PRE-MEETING QUESTIONS

PRE-MEETING QUESTIONS
Personal Information
Name *

First Name Last Name
Age *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email *
example@example.com
Are you married? *

Yes Widowed No Divorced
If yes, spouse name
Spouse Age
Do you have children?

Yes, still at home Yes, Not at home No
Children from previous marriage (you or spouse)

Yes No
Financial Basics
Do you know what you spend monthly? *

Yes Almost Not really
Personal Debt other than mortgage *

Yes No Yes, car loan
What are your financial goals/objectives *

Can I retire Retirement planning Budget planning College planning Basic Financial Planning Saving on Taxes
Other Goals - Share any information related to your goals or how we can help you
Do you or you spouse have any of the following

ESOP Pension Plan ESPP Stock Options
Do you own a home? *

Yes No
Do you have a mortgage *

Yes No
Do you own any rental properties *

Yes No
Investments
Total for all savings, investments and retirement accounts you and your spouse have *
What types of investments do you own?

Money Market CD's Individual Bonds Mutual Funds ETF's Individual Stocks Variable Annuity Fixed Annuity
What is your primary investment objective? *

Safety Income Growth A little of everything
Do you work currently with an advisor? *

No Yes, but seeking second opinion Sort of Do it myself
Are you looking for a firm to manage your investments? *

Yes Maybe No
Insurance
Do you have life insurance *

Yes Both my spouse and I do No Don't know
Do you have long term care insurance *

Yes Both my spouse and I do No
Do you have disability insurance *

Yes Both my spouse and I do Just my spouse No
Do you need help trying to figure out what insurance makes sense? *

Yes No
Retirement Readiness
Please check off retirement accounts you (and/or your spouse) have (check all that apply) *

IRA ROTH IRA SEP SIMPLE IRA 401(k) 403(b) 457 Annuity Other (will discuss)
Have you started Social Security *

Yes No Thinking about it
have you work for a state or federal government? Worked overseas? *

Yes No Don't know
Do you need to decide how or when to take a pension (lump sum vs. monthly payment for example) *

Yes No Don't know
Estate Planning
Do you have a will? *

Yes No Shared with family what I want
Do you have a trust? *

Yes No Don't know
Do you want to leave a legacy? *

Yes No Maybe
Life Events
Have you recently experience the following (check all that apply) *

Divorce Marriage Job change New Child Loss of spouse Inheritance Life is good
Tax Planning
Are you self-employed? *

Yes No
Do you do your own taxes *

Yes No
Please share best DAYS & TIMES for meetings. Share any restrictions on meeting times and anything else you think we should know about you at this point *
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

PRE-MEETING QUESTIONS

Personal Information

Financial Basics

Investments

Insurance

Retirement Readiness

Estate Planning

Life Events

Tax Planning