New Client Fact Finder

Real Estate

Investment Information

Investment Information

Life Insurance

Disability Insurance

Long Term Care

Objectives
Mark any you currently have*

CheckingSavingsMoney MarketCD'sSavings BondsFixed Annuities401(k)Roth 401(k)IRARoth IRA403b/TSAProfit Sharing PlanDeferred CompGov't BondsMunicipal BondsCorporate BondsStocksVariable AnnuitiesIndexed AnnuitiesMutual FundsBusinessesHomeReal EstateTax SheltersOther

Savings

	Yes	No	N/A	Want Reviewed
I believe I should have an emergency fund of at least 50% of my income in safe, secure vehicles
I am satisfied with my present rate of savings
I generally reinvest my interest that I earn in my savings account or money markets
I understand that compound interest may lead to compound taxation
I understand how the FDIC protects my money
I understand and utilize tax-deferred savings vehicles
I understand and utilize tax-free savings vehicles such as 529 plans and Roth IRAs
I maximize my 401(k) and/or retirement plan contributions
I realize that most tax-deductible retirement plans are fully taxable upon distribution
I would like help in reviewing my savings strategies

Debt

	Yes	No	N/A	Want Reviewed
I believe that prepaying or paying off my mortgage is prudent
I believe there are potential benefits to restructuring my outstanding debt
I am able to completely pay off my credit card each month
I understand how intra-family loans may be a valuable option to consider
I have a home equity line of credit
I would like help in reviewing my current debt

Protection

	Yes	No	N/A	Want Reviewed
My vehicle insurance has been properly protected.
I have a complete, up to date inventory of my personal property
My residence and other posessions are insured for their replacement cost
I carry excess liability coverage
I understand how excess liability coverage integrates with the rest of my insurance protection
If I were sick or hurt, my income would be fully replaced, net of taxes
My income protection continues if I leave my employer
I have adequate insurance coverage for long-term illnesses
I understand how asset-based long-teerm care works
I understand my government benefits for disability and death
I understand my government benefits for my retirement
My wills and trusts have been updated within the last two years
All my assets are titled to reduce taxes and probate
I understand how life insurance integrates with my long-term financial objectives
My life insurance program provides for maximum economic life value protection

Growth

	Yes	No	N/A	Want Reviewed
I would like to utilize strategies to minimize my taxable income during retirement
I understand the difference between stocks, bonds, and cash
I understand the differences between government, corporate, and municipal bonds
I realize that municipal bonds provide income that can be both federal and state income tax free*
I understand the difference between ordinary income and long-term capital gains
I understand all the costs and taxes associated with the use of mutual funds

...

*Income from Municipal Bonds may not be tax free in all situations and circumstances. Depending on the individual's circumstances, municipal bond income may be subject to tax under the current Internal Revenue Code if the Alternative Minimum Tax requirements have not been met.
In the next year I am considering or expect to...

Check all that apply
Personal

Change my marital statusAn addition to our familyRelocateTake an extended vacation
Professional

Change careersAccept a job transferChange employersRetireStart a businessSell a business
Financial

Purchase a homeMake a major purchasePay off debtSave moreChange in salarySave for educationReceive an inheritance
Over the next few years I look forward to...
What concerns me the most about the future is...

If you are an owner or partner in a business, please complete the following

	Low	Medium	High	N/A
Maintaining control of your business throughout your lifetime
Eliminating the need to liquidate your business to pay estate taxes
Passing your business to a key employee
Create a business plan to sell your business to key employees efficiently
Provide incentives to key employees with non-stock compensation alternatives
Having your key employees own stock in your company
Protecting your business from the death of a key employee
Protecting your key employees and their families from serious illness and disability
Protecting your company from serious illness and disability of your employees
Passing your business to maintain family ownership & control
Maintaining family harmony after your estate has been settled
Having your spouse take an active/ownership role in the business plan after you pass
Create a business plan to gift/sell/bequest your business to your children/heirs
Equalizing the inheritance for your children not active in the business
Leaving the business only to active children/heirs versus all children/heirs
Having your children/heirs active in the business with regards to the future success of your business
Passing your business to a third party
Reviewing your business property & casualty coverage every 2 years
Reviewing alternative sources for your existing line of credit
Reviewing the efficiency of your existing long term debt structure
Buying out a partner's interest in the event of his/her death
Protecting assets of business from creditors/litigation

Submit form
Thank you for completing this questionnaire. Enter the security message below and click Submit.
Enter the message as it's shown*
Should be Empty:

Property