Questionnaire

Please describe any continuing support obligations from a prior relationship.

For each person, please list: Name | Relationship | Date of Birth | State/Country of Residence | Citizenship | Relationship Status.

If applicable, describe the individual, current benefits/support programs, trusts or accounts, and whether a plan is in place for ongoing support.

Please include the goal, estimated cost/amount in today's dollars, and target year or time frame.

Please include the goal, estimated cost/amount in today's dollars, and target year or time frame.

Please include the goal, estimated cost/amount in today's dollars, and target year or time frame.

What specific questions would you like the financial plan to answer?

Would you like us to compare alternatives? Examples: retire at 62 vs. 65, keep the family home vs. downsize, pay off the mortgage vs. invest, buy a second home vs. not buy.

Please list organizations or causes you currently support or feel connected to.

List each item on a separate line using: Location / Description | Owner(s) | Ownership Type | Ownership % | Asset Type | Estimated Fair Market Value | Cost Basis | Purchase Date.

Examples: private investments, collectibles, notes receivable, cryptocurrency, stock options, restricted stock, or other material assets.

List each account on a separate line using: Institution | Last 4 Digits Only | Owner | Ownership Type | Account Type | Estimated Value | Cost Basis (if applicable) | Beneficiary.

For client and co-client, please list current annual contributions and employer contributions/matches for 401(k), 403(b), 457(b), TSP, SEP/SIMPLE, HSA, or other plans.

List each debt on a separate line using: Debt Type / Related Asset | Borrower | Sole or Joint | Current Balance | Interest Rate | Payment Amount | Payment Frequency | Remaining Term.

List each policy on a separate line using: Company | Policy (last 4 digits only) | Owner | Insured | Policy Type | Death Benefit | Beneficiary | Premium | Cash Value.

For each business, list: Company Name | Owner / Shareholder | Ownership % | Entity / Share Type | Estimated Fair Market Value | Cost Basis | State of Formation.

Examples: continue indefinitely, transfer to family, sell to employees, sell to an outside buyer, wind down at retirement/death, or other.

Please list annual amounts for applicable items: Salary | Self-Employment Income | Bonus | Commissions | Pension Income | Social Security | Rental Income | Rental Expenses (excluding mortgage) | Foreign Income | Other Income.

Please list annual amounts for applicable items: Salary | Self-Employment Income | Bonus | Commissions | Pension Income | Social Security | Rental Income | Rental Expenses (excluding mortgage) | Foreign Income | Other Income.

For client and co-client, list: Plan Type | Current Value | Your Annual Contribution | Employer Annual Contribution.

For each pension, list: Employer | Monthly Pension | Beginning Age/Date | COLA / Indexing | Survivor Benefit % | Any Temporary / Bridge Benefit.

List any significant future expenses with an estimated amount and timing. Examples: home purchase, second home, vehicle, travel, education, wedding, renovation, business investment.

Name | Firm | Phone | Email

Name | Firm | Phone | Email

Name | Firm | Phone | Email

Name | Relationship | Phone / Email