Retirement Planning Profile

Retirement Planning Profile

This personal financial summary is designed to help you take inventory and assign realistic values to your personal assets and liabilities. The information you provide in this questionnaire will assist us in making suitable recommendations for your particular situation, and will allow us to run retirement projections in our planning software. Please complete and return this profile at least 2 business days prior to your planning appointment. Should you have any questions or concerns, please feel free to give us a call.
Name*

First NameLast Name
Employer and Occupation*
Birth Date*

MonthDayYear
Email*
example@example.com
Mobile Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dependent's Name(s) and Date(s) of Birth
Spouse's Name

First NameLast Name
Spouse's Employer and Occupation
Spouse's Birth Date

MonthDayYear
Spouse's Mobile Number

Area CodePhone Number
Spouse's primary email

Personal Assets*

	Owner's Name(s)	Current Value
Personal Residence
Vacation/2nd Residence
Vehicle 1
Vehicle 2
Other personal assets (e.g. Money Markets, Cash, Real Estate)

Investment Assets*

	Account Owner's Name(s)	Current Value
Retirement Plan 1 (e.g. 401k, 403b, TIAA, TSP)
Retirement Plan 2 (e.g. 401k, 403b, TIAA, TSP)
IRA 1
IRA 2
Roth 1
Roth 2
Non-Retirement Investment Accounts
529 Plans

What is your current investment objective?*

Preservation of assetsIncome with moderate growthGrowth with incomeGrowthAggressive Growth

Liabilities*

	Original Balance	Current Balance	Loan Term (years)	Interest %	Monthly Payment
Mortgage 1
Mortgage 2 (or HELOC)
Student Loan 1
Student Loan 2
Sum of Credit Card Debit
Sum of Vehicle Loans
Other Liabilities (IRS debt, medical bills, personal loans)

Current and Future Income*

Savings and Contributions*

	Contribution % or Annual Amount	Employer Match
Retirement Plan 1
Retirement Plan 2
IRA/Roth 1
IRA/Roth 2
Non-retirement Savings (e.g. investment accounts, savings accounts, etc.)
Other

Does your family follow a monthly written budget?*

YesNo
What does your family spend per month to meet your necessary living expenses? (do not include mortgage or debt payments if already listed above) *
Do you keep an emergency fund in a savings or money market account?*

YesNo
If so, how much?
Retirement Goals
Desired retirement monthly income (in today's dollars)*
Planned retirement date, or date retired*
Spouse's planned retirement date, or date retired*
Do you currently own Long Term Care &/or Nursing Home Insurance?*

YesNo
If yes, what is the insurance company?
Do you have life insurance?*

YesNo

Life Insurance Policy Information

Please list your top 3 objectives for retirement / financial goals/ concerns:*
What is your retirement investment objective?*

Preservation of assetsIncome with moderate growthGrowth with incomeGrowthAggressive Growth
How did you hear about us?*
Documents to Include:
- Your latest statements for any existing investment accounts you would like to discuss
- Your most recent Social Security statement(s)
- Your driver's license(s)
- Your monthly budget (if you have one)
- The social security numbers and birthdates for your beneficiaries (optional) Should you want to set up banking instructions for making deposits or withdrawals, please provide a voided check
Click here to upload any documents you would like an advisor to review

Browse Files

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If you have not yet scheduled an appointment, someone from our office will contact you, upon receipt of your profile.

We offer appointments from 10am – 4 pm, Mon – Thur.

and 10am - 2pm on Fridays
Appointment preference:

MondayTuesdayWednesdayThursdayFridayAny Day
Appointment Time of Day Preference:

Earliest ApptMorningAfternoonLatest ApptAny time
What is the best number to reach you?*
The foregoing information fully reflects an accurate picture of my financial position at this time

*Signature serves as an electronic confirmation of information provided
Signature
Today's Date*
Should be Empty: