Prospective Client Consultation

Please provide the following information prior to our initial meeting so we can know how best to help you plan for the future.

Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Age

Marital Status

Employment Status

Income

Bank Savings

Non-Retirement Investments

Retirement plan at work (e.g., 401K)?

Current Value $

IRAs?

Current Value $

Annuities?

Current Value $

Retirement Goals? Age(s) & Amount to live on in retirement $ (annually):

Mortgage $

All other liabilities $

Will

Power of Attorney

Advanced Medical Directive

Trust (s)

Current Insurance (Check all that apply)

Future Insurance Interest (Check all that apply)

1.

2.

3.

Please upload all account statements / documents for review.

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Securities offered through Registered Representatives of Cambridge Investment Research, Inc., a broker-dealer member FINRA/SIPC. Advisory services through Cambridge Investment Research Advisors, Inc., a Registered Investment Adviser. Cambridge and Cornerstone Financial Services are not affiliated. This form collects data for informational purposes only and does not supersede any data or information reported on official Cambridge forms. This information is provided by you (the client). If any of the information is incorrect, you should notify your financial advisor. The information provided by you should be reviewed periodically and updated when either the information or your circumstances change.