New Client Questionaire Step 1 of 11 9% Your GoalsWhat are your primary goals for pursuing financial planning?(Retirement preparation, buy a new home, save for weddings for children, pay for kids' college education, etc.) Client #1 InformationLet's start with your personal information. If you have a partner/spouse, we'll ask for that after your information is finished.Client 1 Name First Middle Last Client 1 PhoneClient 1 Type of Phone Home Phone Mobile Phone Work Phone Client 1 Email Client 1 Type of Email Home Email Work Email Client 1 Birth DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Client 1 Employment Status Currently Full-Time Currently Part-Time Home Maker Retired, Not Working Retired, Working FT Retired, Working PT Other Client 1 OccupationIf retired, what was your occupation when you did work?Client 1 EmployerIf not working, who was your most recent employer?Client 1 Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you own this home or rent?We will ask you about your mortgage/rent information in a few minutes. I own it, with no mortgage. I own it, but it is mortgaged. I rent it. Do you have a partner or spouse to add? Yes No Are their children in your immediate family? Yes No Client #2 InformationClient 2 Name First Middle Last Client 2 PhoneClient 2 Type of Phone Home Phone Mobile Phone Work Phone Client 2 Email Client 2 Type of Email Home Email Work Email Client 2 Birth DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Client 2 Employment Status Currently Full-Time Currently Part-Time Home Maker Retired, Not Working Retired, Working FT Retired, Working PT Other Client 2 OccupationIf retired, what was your occupation when you did work?Client 2 EmployerIf not working, who was your most recent employer?Do you live at the same address listed above for Client 1? Yes No Client 2 Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Additional Family InformationNumber of childrenHow many children are in your household, even if they are grown or "on their own?" Your family affects your financial outlook. Our team uses this information to give you a holistic perspective on your situation.No children.1 - I/we have one kid.2 - I/we have two kids.3 - I/we have three.4 - I/we have four.5 - I/we have five.6 - I/we have six.7 - I/we have seven.8 - I/we have eight.We're gonna have to discuss this, but let's start with 8.1st Child's Name First Middle Last 1st Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 1st Child Married? Yes No 2nd Child's Name First Middle Last 2nd Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 2nd Child Married? Yes No 3rd Child's Name First Middle Last 3rd Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 3rd Child Married? Yes No 4th Child's Name First Middle Last 4th Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 4th Child Married? Yes No 5th Child's Name First Middle Last 5th Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 5th Child Married? Yes No 6th Child's Name First Middle Last 6th Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 6th Child Married? Yes No 7th Child's Name First Middle Last 7th Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 7th Child Married? Yes No 8th Child's Name First Middle Last 8th Child's BirthdateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is the 8th Child Married? Yes No Client #1 - Income Amounts & SourcesDoes Client 1 have a non-military pension? Yes No Has Client 1 started taking their pension? Yes No Source of Client 1 Pension(federal, state, corporate, etc.)Client 1 Monthly Pension AmountClient 1 - What kinds of income do you regularly deposit? Wages/Salaries Social Security Military Benefit VA Benefit Rental Income Other Client 1 Wages/SalaryMonthly total of wages and salaries for Client #1Client 1 Social Security IncomeMonthly total of social security incomeClient 1 Military BenefitMonthly amount of benefitClient 1 VA BenefitMonthly amount of benefitClient 1 Rental IncomeMonthly total of rents collectedWhat other income does Client 1 need to discuss?(side job, investments, gambling winnings, royalties, etc.)Client #2 - Income Amounts & SourcesDoes Client #2 have a non-military pension? Yes No Has Client #2 started taking it? Yes No Source of Client #2 Pension(federal, state, corporate, etc.)Client #2 Monthly PensionClient 2 - What kinds of income do you regularly deposit? Wages/Salaries Social Security Military Benefit VA Benefit Rental Income Other Client 2 Wages/SalaryMonthly total of wages and salaries for Client #2Client 2 Social Security IncomeMonthly total of social security incomeClient 2 Military BenefitMonthly amount of benefitClient 2 VA BenefitMonthly amount of benefitClient 2 Rental IncomeMonthly total of rents collectedWhat other income does Client 2 need to discuss?(side job, investments, gambling winnings, royalties, etc.) Client 1 Rental Property InformationClient 1 Property Value of RentalsWhat is the total property value of all rental properties in your portfolio (even if they are mortgaged)?Client 1 Mortgages on Rental PropertyWhat is the total amount of all mortgages held against rental property?Client 1 Rental Property ReservesWhat is the total amount of cash reserves set aside specifically for maintaining and servicing rental properties?Client 2 Rental Property InformationClient 2 Property Value of RentalsWhat is the total property value of all rental properties in your portfolio (even if they are mortgaged)?Client 2 Mortgages on Rental PropertyWhat is the total amount of all mortgages held against rental property?Client 2 Rental Property ReservesWhat is the total amount of cash reserves set aside specifically for maintaining and servicing rental properties? Household Account BalancesEnter your personal household balances here. We will ask about any business or rental property financials later.Checking Accounts Balance RangeTotal all checking accounts$0$1-999$1,000-$4,999$5,000-9,999$10,000-14,999$15,000-19,999$20,000-29,999$30,000-49,999$50,000+Saving Accounts Balance RangeTotal all saving accounts $0$1-999$1,000-$4,999$5,000-9,999$10,000-14,999$15,000-19,999$20,000-29,999$30,000-49,999$50,000+Money Market Accounts Balance RangeTotal all money market accounts $0$1-999$1,000-$4,999$5,000-9,999$10,000-14,999$15,000-19,999$20,000-29,999$30,000-49,999$50,000+Certificate of Deposit Balance RangeTotal all CD accounts $0$1-999$1,000-$4,999$5,000-9,999$10,000-14,999$15,000-19,999$20,000-29,999$30,000-49,999$50,000+Business AssetsDo you own any businesses? Yes No Client #1 Retirement Accounts InformationCompany Retirement Plan - Client 1.1Recurring Contribution to Plan - 1.1Frequency of Contribution to Plan - 1.1AnnuallyMonthlyWeeklyOtherCompany Retirement Plan - Client 1.2Recurring Contribution to Plan - 1.2Frequency of Contribution to Plan - 1.2AnnuallyMonthlyWeeklyOtherTraditional IRA Account Balances - 1Recurring Contribution to Trad. IRA - 1Frequency of Contributions to Trad. IRA - 1AnnuallyMonthlyWeeklyOtherRoth IRA Account Balances - 1Recurring Contribution to Roth IRAs - 1Frequency of Contribution to Roth IRAs - 1AnnuallyMonthlyWeeklyOtherHSA Account Balances - 1Recurring Contribution to HSAs - 1Frequency of Contributions to HSAs - 1AnnuallyMonthlyWeeklyOtherClient #2 Retirement Accounts InformationCompany Retirement Plan - Client 2.1Recurring Contribution to Plan - 2.1Frequency of Contribution to Plan - 2.1AnnuallyMonthlyWeeklyOtherCompany Retirement Plan - Client 2.2Recurring Contribution to Plan - 2.2Frequency of Contribution to Plan - 2.2AnnuallyMonthlyWeeklyOtherTraditional IRA Account Balances - 2Recurring Contribution to Trad. IRA - 2Frequency of Contributions to Trad. IRA - 2AnnuallyMonthlyWeeklyOtherRoth IRA Account Balances - 2Recurring Contribution to Roth IRAs - 2Frequency of Contribution to Roth IRAs - 2AnnuallyMonthlyWeeklyOtherHSA Account Balances - 2Recurring Contribution to HSAs - 2Frequency of Contributions to HSAs - 2AnnuallyMonthlyWeeklyOtherNon-Retirement Investment AccountsInvestment accounts other than IRA's and 401k's, etc.Total Value of NRIATotal of all non-retirement investment balances.Recurring Contribution of NRIATotal amount of recurring contributionsFrequency of Contributions to NRIA.AnnuallyMonthlyWeeklyOtherEducational Savings Accounts for Children529 AccountsHow many 529 accounts have you opened for children or dependents?529 Accounts ValueWhat is the total value of your 529 accounts?529 Monthly ContributionsWhat is the total monthly contribution to 529 accounts?ESA AccountsHow many ESA accounts have you opened for children or dependents?ESA Accounts ValueWhat is the total value of your 529 accounts?ESA Monthly ContributionsWhat is the total monthly contribution to ESA accounts? More about your businessTell us about your business interests.Name(s) of business(es), value, percentage of ownership, nature of the business, etc. Debt InformationHome ValueMortgage BalanceMonthly Mortgage PaymentSecond Mortgage BalanceMonthly Second Mortgage PaymentHELOC/HEL BalanceMonthly HELOC/HEL PaymentDo you need to enter this information for a second home?If Client 2 lives in a separate home, and it is not considered rental property, please enter that information here. Yes No Client 2 Home ValueClient 2 Mortgage BalanceClient 2 Monthly Mortgage PaymentClient 2 Second Mortgage BalanceClient 2 Monthly Second Mortgage PaymentClient 2 HELOC/HEL BalanceClient 2 Monthly HELOC/HEL PaymentCredit CardsTotal of All Credit Card BalancesTotal of Credit Card Monthly Minimum PaymentsStudent LoansTotal of All Student Loan BalancesTotal of Student Loan Monthly Minimum PaymentsCar LoansCar Loan #1 BalanceCar Loan #1 Minimum PaymentCar Loan #2 BalanceCar Loan #2 Minimum PaymentOther DebtsDo you have other debts to discuss? Yes No What other debts concern you?List anything here that you'd like to cover with an advisor. Insurance Coverage InformationWhich kinds of insurance does Client #1 carry? Health Life Long Term Disability Long Term Care Select AllWhich kinds of insurance does Client #2 carry? Health Life Long Term Disability Long Term Care Select AllClient #1 Insurance InformationWhat kind of health insurance does Client #1 have? Group Individual I'm not sure. What kind of life insurance does Client #1 have? Group Individual I'm not sure. Client #2 Insurance InformationWhat kind of health insurance does Client #2 have? Group Individual I'm not sure. What kind of life insurance does Client #2 have? Group Individual I'm not sure. Estate DocumentsDo you have a will? Yes No Year Will UpdatedDo you have a Power of Attorney? Yes No Year Power of Attorney UpdatedDo you have a Trust? Yes No Year Trust UpdatedOther InformationIs there anything else you'd like to share with us?e.g., parents' health care needs, inheritance, number of siblings, special needs child(ren), etc.Upload any financial statements for accounts referenced Drop files here or Select files Max. file size: 80 MB.
