Fact Finder

Client Information
Date of Birth *
Date of Birth
Marital Status
Gender
Spouse Information
Date of Birth
Date of Birth
Gender
Contact Information
Address *
Address
Cell Phone *
Cell Phone
Spouse Cell Phone *
Spouse Cell Phone
Children
Child 1
Date of Birth
Date of Birth
Gender
Special Needs
Child 2
Date of Birth
Date of Birth
Gender
Special Needs
Child 3
Gender
Special Needs
Child 4
Gender
Special Needs
In the event of a premature death of you or your spouse, would the survivor want:
The mortgage & debt to be paid off?
Children's education fully funded?
Extended period of time off of work?
In the event of injury or sickness, do you believe you could maintain your monthly living expenses and achieve long term goals, with your current disability income insurance?
Are you aware of upcoming changes in your life which could directly change your present financial situation?
Do you or your spouse have any health problems that may cause you to retire earlier than you wish?
Do you expect any inheritances, legal settlements, or gifts that may affect your financial plan?
Retirement Goals
$
$
What do you expect to happen to your expenses when you retire?
Will you and/or your spouse receive a pension?
ESTATE PLANNING
Have you established a will?
Have you established an Irrovocable or Revocable Trust?
Have you established a Power of Attorney?
Have you established a Health Care Proxy?
Cash Reserves / Emergency Funds
Your Estate Attorney's Name
Your Estate Attorney's Name
$
$
Home Purchase/Vacation Home
$
$
OTHER GOALS
(Ex - Boat, wedding, legacy, charity, etc...)
$
(Ex - Boat, wedding, legacy, charity, etc...)
$
(Ex - Boat, wedding, legacy, charity, etc...)
$
TAX PLANNING
Do you usually owe taxes at the end of the year?
$
$
Your Accountant's Name
Your Accountant's Name