Financial Planning Questionnaire

1
Client A Full Name* This field is required.
First Name
Last Name
2
Client B Full Name
First Name
Last Name
3
Client A Email Address* This field is required.
example@example.com
4
Client B Email Address
example@example.com
5
Client A Phone Number* This field is required.
Please enter a valid phone number.
6
Client B Phone Number
Please enter a valid phone number.
7
Client A Date of Birth* This field is required.
8
Client B Date of Birth
9
Current 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
10
What are your primary financial goals?* This field is required.
Retirement planning
Saving for education
Buying a home
Debt reduction
Building an emergency fund
Other
11
Client A: What is your current occupation?
12
Client B: What is your current occupation?
13
Client A: Annual Gross Income (USD)* This field is required.
14
Client B: Annual Gross Income (USD)
15
Monthly Rent/Mortgage Payment* This field is required.
16
Estimated Monthly Expenses (USD) (Food, Entertainment, Insurance, etc)* This field is required.
17
Please list any major assets and estimated values (e.g., home(s), businesses, trailers, etc)* This field is required.
18
Please list any retirement assets and estimated balances (e.g., 401ks, Roth IRAs, IRAs, SEP IRAs, etc)* This field is required.
19
Please list any non-retirement assets and estimated balances (e.g., checking/savings accounts, brokerage accounts, etc)* This field is required.
20
Please list any major liabilities and their balances (e.g., mortgage, loans, debts)* This field is required.
21
How would you describe your risk tolerance?* This field is required.
Conservative
Moderate
Aggressive
Not sure
22
What age do you think you can retire at?* This field is required.
45-50
51-59
60-65
60+
23
Do you have any of the following in place already?* This field is required.
Will(s)
Power of Attorney(s)
Trust
All
Health Directive(s)
None
24
Do you have any of the following?* This field is required.
Life Insurance
Pension(s)
Annuities
Long-term Care Insurance
None
25
How quickly would you like to begin working with us?* This field is required.
As soon as possible
Within 3-6 months
I need more time to decide
I am not sure
26
What are your biggest fears/concerns when it comes to both investing and your overall financial future (if any):
27
Is there anything else you would like us to know about your financial situation or goals?
28
Please upload any statements or additional information here:Or, you can use this link to upload documents to us as well: Click Here To Upload Files
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
Should be Empty: