Personal Financial Snapshot
Completing this form is the first step in the coaching process. This will help me prepare for your complimentary session. I do not sell product, so no hard sell. I look forward to helping you!
PERSONAL
INFORMATION
Name
First Name
Last Name
Cell Phone
-
Area Code
Phone Number
Email
example@example.com
Your age
Type of Work
Spouse Name
First Name
Last Name
Spouse's Phone
-
Area Code
Phone Number
Spouse's Email
example@example.com
Your spouse's age
Spouse's Work
Number of Children
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you been through FPU?
Yes
No
What is FPU?
Preferred method of contact for your session?
In Person
Phone
Video Conferencing
INCOME
What is your monthly net take-home pay?
Do you have irregular income?
Yes
No
Do you regularly budget?
Yes
No
Have you ever budgeted before?
Yes
No
HOUSING
Do you own or rent?
Rent
Own
Are you current on your payments?
Yes
No
What are your total monthly payments?
What is the balance of your home loan?
CONSUMER DEBT
Do you have any vehicle loans?
Yes
No
What are your total monthly payments?
What are the balances of your vehicle loans?
Do you have Credit Card debt?
Yes
No
What is the total Credit Card balance?
Do you have Student Loans?
Yes
No
What is your total Student Loan balance?
Do you owe Taxes?
Yes
No
What is your Tax balance due?
Do you have other debt?
Yes
No
What is your other debt balance due?
SAVINGS
Do you have an emergency fund?
Yes
No
How much is in the fund?
Are you currently investing for retirement?
Yes
No
What is your balance?
What are your current monthly contributions?
WHAT PRIMARY ISSUE SHOULD WE FOCUS ON DURING YOUR COACHING SESSION?
Budgeting
Real Estate
Dealing with Collectors
Wealth Building/Investing
Debt Elimination
Other
LIST THE TOP THREE CONCERNS/QUES-TIONS RELATED TO YOUR ABOVE SELECTION:
Submit
Should be Empty: