Acme Inc.
Instructions
Instructions
Personal Information
*Full Name
*Date of Birth
*Marital Status
Dependents (if any)
Phone Number
*Email Address
Employment Details
*Occupation
*Employer
*Annual Income
Spouse/Partner's Details
Spouse’s Information
Full Name
Occupation
Employer
Annual Income
Current Financial Situation
*Monthly Income Breakdown
*Monthly Expenses
*Debt Overview
*Emergency Savings
*Current Net Worth
Financial Goals
Short-Term Goals (1-5 years)
Medium-Term Goals (5-10 years)
Long-Term Goals (10+ years)
Savings and Investment Plans
*Current Retirement Savings (e.g., 401(k), IRA, Pension)
*Annual Contributions
Employer Match (if applicable)
*Retirement Age Target
*Desired Retirement Income
*Investment Accounts
*Your Preferred Investment Strategy
Savings Accounts
Insurance and Protection
Life Insurance
Health Insurance
Disability Insurance
Homeowners or Renters Insurance
Auto Insurance
Other Insurance
Estate Planning
*Do You Have a Will?
Trusts or Estate Plans in Place?
Powers of Attorney (Financial and Medical)
Beneficiaries on Accounts
Planned Charitable Giving
Tax Planning
*Current Tax Bracket
*Tax-Advantaged Accounts (IRA, Roth IRA, HSA)
*Estimated Annual Tax Payment
Mortgage Interest
Charitable Contributions
Student Loan Interest
Risk Tolerance and Investment Preferences
*Risk Tolerance
Investment Preferences: Ethical/Impact Investing
Specific Industries to Avoid
Specific Industries to Focus On
Retirement Planning
*Desired Retirement Age
*Desired Monthly Retirement Income
*What Amount Do You Contribute Each Year to Your Retirement Plan?
*Current Savings for Retirement
*Pension or Social Security Projections
*Planned Retirement Lifestyle (Travel, relocation, etc.)
Other Financial Considerations
Have Any Education Savings (For children or self)
Charitable Donations (Regular contributions, planned donations)
Gifts to Family
Business Ownership (If applicable)
Tell us About Other Major Financial Obligations or Upcoming Life Events
Financial Concerns or Areas Needing Improvement
*Have a Financial Advisor (Currently)?
Expectations from a Financial Advisor
What’s the Most Pressing Financial Issue You’d Like to Resolve?
What Would You Like to Accomplish in the Next 12 Months?
Financial Planning
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*Response requiredFull Name
*Response requiredDate of Birth
*Response requiredMarital Status
Dependents (if any)
Phone Number
*Response requiredEmail Address
*Response requiredOccupation
*Response requiredEmployer
*Response requiredAnnual Income
Spouse’s Information
Leave this section blank if not applicable.
Full Name
Occupation
Employer
Annual Income
*Response requiredMonthly Income Breakdown
Example:
*Response requiredMonthly Expenses
Example:
*Response requiredDebt Overview
Example:
*Response requiredEmergency Savings
*Response requiredCurrent Net Worth
Assets (Cash, Investments, Property, Retirement Accounts)
Short-Term Goals (1-5 years)
Saving for a car, vacation, emergency fund, etc. Include expected cost and timeline for each.
Add the goal you prioritize the most, first.
Medium-Term Goals (5-10 years)
Home purchase, starting a business, etc. Include expected cost and timeline for each.
Add the goal you prioritize the most, first.
Long-Term Goals (10+ years)
Retirement, children’s education, etc. Include expected cost and timeline for each.
Add the goal you prioritize the most, first.
*Response requiredCurrent Retirement Savings (e.g., 401(k), IRA, Pension)
*Response requiredAnnual Contributions
Employer Match (if applicable)
*Response requiredRetirement Age Target
*Response requiredDesired Retirement Income
*Response requiredInvestment Accounts
Type of Investments (Stocks, Bonds, Mutual Funds, Real Estate, etc.)
*Response requiredYour Preferred Investment Strategy
Savings Accounts
Include Emergency Funds and Regular Savings Accounts
Life Insurance
Please include:
Health Insurance
Current Coverage (Private, Employer-provided, Government)
Disability Insurance
Include Short-Term and Long-Term Coverage
Homeowners or Renters Insurance
Auto Insurance
Other Insurance
What Other Insurances Do You Require? (e.g., Umbrella Insurance, Business Insurance)
Are There Any Gaps in Your Current Coverage vs. Needed Coverage?
*Response requiredDo You Have a Will?
Trusts or Estate Plans in Place?
Powers of Attorney (Financial and Medical)
Beneficiaries on Accounts
Planned Charitable Giving
*Response requiredCurrent Tax Bracket
*Response requiredTax-Advantaged Accounts (IRA, Roth IRA, HSA)
*Response requiredEstimated Annual Tax Payment
Mortgage Interest
Charitable Contributions
Student Loan Interest
*Response requiredRisk Tolerance
Investment Preferences: Ethical/Impact Investing
Specific Industries to Avoid
Specific Industries to Focus On
*Response requiredDesired Retirement Age
*Response requiredDesired Monthly Retirement Income
*Response requiredWhat Amount Do You Contribute Each Year to Your Retirement Plan?
*Response requiredCurrent Savings for Retirement
*Response requiredPension or Social Security Projections
*Response requiredPlanned Retirement Lifestyle (Travel, relocation, etc.)
Have Any Education Savings (For children or self)
Charitable Donations (Regular contributions, planned donations)
Gifts to Family
Business Ownership (If applicable)
Tell us About Other Major Financial Obligations or Upcoming Life Events
Financial Concerns or Areas Needing Improvement
*Response requiredHave a Financial Advisor (Currently)?
Expectations from a Financial Advisor
Please tell us about:
What’s the Most Pressing Financial Issue You’d Like to Resolve?
What Would You Like to Accomplish in the Next 12 Months?