Let’s work together Interested in working together? Fill out some info and we will be in touch shortly! We can't wait to hear from you! Name * First Name Last Name Email * Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country What is your date of birth? * MM DD YYYY What service(s) are you interested in? * Investment Advisory Financial Planning Specific Project Other How did you hear about us? Instagram Twitter LinkedIn I was referred Google search Free workshop Are you married? * Yes No Recently engaged Recently divorced Widowed Please include your spouses name, date of birth, address, contact number & email. If this does not apply, please type "N/A". * Do you have any children? * No Yes If you responded "Yes" to the above question, please detail how many children you have. We'd love to know their names and age to get to know you and your family better. In you responded "No" to the above question, please type "N/A". Please tell us where you work, what your title is, and your total compensation. * What's your current household annual salary? * Less than $100k $100k-$150k $150k-$200k $200k or more Do you know how much your household spends on a monthly basis? * Yes, down to the penny Approximately No, not really Are you adding to your savings account? * Yes, frequently Yes, when possible Rarely Not at all How much do you currently have in your savings? * Feel free to detail the purpose of savings if the total doesn't tell the full story. For example, "$30k for home down payment," "$15k for emergencies," etc. Please indicate the type(s) of debt you carry. * Mortgage Personal Loan Student Loan Credit Card Margin Loan Auto Loan Other Do you contribute to a retirement plan? * Yes, company sponsored 401(k) or 403(b) plan Yes, company sponsored defined contribution plan Yes, Solo 401(k) Other No How much do you contribute to your retirement? * Max Up to company match None Help me decide how much I should contribute Does your company offer a Roth 401(k)? * Yes No Does your household participate in any of the following benefit plans? * Deferred compensation plan ESPP (Employee Stock Purchase Plan) ESOP (Employee Stock Ownership Plan) Stock Options (Restricted, ISO or NQs) Pension Plan SERP (Supplemental Executive Retirement Plan) Other None Does your company offer insurance benefits? * Be prepared to provide details in our meeting. Having statements summarizing your coverage is helpful. Life Disability Long-Term Care Health Vision Dental None If you're not employer-insured, please indicate which policies you personally own: * Be prepared to provide details in our meeting. Having statements summarizing your coverage is helpful. Life Disability Long-Term Care Health Vision Dental Property/Casualty Umbrella None Do you own any cash-value life insurance? * Yes No Do you and/or your spouse own property? * None Primary residence 1-5 rental properties 5-10 rental properties 10+ real estate portfolio Do you have a mortgage on your primary residence? * Yes No When you calculate the total values across your savings, investments, and retirement accounts, your aggregate investible assets amount to approximately: * Less than $100k Between $100k-$1M More than $1M What's your primary investment objective? * preservation of capital (no growth) Income for upcoming retirement Growth for future use (within 1 year) Growth for future use (No sooner than 5 years) Growth for future use (No sooner than 10 years) What's your retirement status? * Retired Looking to retire in the next 10 years Looking to retire in the next 20 years Help me determine when I can retire Please check off which types of retirement accounts you (and/or your spouse) have (check all that apply): * [Rollover] IRA Roth IRA SEP IRA 401(k) / 403(b) 457 Plan Annuity (of any type) Profit sharing account Other (we'll ask at meeting) Do you have a Will? * Yes No Do you have a Trust? * Yes No Have you named an executor for your estate? * Yes No Have you reviewed beneficiary designations within the past year? * Yes No Have you recently experienced or anticipate any of the following (check all that apply)? * Marriage Divorce New child New job Inheritance Loss of spouse Other (We'll ask at meeting) None Do you anticipate future dependency from relatives? * Yes and it's important that I assist financially Yes, but I'm not sure I can No Do you own a business? * Yes; sole owner Yes; with a partner No, but planning to within 1 year No Are you considering selling the business or acquiring another business? * No Yes, selling within the next 5 years yes, selling no sooner than 5 years Yes, acquiring within the next 5 years Yes, acquiring no sooner than 5 years Do you prepare your own taxes? * Yes No If you have a tax preparer, would you please provide their contact information? * Are you saving for kids college? * Yes No Do you need to figure how much you need to save for college? * Yes, I need help No, I know Do you have 529 Plans or Coverdell Education accounts? * Yes No Other Please share the best Days/Times for meetings, any restrictions on meeting times, and summarize what you need help with and what you hope to accomplish in our meeting: * Thank you!
