New Client Questionnaire

Personal:
• Legal Name(s)/Birthdate(s):
• Wedding Anniversary:
• Are you a Veteran?
• Children? If so, their names and ages:
• Employer(s)/Position(s):
• What is your approx. annual income?
• When do you realistically want to retire by?
• How much do you think you would need (in today’s dollars) per month, to live your preferred lifestyle
during retirement?

Additional Objectives:
• Any major purchases you are planning for (new car, home renovation, big vacation, etc.)?
• Do you plan to help pay for kid’s or grandkid’s education beyond K-12? If so, any accounts started for
them?
• Any other major financial goals outside of retirement (savings for new home, plans for a cottage,
charitable gifting, etc.)?

Protection:
• Do you work with a CPA?
• Do you have a trust or will?
• Do you own any life or long-term care insurance, outside of company benefits? If so, please summarize.

Current Investments:
• Do you qualify for or have a pension? If yes, please provide pertinent details
• Please provide your projected social security amounts.
If you are unsure, consider visiting SSA.gov and
under “PREPARE”, select “Get Benefits Estimate.” This may require you to start an account, but this data
is very important for your retirement income projections. We can estimate if this is not provided.
• Current employer plans (401ks/403Bs/etc.)-what are you contributing, what does your employer match,
and what are the balances?
• Approx. how much do you have in cash/checking/savings currently?
• Any additional side income or rental properties?
• Please summarize any other investment accounts you have started (brokerages, ROTHs, IRAs, etc.):

Debt/Other Assets:
• Do you have a mortgage on your home? What is the current interest rate, monthly payment, and
balance? When did the loan start and what length of term? Does this include escrow? What is it worth?
• Any other appreciating assets you own (second home, rental property, business, etc.):
• Any Car payments- if so monthly amount, balance and interest rate?
• Additional Credit card, school, or medical debt?
• Any other monthly debt/payments not listed above?
• Do you anticipate ever having to financially care for a parent or child during your retirement years?

Any Other Goals?
Please let us know if there are any other objectives, concerns or aspirations that we have missed that you believe
are pertinent for us to consider. Please save this document and forward or simply copy and paste your responses
back to us.