New Client Prep
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthdate
*
-
Month
-
Day
Year
Birthdate
Cell Number
*
Preferred
Home Number
Email
*
example@example.com
What brought you to Leverage Planners?
*
Please Select
Live Social Security/Retirement class
Live Medicare class
Live Dinner Seminar
Live Theater Seminar
Live Web Class
Recorded Web Course
TV Ad
Radio Ad
Web Ad
Mailer, Postcard
Mailer, Envelope Letter
King 5 New Day Interview
Friend Referral
Web Search
Phone Offer
F3 Pax
Back
Next
Leverage Planners is a Safety First firm. We believe you should KEEP what you HAVE, before pursuing what you DO NOT have. Is that what you want?
*
Yes
No
What else were you hoping we might accomplish for you?
*
What do you want to start with?
*
Greenline (Tortoise)protected accounts
LTC Savings strategies
Tax reduction strategies
Tax-Free Roth alternatives for higher earners
Guaranteed Lifetime income strategies
Managed portfolios with safer bond alternatives
Fees & expense reductions
ALL of the ABOVE
Concerns about Retirement Income?
*
Yes
No
Describe these concerns
*
Concerns about your Nest Egg/Assets?
*
Yes
No
Describe these concerns
*
Concerns about Taxes, Fees, Expenses?
*
Yes
No
Describe these concerns
*
Back
Next
Concerns about health Safety Nets (such as Medicare, Obamacare, LTC)?
*
Yes
No
Describe these concerns
*
Concerns about legacy planning (wills, trusts, estate?)
*
Yes
No
Describe these concerns
*
Back
Next
Do you want us to fix a single account; or your whole financial profile?
*
Specific Account
Whole Profile
What kind of account?
*
Please Select
Bank account
Brokerage account
Insurance account
Account Balance
*
Employer plans? (401k, 403b, 457. Pension w/Lump Sum options)
*
Yes
No
Total 401k, 403b, 457 plans and Pension Lump Sum values
*
IRA accounts?
*
Yes
No
Total IRA value
*
Roth accounts?
*
Yes
No
Total Roth account value
*
Bank accounts? (Checking, Savings, CDs, Money Markets)
*
Yes
No
Total Bank account value
*
Taxable Brokerage accounts?
*
Yes
No
Total Taxable Brokerage values
*
IMPORTANT: Fill & Scroll Down to internal BLUE 'Continue' / 'Upload' buttons
Submit
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