Glen Eagle Financial Budget
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Number
*
-
Area Code
Phone Number
Home Number
*
-
Area Code
Phone Number
Are you a current client or a prospective client?
*
Current Client
Prospective Client
What is your advisor's name?
The Michel Team
Peter (Tom) Agnew
John Blackmon
Bob Eng
Jane Gore
Jay Lipchutz
Kathy Lo Bue
Charles Naddaff
Stevan Radanovic
Marylou Wellbrock-Reeves
Robert Zawisha
Relationship Status
*
Single
Married
Divorced
Widowed
Do you have children?
Yes
No
Do you pay child support? if so, how much?
What is your monthly income?
*
What is your estimated variable income? (such as commissions and bonuses)
*
What is your spouse's annual income? (if applicable)
What is your social security number?
What is your spouses social security number?
How much in interest/dividend do you receive?
(if any) How much do you collect in annual bonuses?
(if any) How much do you collect in other gifts, RE income, etc. ?
How much do you pay in mortgage and/or rent?
*
How much do you pay in home/rent insurance?
*
How much do you pay in Real Estate Taxes?
How much do you pay in utilities?
*
How much annually do you pay in home repairs and/or improvement?
*
How much do you pay for home security?
How much do you spend on groceries monthly?
*
How much do you spend on child care monthly?
How much do you spend on dry cleaning monthly?
How much do you spend on dining out monthly?
How much do you spend on house cleaning services monthly?
How much do you spend monthly on cell phone payments?
*
Hoe much do you spend on transportation monthly? (gas, train, etc.)
*
How much do spend on auto insurance?
Do you have any other expenses?
Yes
No
Approximately how much do you spend on the above extra expenses?
How much do you spend on Cable TV monthly?
How much do you spend on video rentals or online video subscriptions monthly?
How much do you spend on movies/shows monthly?
How much do you spend on concerts or clubs monthly?
How much do you spend on plane fare annually?
How much do you spend on hotels/accommodations annually?
How much do you spend on food while on vacation annually?
How much do you spend on souvenirs annually?
How much do you spend on rental cars annually?
How much do you spend on Magazine/Newspaper subscriptions?
How much do you spend on wifi?
*
How much do you donate to charity yearly?
how much do you donate to religious organizations yearly?
How much do you spend monthly on clothing?
*
how much do you spend monthly on gifts?
*
How much do you spend monthly at the hair salon?
How much do you spend on books/music monthly?
How much money do you have in your long term savings?
*
How much is in your retirement fund? (401K, Roth IRA)
*
On average how much are your monthly credit card payments? (Excluding amounts already covered by previous questions)
*
How much do you pay in income tax?
Do you have any other financial obligations/payment?
*
Yes
No
if answered yes to the above question, how much do you normally spend monthly?
Submit
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