CLIENT FINANCIAL SNAPSHOT
Your Name
First Name
Last Name
Spouse Name
First Name
Last Name
Your Email
example@example.com
Spouse Email
example@example.com
Your Cell Phone Number
-
Area Code
Phone Number
Spouse Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you been through Financial Peace University?
Yes
No
Back
Next
How important are healthy money habits to you?
Very Important
Important
Slightly Important
Not At All Important
Do you currently use a monthly budget?
Yes
No
Are you familiar with a zero based budget?
Yes
No
Is it important for you to "Keep up with the Joneses"?
Yes
No
Do you compare yourself and your lifestyle to others on social media?
Yes
No
Do you use credit cards?
Yes
No
If married, do you use a joint checking and joint savings account?
Yes
No
N/A
If married, do you discuss major purchases?
Yes
No
N/A
Are you a cosigner on any loans?
Yes
No
N/A
Back
Next
Do you have a minimum of $1,000.00 in a savings account?
Yes
No
Do you have any debt?
Yes
No
If you have debt, how much?
Do you contribute to a retirement plan?
Yes
No
If you have dependents, are you saving for their college?
Yes
No
Do you donate to charitable organizations?
Yes
No
How important is it to you to donate to charitable organizations?
Very Important
Important
Slightly Important
Not At All Important
List your financial goals:
List any questions that you would like to discuss:
Submit
Print Form
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm