Discovery Questionnaire

Discovery Questionnaire

We look forward to hearing your story! Please take a few minutes to complete this form prior to our first conversation. This information will allow us to make better use of our time together. Once completed, you will be directed to our scheduling page. If you have any questions, please email danyell@wheelsupwealthinc.com.
Household Information
Client First Name*
Client Last Name*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*

Area CodePhone Number
Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship Status

Single, Never MarriedSingle, DivorcedSingle, WidowedDomestic PartnershipMarriedMarried, SeparatedOther
If divorced, was length of marriage over ten years?

YesNo
Spouse/Partner's First Name
Spouse/Partner's Last Name
Spouse/Partner's Date of Birth

MonthDayYear
Date
Spouse/Partner's Email Address
example@example.com
Spouse/Partner's Primary Phone

Area CodePhone Number
Client: Are you a U.S. Citizen or Permanent Resident?*

YesNoOther
Spouse/Partner: U.S. Citizen or Permanent Resident?

YesNoOther
Number of Dependents (children or parents, someone you provide more than 50% support to annually)*

0123+
Key Family Members (including kids' names and birthdays)
Are you retired?*

YesNoOther
If no, desired retirement date*

MonthDayYear
Date
Income Sources
Client: How do you earn your income? (check all that apply)*

W2-Earner1099 EarnerBusiness Owner (Salary, Owner Draws, Profit Distributions)Other
Client's Employer Name*
Position*
Years Employed*
Annual Base Salary ($)*
Annual Commissions, Tips, Bonuses (Other Variable Pay), Actual or Anticipated ($)*
Spouse/Partner: How do you earn your income?

W2-Earner1099 EarnerBusiness Owner (Salary, Owner Draws, Profit Distributions)Other
Spouse/Partner's Employer Name
Spouse/Partner's Position
Spouse/Partner's Years Employed
Spouse/Partner's Annual Base Salary ($)
Spouse/Partner's Annual Commissions, Tips, Bonuses (Other Variable Pay), Actual or Anticipated
Assets
Cash Accounts (approx. value): Savings, Checking Accounts, CDs*
Retirement Accounts (approx. value): 401(k)s, 403(b)s, 457s, IRAs, Pensions*
Investment Accounts (approx. value): Any funds invested outside of your retirement plans*
Primary Residence (approx. value), if owned*
Other Assets (Please briefly describe and state approx. value)
Liabilities (Debt)
Student Loans Balance*
Student Loans Interest Rate(s)*
Credit Card Balance (if not paid off each month)*
Credit Card Interest Rates (if not paid off each month) *
Mortgage(s) and/or Home Equity Loan(s) Balance*
Mortgage(s) and/or Home Equity Loan(s) Interest Rate(s)*
Vehicle Loan(s) Balance*
Vehicle Loan(s) Interest Rate(s)*
Total Monthly Expenses (estimated amount)*
Life Transitions and Goals
Have you or your significant other recently experienced or are you anticipating any of the following? (check all that apply)*

New JobMarriage/EngagementInheritanceNew ChildJob Loss/Lay-offDivorce/SeparationRecent loss of a loved oneNoneOther
Do you have any of the following documents already prepared? (check all that apply)*

WillDurable Power of AttorneyHealth DirectivesTrustI need help getting my documents done
What are your most pressing financial concerns?*
What are your most pressing non-financial concerns?*
How long have you been considering working with, or searching for, a financial planner? *
If you have worked with a financial planner before, what did you enjoy about that experience? What was unsatisfactory? (If you haven't worked with a financial planner, please write N/A.)*
Describe the kind of service that an ideal financial planner would provide for you. What is the key to making this relationship successful for you?*
Do you work, or have you worked, with other helping professionals as an investment in yourself (i.e., a personal trainer, nutritionist, career coach)? If yes, how would you describe the value you received from working with them?*
Insurance
Do you have long-term disability insurance?*

I doBoth my partner and I doJust my partner doesNo
Do you have a life insurance policy?*

I doBoth my partner and I doJust my partner doesNo
Do you have a long term care insurance policy?*

I doBoth my partner and I doJust my partner doesNo
Do you need help determining what type of insurance to own?*

YesNo
Risk Assessment
If you own a home, do you have more than 30% equity?*

YesNoI don't own a home
Which of the following best describes your current employment?*

Full-timePart-timeRetiredUnemployed
From an original investment of $15,000, your portfolio now worth $25,000 suddenly declines $3,750 or 15%, which best describes your response?*

I would look for a way to invest moreI would take no actionI would be somewhat concernedI would avoid any investment that could suddenly lose 15% of its value (Choose last answer for next question)
Your portfolio, from previous question, now worth $21,250 suddenly declines another $2,125 or 10%, which best describes your response?*

I would look for a way to invest moreI would take no actionI would be somewhat concernedI would probably sellI would have never made this investment (Chose last answer for previous question)
Have you invested in Equities (also known as stocks)?*

YesNo
Have you invested in Fixed Income (also known as bonds)?*

YesNo
Have you invested in Mutual Funds?*

YesNo
Have you invested in Options, Futures or Derivatives?*

YesNo
How would you describe your level of investment knowledge?*

NoneLimitedGoodExtensive
How much investment experience do you have?*

NoneLimited (1-3 years)Good (4-5 years)Extensive (5+ years)
Do you have current income needs from your investments?*

YesNo
When will you begin to use your invested funds?*

Less than 2 years2-5 years6-10 years10+ years
Our Offering

Please review our services and fees prior to our meeting.

Comprehensive Wealth Management: The core of what we do, comprehensive wealth management includes full-service ongoing implementation, support and guidance from CFP® professionals throughout the year, investment management, and formal check-in meetings at specified intervals during the year. This service is billed as a percentage of assets under our management per the fee schedule below, with a minimum annual fee of $10,000. Clients who benefit most from this service value a trusted coach who will be there with them every step of the way to plan, make adjustments, and hold them accountable through life's changes.

Account Value	Annual Advisory Fee
$0 - $1,000,000	$10,000
$1,000,001 - $2,000,000	0.75%
$2,000,001 - $5,000,000	0.50%
$5,000,001 and Above	0.40%

I have reviewed Wheels Up Wealth's services and associated fees.*

Yes
Which service model are you interested in pursuing?

Comprehensive Wealth ManagementProject-Based Financial Planning
How did you hear about Wheels Up Wealth? If referred, please let us know who to thank.

Friends or FamilyReferred by Trusted Professional (CPA, Attorney, etc.)Benicia MagazineFinancial Planning Association (FPA)CFP BoardEventDimensional Fund Advisors Find an AdvisorSocial MediaType option 9Other
How did you hear about Wheels Up Wealth? If referred, please let us know who to thank.

Financial Planning Association (FPA)CFP BoardDimensional Fund Advisors Find an AdvisorSocial MediaBenicia MagazineEventReferred by Friends or FamilyReferred by Trusted Professional (CPA, Attorney, etc.)Other
Would you like to stay up to date with helpful financial tips and economic news?

Yes, please add me to your mailing list!No thanks, I'm not interested.
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Discovery Questionnaire

Household Information

Income Sources

Assets

Liabilities (Debt)

Life Transitions and Goals

Insurance

Risk Assessment

Our Offering