How did you hear about us and / or find us??
*
Name
*
First Name
Last Name
Your Age
*
Are you Married?
*
Spouse Name (If Applicable)
First Name
Last Name
Spouse Age
Your Address
*
We do not share your information with any marketing company or outside companies
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Do you have children?
*
If Yes, do you or your spouse have children from previous marriages?
What are you primary financial planning objectives?
*
check all that apply
Other: Please share any additional information related to your goals or areas where you are hoping we can assist.
Do you or your spouse have any of the following types of benefits plans?
*
check all that apply
Do you have personal debt other than a mortgage?
*
Do you own a home?
*
Do you have a mortgage?
*
Do you own any rental properties?
*
When you add up values for all savings, investments and retirement accounts you have roughly:
*
$0 - $250,000
$250,001 - $500,000
$500,001 - $1,000,000
$1,000,001 - $1,500,000
$1,500,001 - $2,000,000
$2,000,001 - $5,000,000
$5,000,001 - $10,000,000
$10,000,000 +
What is your primary investment objective?
*
Are you currently working with an investment advisor / planner?
*
Are looking for a firm to manage your investments?
*
Do you need help determing what types of insurance you should own?
*
Please check off which types of retirement accounts you (and / or your spouse) have.
*
check all that apply
Please explain your "Other" situation
Have you ever worked for the federal or state government, or worked overseas?
*
Do you need to decide how or when to take a pension (ex: lump sum vs annuity)
Do you have a will?
*
Do you have a trust?
*
Is leaving assets to an heir or charity an important goal?
*
Have you recently experience the following?
*
check all that apply
Other explain your "Other" situation
Are you self-employed
*
Do you prepare your own income tax return?
*
Schedule A Conversation or A Meeting:
*
Please share the best Day / Times during business hours for meetings, any restrictions on meeting times, and anything else you thing we need to know at this point. PUT N/A OF NOTHING ELSE TO ADD.
How Did You Learn About Us?
*
Click all that apply
Your Best Contact #
*
Please provide the best number to use to touch base regarding scheduling options?
(###)
###
####
Spouse Best Contact # (If Applicable)
(###)
###
####
