LIFE TRANSITION AND GOAL SETTING WORKSHEET

Transcription

1 LIFE TRANSITION AND GOAL SETTING WORKSHEET Select the life transitions that you are experiencing now or expect to experience in the future. Leave all others blank. Personal / Family Getting married Going through a divorce or separation Recent loss of your spouse Expecting a child Adopting a child Need to hire child care Child entering adolescence Child with special needs Child preparing for college Child going away to college Child getting married Empty nest Special family event Providing assistance to a family member Concerned about an aging parent Concerned about the health of spouse or child Concerned about personal health Family member in need of professional care Family member disabled or seriously ill Family member expected to die soon Recent death of family member Recent birth of a child Family member diagnosed with cancer Entering single parenthood Community / Charitable Give to other charitable organizations Monthly stipend to parent s (parental pension) Gifting to children / grandchildren Develop or review estate plan Develop end of life plan Creating or funding a foundation Creating or funding a scholarship fund Give to community causes / events Give to church or religious organizations Financial / Investment Selling a house Refinancing your mortgage Purchase a home Relocating Reconsidering investment philosophy and risk Significant investment gain Significant investment loss Concerned about debt Considering an investment opportunity Receiving an inheritance or financial windfall Selling assets Considering changing financial services provider Work / Career Contemplating a career change New job Job promotion Job loss Job restructuring New job training / education program Starting a new business Gaining or losing a business partner Selling or closing a business Transferring business to family member Taking a sabbatical leave or absence Phasing into retirement Full retirement from current job / career Buying an existing business Expanding an existing business

2 > List Your Life Goals Name: Date: Short-Term Goals Goal Long-Term Goals Goal Time Horizon Time Horizon Priority Low Medium High Priority Low Medium High Dollar Amount Full Retirement In 5 YRs X 80K/Yr Dollar Amount Vacation Home 10 Yrs X 200K

3 (Please print above the line) Confidential Financial/Life Planning Data Form Your Name (Client A) Age Birth Date Social Security # Spouse s Name (Client B) Age Birth Date Social Security # Marital Status: Single Married / / Separated Divorced Widowed Anniversary (m/d/y) CLIENT A CLIENT B Driver s Lic. # U.S. Citizen If No: What Country Driver s Lic. # U.S. Citizen If No: What Country Residence Address City State Zip Code Mailing Address City State Zip Code Home Phone Cell Phone #1 Cell Phone #2 Fax CLIENT A OCCUPATION CLIENT B OCCUPATION Job Title Employer (last if retired) Job Title Employer (last if retired) Date of Hire Retirement Date Work Phone Date of Hire Retirement Date Work Phone Pension Profit Sharing 401K Other Pension Profit Sharing 401K Other Please check if employer provides the above: Please check if employer provides the above: CHILDREN/DEPENDENTS EVEN IF GROWN (please print above the line) Child 1 Age Birth Date Provide Education Social Security # Child 2 Age Birth Date Provide Education Social Security # Child 3 Age Birth Date Provide Education Social Security # Child 4 Age Birth Date Provide Education Social Security # Child 5 Age Birth Date Provide Education Social Security #

4 PERSONAL ADVISORS Financial Advisor s / Planner s Name: Do you have a preference or a commitment to this advisor? Attorney s Name: Do you have a preference or a commitment to this advisor? Accountant s Name: Do you have a preference or a commitment to this advisor? Stockbroker s Name: Do you have a preference or a commitment to this advisor? Insurance Agent s Name: Do you have a preference or a commitment to this advisor? Other: Do you have a preference or a commitment to this advisor? YOU AND THE ECONOMY 1) From an investment point of view, what is your opinion of the current economic climate? YOU AND YOUR TAXES 1) Do you consider tax consequences in making investment decisions? 2) Are you interested in developing strategies for reducing your taxes? 1) Do you prepare an annual budget? (please explain) MANAGING YOUR MONEY 2) Do you feel you manage your cash flow in an acceptable manner? (please explain) 3) How do you feel about borrowing money for the following? a) For consumer debt? b) For investments or appreciating assets?

5 YOUR FINANCIAL PERFORMANCE 1) Have you ever developed a comprehensive financial plan? If yes, with whom? How long ago? Did you ever implement the plan? How did you feel about it? 2) Is there anyone, other than your spouse, providing you with financial advice at this time? If yes, then to what extent? 3) Are there any investments that you feel tied to, either for past performance, tax or emotional reasons etc.? If yes, please explain: 4) Do you expect to have significant estate transfer taxes (death taxes) at your or your spouses death? Not Sure Is a large part of your net worth composed of retirement accounts? WILLS AND TRUSTS Client A Client B Do you have a will? If Yes, then Do you have a will? If Yes, then Year executed? Executor? Year executed? Executor? Type of Will Type of Will Simple Complex (A & B Trust) Not Sure Simple Complex (A & B Trust) Not Sure Provide for Generation Skipping? Provide for Generation Skipping? Guardian of minor children? Guardian of minor children? If yes, who? Check if you have or do not have the following If yes, who? Check if you have or do not have the following Durable Power of Attorney Durable Power of Attorney Health Care Power of Attorney Health Care Power of Attorney Living Will Living Will If married, is this your first marriage? If married, is this your first marriage? Do you own property in other states? Do you own property in other states? Do you expect to inherit any assets? Do you expect to inherit any assets?

6 FAMILY BALANCE SHEET - SNAPSHOT Assets Liabilities Cash and Cash Equivalents: Short Term: Checking Credit Cards, Notes Savings Long Term: Money Market Home Other Business Investments (Non-Retirement): Additional Property Stocks Other: Bonds Mutual Funds Others Annual Income: Family Income Statement Investments (Retirement): Earned Income IRAs Investment Income 401Ks Social Security 403(b)s Pension Income Profit Sharing Other Income 457s or Others Total Home:aaaa aaa a Annual Expenses: Real Estate: Fixed Personal Property: Variable Other: Total

7 RISK PROFILE Please check the appropriate response for each question. 1. I Plan to take withdrawals from my portfolio in the next Immediately 1 to 5 years 6 to 10 years 11 to 15 years more than 15 years 2. I plan to spend the money in my portfolio over a period of 2 years or less 3 to 5 years 6 to 10 years 11 to 15 years more than 15 years Life 3. When making a long term investment, I plan to hold the investment for: 3 to 5 years 6 to 10 years 11 to 15 years more than 15 years 4. In October 1987, stocks fell by more than 20% in one day. If I owned a stock investment that fell by 20% over a short period of time, I would Sell all of the remaining investment Sell a portion of it Hold on and do nothing Buy more of the investment 5. To reach my financial goals, I prefer investments with little or no fluctuation in value, and I am willing to accept lower returns associated with these investments. I strongly disagree I disagree I somewhat disagree I agree I strongly agree 6. During periods of market declines, I tend to sell off parts of my riskier assets and put the money into safer assets. I strongly disagree I disagree I somewhat disagree I agree I strongly agree 7. Based solely on a brief conversation with a friend, coworker, or relative, I would invest in a mutual fund. I strongly disagree I disagree I somewhat disagree I agree I strongly agree Continued on next page

8 8. During the first half of 1994, some bond investments fell by more than 10%. If I owned a bond investment that fell by 10% over a short period of time, I would Sell all of the remaining investment Sell a portion of it Hold on and do nothing Buy more of the investment 9. Assuming I invested 100,000 in a long-term investment, which has the potential to fluctuate by the total amounts indicated in any given year, I would be most comfortable in the following fund. Fund A 106,000 to 98,000 Fund B 120,000 to 90,000 Fund C 143,000 to 64, The stability of my current and future income from sources such as salary, Social Security, and pension plans is Very unstable Unstable Somewhat unstable Stable Very stable 11. When it comes to investing in stock or bond mutual funds (or individual stocks and bonds), I would describe myself as a/an Very inexperienced investor Somewhat inexperienced investor Somewhat experienced investor Experienced investor Very experienced investor I have reviewed the information I provided and my answers to each question. I understand that any investment recommendations made to me are based on the assumption that the information that I provided on this profile is accurate. Please Sign and Date Client Signature Print Date Client Signature Print Date Strategic Advisory Services, L.P. Print Date

9 How would you answer the following questions? 1. Imagine that you are financially secure, that you have enough money to take care of your needs now and in the future. The question is, how would you live your life? What would you do with the money? Would you change anything? How would you describe a life that is complete, that is richly yours? Client: FOOD FOR THOUGHT Client Spouse: Please see the next page for question number 2

10 2. This time, you visit your doctor who tells you that you have five to ten years to live. The good news is that you will never feel sick. The bad news is that you will have no notice of the moment of your death. What will you do in the time you have remaining to live? Will you change the way you live your life, how will you do it? Client: Client Spouse: Please see the next page for question number 3

11 3. This time, you doctor shocks you with the news that you have only one month left to live. Notice what feelings arise as you confront your very real mortality. Ask yourself: What dreams will be left unfulfilled? What do I wish I had finished? What do I wish I had done? What did I miss? Client: Client Spouse: Thank you for your time. We look forward to meeting with you.