New Client Information
Please fill out the information below. A JMR Financial Group representative will contact you to further assist you.
Primary Contact
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email Address
*
Child 1:
Child 2:
Spouse Contact
First Name
Last Name
Mailing Address
Select if same as primary contact
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email Address
*
example@example.com
Child 3:
Child 4:
Tax Preparation/Planning Client
Please prepare to provide a copy of prior year's return to JMR representative.
In previous years I...
Hired a professional to prepare my returns
Prepared my own tax returns
Professional service used
Investment Clients
What is the nature of the counseling you are seeking? (check all that apply)
Financial Planning/Retirement Planning
Investment Management
Legacy Planning
Investment Accounts Owned & Estimated Value
Yes/No
Estimated Value ($)
401(k)
403(B)
529 Plan
HSA
Roth IRA
SIMPLE IRA
Traditional IRA
Coverdel Educational Savings Plan
What is keeping you up at night with your finances?
Enter the message as it's shown
*
Submit
Should be Empty: