16%

    CONTACT INFORMATION

    SPOUSE DETAILS

    24%

    FAMILY

    Family Hierarchy

    32%

    LEGAL ITEMS

    Which of the following documents do you have?

    40%

    ADD’L ITEMS

    Which of the following do you have?

    48%

    POLICY

    Select Policies:

    56%

    CASH FLOW

    Please list before tax monthly income from each source:

    Social Security
    (Survivor Options)
    Wages
    Pension
    Other Income
    Retirement Plan Contributions

    64%

    LIFE EVENTS

    In the near future, I expect to: (Please check all that apply)











    72%

    ASSETS

    Please check off the accounts you currently hold. Note the approximate value and bring in the latest statement.







    Property:









    80%

    RETIREMENT INFORMATION

    88%

    CONCERNS

    Which of the following are your top three concerns?








    96%

    OBJECTIVES

    Please prioritize your financial objectives by numbering the following 1 through 9, with 1 being the most important:







    100%

    RISK/GOALS

    Please pick the top two for your retirement “nest egg” money.

    Risk Tolerance?

    How would you describe your investment knowledge?

    How would you describe your spouse’s investment knowledge?