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Initial Interview Form

To make the best use of our time together please complete and return this form to us before our meeting.

Full Name(s)Date of BirthTelephoneE-mail Address
A.
B.
Home Address
EmployerProfession
A.
B.
  1. Yes   No   Do you have a will?
  2. Yes   No   Do you have a living trust?
  3. Yes   No   Do you have life insurance?   Term: $  Whole Life: $
  4. Yes   No   Do you have an irrevocable life insurance trust?
  5. Yes   No   Do you have an asset protection trust?
  6. Yes   No   Do you have long-term care insurance?
  7. Yes   No   Do you own any real estate in your own name?
  8. Yes   No   Do you track personal expenses?    Quickbooks   Quicken   MSN Money   Manually
  9. Yes   No   Do you have a retirement plan?    IRA   401K   MPPP   DB Plan
  10. Yes   No   Do you have a small business?    Sole Proprietor   Partnership   LLC   S-Corp   C-Corp
  11. Yes   No   Have you funded your kid’s education?    UGTMA   529   Cloverdale   Personal Savings
  1. INCOME
  2. $ Annual Gross Income (before taxes)
  3. $ Annual Savings/Retirement Plan Contributions
  4. ASSETS
  5. $ Non-retirement Assets (stocks, bonds, options, REITS, mutual funds, money market, 529 plan)
  6. $ Retirement Assets (IRAs, 401K, MPPP, DB Plans)
  7. $ Investment Real Estate (office buildings, rental properties, vacation home)
  8. $ Business Interests (partnerships, closely held corporations, limited partnerships)
  9. $ Home
  10. LIABILITIES
  11. $ Home Mortgage (first, seconds, HELOCs)
  12. $ Consumer Loans (credit cards, student loan, car loans, etc. )
  13. $ Investment Real Estate or Business Loans
  14. TOTAL
  15. $ Total Net Worth (Assets minus Liabilities)
  1. Please prioritize the financial assistance you are seeking (1-top priority, 2-second….6-lowest):
  2. What are your most important financial concerns? What do you want to accomplish through this engagement?
  3. Tell us about your most important non-financial concerns right now?
  4. How do you envision your lifestyle 5 years from now? (What are you doing or becoming, where, how, etc)
  5. Have you worked with a financial advisor before? What was good/unsatisfactory about that experience?
  6. Tell us how do you make important investment decisions?
  7. What changes do you expect in the future in your finances that you wish to plan for? Family obligations/inheritances...
  8. During our review 3 years from now, what will need to have happened for you to be satisfied with your progress?
  9. Have you ever been involved in litigation? Yes No What happened?
  10. Tell us what the ideal relationship with a financial planner looks like to you?
  11. Is there anything else we need to talk about? Any "special needs" situations you are responsible for?
  12. Where did you hear about us?