here are a few options to help us move forward.

🖥️ Complete this Electronic Questionnaire
- Fill out online at your own pace
- Save your progress and return anytime
- Upload PDF documents to us securely
📄 Complete a Paper Questionnaire
- Call the office at 714.738.0220 and we will mail you a paper copy along with a large return envelope. (or if you live nearby, feel free to dropby the office with your documents)
📅 Schedule a “Get Organized” Appointment
- Gather all of your important documents, login credentials, and your cell phone, and you can work through the new client questionnaire here in the office or online with our associate advisor(s).
- Schedule Online Appointment
- Schedule In-Person Appointment

Helpful Hints.

The questions are designed to help us get to know your current financial situation. Here are a few helpful tips as you begin:

1.) Please respond with your initial thoughts as there are no right or wrong answers.

2.) If a question doesn't apply to you or isn't clear, feel free to skip it.

3.) Please share as much (or as little) information as you are comfortable. Keep in mind that the more information provided, the more detailed our initial plan can be.

4.) Many of the questions request that you upload your most recent PDF statements. These PDF statements are typically located in the "Statements/ Documents" area of their respective websites if you have online access.

5.) If you do not have online access, you can either scan your full paper statements into your computer if you have a scanner, or feel free to bring them to the office and we'd be glad to make copies here.

6.) If you have already provided us with a statement for a particular question, simply enter "already provided" in the comments box.

7.) If you need additional space to write in any of the comment boxes, you can click the arrow icon in the upper right of each box to expand to full screen mode.

Household Information.

If you have a spouse/partner that will also be working with us, we typically only need one questionnaire per household with information for both individuals.

If it is your preference to maintain separate plans for your finances, please let us know in the comments box and feel free to submit separate questionnaires.
Primary Contact
Name*

First NameLast Name
Email Address*
example@example.com
Mobile Phone Number*
Please enter a valid phone number.
Secondary Contact (if applicable)
Name

First NameLast Name
Email Address
example@example.com
Mobile Phone Number
Please enter a valid phone number.
Comments

Assets & Liabilities.

This section will focus on gathering information related to your current assets and liabilities. Please upload recent PDF statements where available.

If a PDF statement is not available, please provide a brief description and approximate value in the "comments" box. (i.e. BofA Checking - $5k)
Cash Accounts

Checking, Savings, CDs, Money Markets, Savings Bonds, etc.
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Comments
Investment Accounts

Brokerage, IRA, Roth IRA, 401k, 403b, 457, Stocks, Bonds, etc.
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Comments
Real Estate

Primary Residence, Vacation, Rental Property, Timeshare, etc.

Attach property tax statement if available.

(i.e. Fullerton Primary Residence - $1M)
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Comments
Custodial Accounts

529 College Savings Plans, UTMAs, UGMAs, Custodial IRAs, etc.
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Comments
Other Assets

Please provide statements or descriptions of any assets not listed above. Examples include closely held businesses, charitable accounts, cash value life insurance, collectibles, automobiles, RVs, boats, etc. Please also provide approximate values.
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Comments
Liabilities

Mortgages, Lines of Credit, Auto Loans, Credit Cards, Personal Loans, Student Loans, etc. Where statements unavailable, please provide description, loan balance, and interest rate details.
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Comments
Additional Comments

Please provide any additional information that you would like to share with us regarding your assets and liabilities.
Comments

Income.

This section will focus on gathering information related to your current income and expected future income.
Tax Return

Please provide us with your most recently filed income tax return.

If you do not have a PDF file available, please provide your tax preparer's contact information below and with your permission we will reach out directly.

Simply type "ask preparer" in the comments section.
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Comments
Tax Preparer Name
Email
Phone Number
Please enter a valid phone number.
Employment Income

If you are currently employed, please provide us with your prior year-end paystub and your most recent paystub. If this doesn't apply to you, please enter "n/a".
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Comments
Social Security

Please provide us with a current Social Security benefit statement which can be obtained at www.ssa.gov/myaccount.

If you have already elected to begin Social Security benefits, you can skip this question as we will look to your tax return for this information.

If this doesn't apply to you, please enter "n/a".
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Comments
Pensions

If you are eligible for any employer pension benefits, please provide us with a recent summary. Often this information is difficult to locate online.

We are looking for an estimate of what your pension benefit will be at retirement age to factor into our retirement projections for you.

Additionally, if you are aware of any "survivorship" option associated with your benefit, please include this information in the comments section. (i.e. 50% Joint and Survivor) If this doesn't apply to you, please enter "n/a".
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Comments
Other Income

Please provide information on any other income you have or expect to receive during retirement. Examples include partnership income, rental income, royalties, etc. If this doesn't apply to you, please enter "n/a".
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Comments
Do you expect your income to change significantly in the near future? (Please explain)
Which of the following best describes your attitude towards your income needs?

My present income is adequate for my needsI need more current incomeI can forego current income to improve my future incomeI don't know
Approximately how much are you saving annually towards retirement from all sources? (Skip this question if already retired.)
At what age do you expect to retire and what will influence this decision? (Skip this question if already retired.)
Please provide us with a rough estimate of your current average monthly expenses? (Okay to enter "I don't know")
We typically use age 95 as a default life expectancy for retirement income projections. Let us know if you think we should adjust this age up/down based on your health and family history.

Estate Planning.

If you have worked on estate planning before, please provide us with your trust, will(s), power of attorney(s), and advanced healthcare directives below if you have PDF files available.

We can also request a secure electronic copy from your estate attorney directly via email if you enter "ask attorney" in the comments box and provide us with contact information.

If it would be simpler for you to drop a binder by the office, we'd be happy to scan it for you here as well. If you have yet to work on any estate planning, simply enter "no documents".
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Comments
Attorney Name
Email
Phone Number
Please enter a valid phone number.
Would you like to make charitable donations either now or in your estate plans? Let us know if there are any organizations that are especially important to you.
If you have children, please provide us with their names and birthdates. If you have any grandchildren or other individuals that you would like to include in your planning, please provide their information as well and any other information you'd like to share that relates to family.
If you would like to assist with educational funding or any other savings for any of the individuals listed in the previous question, please describe below.

Insurance.

This section will focus on gathering information related to your current insurance coverage in various areas.

We can also request a secure electronic copy from your insurance agent(s) directly via email if you enter "ask agent" in the comments box and provide us with contact information.

If it would be simpler for you to drop the original policies by the office, we'd be happy to scan them for you here as well. If you do not have a policy in a particular area, simply enter "no policy".
Life Insurance Policies
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Comments
Agent Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Property/Casualty/Umbrella Policies
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Comments
Agent Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Disability Insurance Policies
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Comments
Agent Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Long Term Care Insurance Policies
File Upload

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Comments
Agent Name
Email
example@example.com
Phone Number
Please enter a valid phone number.

Move Money Setup.

As part of our account setup process, we usually find it helpful to establish an electronic ACH link between your investment accounts and a checking account of your choice to facilitate secure transfer requests in the future.

Please upload a PDF statement from the bank account of your choice reflecting the account registration and full account number. Alternatively, you may also upload an image of a voided check or deposit slip from your preferred account.

Feel free to skip this step if not comfortable or if you would prefer to setup later.
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Comments

Credentials.

For active employer plans only. (optional)

If you are currently employed and actively participating in a workplace retirement plan—such as a 401(k), 403(b), or 457—we can help you evaluate the investment options available within your plan and integrate these accounts into your overall financial plan.

In most cases, it’s most beneficial to keep these accounts with your current provider while you remain employed to take advantage of possible matching and/or profit sharing contributions from your employer.

If you're comfortable sharing login credentials, we can securely access your account to research available investment choices and attempt to establish a data feed into our portfolio management system. Please note that we may need your assistance with two-factor authentication (2FA) during the initial setup.

If you’d like our help this, please provide the relevant details in the spreadsheet below.
Credential Information

Additional Comments.
Is there anything else you would like to tell us about your situation?*
Should be Empty: