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Financial Planning Fact Finder

Fill out the form below so that we may get an accurate overview of your situation.
All information is confidential and intended solely for the use of financial planning.
Please include the latest amounts and provide the latest account statements.
Provide as much information as you can but leave any columns you do not have the information for blank.
Time to complete 45min or less.

Client / Co-Client Info.

Client First Name

Client Last Name

D.O.B.

US Citizen

Tax Filing Status

Home Address

Co-Client First Name

Co-Client Last Name

D.O.B.

Dependents.

How Many Children/Dependants do you have?

Dependent 1 Name

Dependent 1 D.O.B.

Dependent 2 Name

Dependent 2 D.O.B.

Dependent 3 Name

Dependent 3 D.O.B.

Dependent 4 Name

Dependent 4 D.O.B.

Income.

Client

Gross Salery

Bonus Income

Co-Client

Gross Salery

Bonus Income

Social Security Income.

Social Security Client

FRA Amount (If not Receiving)/ Amount Currently Receiving

Pension Income Amount

COLA

Survivorship Percentage

Start Date

Social Security Co-Client

FRA Amount (If not Receiving)/ Amount Currently Receiving

Pension Income Amount

COLA

Survivorship Percentage

Start Date

Assests.

Personal Residence Owner/Owners

Purchase Price

Current Value

Property Taxes

Loan

Liabilities Mortgage.

Mortgage

Start Date

Term

Interest Rate

Payment (P & I only)

Additional Payment

Liabilities Mortgage Con't.

Mortgage/ HELOC

Start Date

Term

Interest Rate

Payment (P & I only)

Additional Payment

Liabilities Credit Cards.

Credit Cards

Credit Cards Interest Rate

Liabilities Student Loans.

Student Loans Client

Student Loans Client Start Date

Student Loans Client Term

Student Loans Client Interest Rate

Student Loans Co-Client

Student Loans Co-Client Start Date

Student Loans Term Co-Client

Student Loans Interest Rate Co-Client

Liabilities "Other Loans".

Other Loans Current Balance

Other Loans Start Date

Other Loans Term

Other Loans Interest Rate

Fixed Expenses

Housing Excluding Mortgage

Medical

Transportation

Groceries

Clothing

Total

Discretionary Expenses. Enter Yearly Amounts.

Furnishings

Personal Care / Cash

Child Care

Vacation

Entertainment

Charity

Gifts

Pets

Professional Services

Miscellaneous

Total

Cash Accounts

Client Cash Account

Client Checking Account

Client Money Markets CD's

Co Client Cash Account

Co Client Checking Account

Co Client Money Markets CD's

Investments (e.g. 401(k), IRA, After-Tax)

Owner

Account Type?

Select All That Apply 401(k) IRA, ( After-Tax) Roth IRA

Balance?

Contribution/Savings (pre-tax, post- tax, roth)

Employer Contributions (% of salary, fixed amount)

Co Client Investments

Owner

Account Type?

Select All That Apply 401(k) IRA, ( After-Tax) Roth IRA

Balance?

Contribution/Savings (pre-tax, post- tax, roth)

Employer Contributions (% of salary, fixed amount)

Group/Individual Life Insurance

Insured

Owner / Beneficiary

Start Date

Type Term

Death Benefit

Monthly Premium

Cash Value

Other household members insured.

Insured

Owner / Beneficiary

Start Date

Type Term

Death Benefit

Monthly Premium

Cash Value

Other household members insured.

Insured

Owner / Beneficiary

Start Date

Type Term

Death Benefit

Monthly Premium

Cash Value

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Financial Planning Fact Finder

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