It s easy to get started today.

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Christina Hubbard
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1 It s easy to get started today. 1 2 Complete this workbook as accurately and completely as possible. Make an appointment with your Fidelity Workplace Planning and Guidance Consultant to discuss your plan. OR Save time online. If you have a Fidelity account you can use Fidelity s online tool to provide the information requested in this workbook. It s the quickest way to get started. Plus your Fidelity information can be automatically imported into your online worksheet. It s easy. Visit Fidelity.com/incomeplanner* which uses advanced encryption software and other safety measures to protect your information. Then after you ve completed the tool call to schedule a consultation. Together we can plan for your retirement goals and address the challenges you may face in retirement. * Fidelity periodically updates the tool so the results generated during a retirement planning session may change as Fidelity updates or modifies it. Because the results the tool generates may change you should periodically return to the tool for updated results. Each time you use it you should revalidate each of your inputs and assumptions rerun an analysis of your situation using the updated tool and save a new Plan of Record. Be sure to review your updated results in place of any previously generated results. The tool is provided for educational purposes only. You should not rely on it as the primary basis for your investment financial or tax-planning decisions. The tool s illustrations result from running a minimum of 250 hypothetical market simulations. The market return data used to generate the illustrations is intended to provide you with a general idea of how asset mixes have performed historically. Our analysis assumes a level of diversity within each asset class consistent with a market index benchmark that may differ from the diversity of your own portfolio. Please note that the projections do not reflect the impact of any transaction costs or management and servicing fees (except variable annuities); if these had been included the projected account balances would have been lower. important: The projections or other information generated by the tool regarding the likelihood of various investment outcomes are hypothetical in nature do not reflect actual investment results and are not guarantees of future results. Results may vary with each use and over time. Begin Here _08_bro_Workbook_TEM.indd 1

2 Your Workbook Checklist Before you begin collect and organize the following personal financial information: List of other investments held outside Fidelity that you plan to use to fund your retirement Statements for other sources of income (e.g. annuity income rental income) Actual or estimated Social Security payments in retirement Actual or estimated pension payments in retirement Bank statements List of monthly bills and other anticipated expenses Please use a black pen and print clearly in CAPITAL LETTERS. Information that is required to create your plan is noted by an asterisk ( * ). Estimate your anticipated expenses for retirement in Section 2. The Household Budget Worksheet in the Appendix is optional but can help to determine your anticipated expenses in retirement (Section 2) in detail. Take advantage of this workbook by completing and returning all pages including Sections 1 through 4. Need assistance? Call us at if you need help completing your workbook. Note: Any information that may have been previously entered into Fidelity online tools such as Retirement Income Planner will be replaced with the information from this workbook _08_bro_Workbook_TEM.indd 2

3 fold at perforation and Detach The information you provide on these pages will be entered into Fidelity s online Retirement Income Planner tool. Your Fidelity Workplace Planning and Guidance Consultant will refer to it as you work together to develop your unique plan. 1. PLEASE TELL US ABOUT YOU In order for us to formulate a focused customized plan that can help you fulfill your retirement vision please provide us with an understanding of who you are. Please use a black pen and print clearly in CAPITAL LETTERS. Personal Information* First Name: Last Name: Street Address: City: ZIP: Sex: Male Female Date of Birth: M M D D Y Y Y Y Phone: Already Retired? Yes No If not already retired planning to retire at age: Spouse/Partner State: Include a spouse or partner in your plan? Yes No Sex: Male Female Spouse/Partner s First Name: Last Name: Date of Birth: M M D D Y Y Y Y Already Retired? Yes No If not already retired planning to retire at age: *Information required to complete the Retirement Income Planner. Required only if your spouse or partner is included in your plan. The tool assumes that you and the spouse/planning partner can file a federal tax return as Married Filing Jointly. It also assumes that you and the spouse/planning partner qualify for certain Social Security benefits transfer-tax marital deductions and other benefits to which only individuals qualifying as spouses under federal tax or other law may be entitled. You should consider planning separately if you do not qualify for these benefits. For Fidelity Internal Use Only. Consultant ID Customer ID _08_bro_Workbook_TEM.indd 1

4 2. determine Your anticipated expenses Please provide an estimate of your total monthly essential expenses (need to have) and discretionary expenses (nice to have). Provided in the Appendix is a detailed Household Budget Worksheet which may help you calculate these expenses. The details from the worksheet could help determine your expenses with more accuracy. Monthly Expenses Total Essential Expenses:* Total Discretionary Expenses:* Total Monthly Expenses: Insurance Which of the following types of insurance do you have? (Check all that apply.) Medigap and other supplemental health care insurance Long Term Care Insurance 3. Identify Your Retirement Income Please identify all income sources available to help fund your retirement. This includes lifetime income such as Social Security pensions and income annuities as well as potential part-time sources such as temporary work or rental income. Current Income from Work (This section applies if you and/or your spouse are currently working.) TIP All income should be entered before taxes (or gross amount). Most Recent Monthly Salary (include bonuses and commissions): You: per month Annual salary increase: % Anticipate number of years you will be working: Spouse/Partner: per month Annual salary increase: % Anticipate number of years you will be working: *Information required to complete the Retirement Income Planner _08_bro_Workbook_TEM.indd 2

5 fold at perforation and Detach 3. identify your retirement income (continued) Federal Tax Filing Status* Single Married Filing Jointly Qualified Widow/Widower/Dependent Child Head of Household Married Filing Separately State of residence for income taxes: 2 Local income tax rate if any: % Work in Retirement (part-time jobs or other work income before taxes) You: Spouse/Partner: Lifetime Income Social Security You: Spouse/Partner: TIP Pension Income per month From age: To age: per month From age: To age: per month per month Beginning at age: Beginning at age: To help determine your Social Security benefits please contact the Social Security Administration at or You: per month Is there a Cost of Living Adjustment with pension? Yes No Beginning at age: Spouse/Partner: per month Beginning at age: Is there a Cost of Living Adjustment with pension? Yes No Annuity Income You: per month Beginning at age: Spouse/Partner: per month Beginning at age: *Information required to complete the Retirement Income Planner. Tax information you provide here will be used by Fidelity s Retirement Income Planner tool to estimate certain taxes associated with your income and distribution needs during retirement as calculated by the tool. For purposes of this income plan pensions are assumed to be tax deferred and distributions are therefore taxed as ordinary income. Please consult your tax advisor if you have any questions regarding the taxability of your pension benefit. If your pension is from an employer that recordkeeps with Fidelity please do not enter it as it should automatically be fed into the tool _08_bro_Workbook_TEM.indd 3

6 3. identify your retirement income (continued) Other Income (rental income royalties other types of income annuities or other support) You: per month To age: Spouse/Partner: per month To age: 4. Review Your Available Assets and assess your risk tolerance The next step in the process is to list the assets and accounts not held at Fidelity that you will use to fund your retirement. We will use this to match your savings to your expenses and suggest the most efficient ways to help you fund your desired retirement. Non-Fidelity Accounts Note: Please include your latest statements from accounts not held with Fidelity when returning this workbook. The accounts you list below should not include your Fidelity accounts. Tax-Advantaged Retirement Accounts Employer-Sponsored Retirement Savings [401(k)s 403(b)s] Traditional IRAs Rollover IRAs Roth IRAs Owner Y = You 1. Institution S = Spouse Current Value Annual Contribution Stocks Bonds Short-Term Other 2. Institution 3. Institution 4. Institution 5. Institution _08_bro_Workbook_TEM.indd 4

7 fold at perforation and Detach 4. Review Your Available Assets (continued) Tax-Advantaged Retirement Accounts (cont.) Employer-Sponsored Retirement Savings [401(k)s 403(b)s] Traditional IRAs Rollover IRAs Roth IRAs Owner Y = You 6. Institution S = Spouse Current Value Annual Contribution 7. Institution 8. Institution Tax-Deferred Annuities Fixed and Variable Stocks Bonds Short-Term Other Owner Y = You S = Spouse 1. Institution J = Joint Current Value Annual Contribution 2. Institution Stocks Bonds Short-Term Other 3. Institution _08_bro_Workbook_TEM.indd 5

8 4. Review Your Available Assets (continued) Taxable Accounts Taxable Mutual Funds and Individual Securities Owner Y = You S = Spouse 1. Institution J = Joint Current Value Annual Contribution Stocks Bonds Short-Term Other 2. Institution 3. Institution 4. Institution Taxable Accounts Savings Accounts Checking Accounts CDs 1. Institution Current Value Annual Contribution 2. Institution 3. Institution _08_bro_Workbook_TEM.indd 6

9 fold at perforation and Detach 4. Review Your Available Assets (continued) Financial Holdings/Events Complete this section only if you intend to use these assets to fund your retirement. The assets will be added to your investments based on the expected distribution age you provide. Expected distribution Type of Asset Amount at Age Life Insurance Not Including Annuities (cash value) Inheritance Primary Residence Sale of Business Employee Stock Options Other Other The entry of items such as the sale of a home does not apply any tax exclusions that may be applicable _08_bro_Workbook_TEM.indd 7

10 Assessing Your Risk Tolerance* Before we can suggest a planning strategy for you to consider we need to understand how much investment risk you can comfortably assume. Most investments fluctuate over the short term. If the investment you made kept pace with the world financial markets but still lost value during the first year what would you be likely to do with your assets in that investment? Sell less than 25% of investments in my account. Sell 25% to 50% of investments in my account. Sell 50% to 75% of investments in my account. Sell more than 75% of investments in my account. Based on your tolerance for fluctuations in the market as well as your overall investment goals how comfortable are you with risk in your portfolio? More Risk Risk is not a concern Comfortable with higher-risk investments 10 is associated with a very aggressive investor who is comfortable investing primarily in individual stocks or sector funds. 7 6 Somewhat comfortable with risk 7 is associated with a growth investor who prefers a more diversified portfolio weighted more toward stock investments but also with some fixed income investments. 5 4 Prefer moderate risk 4 is associated with a more conservative investor who is comfortable with a more balanced portfolio approach with the majority of the portfolio in fixed income investments. Less Risk Comfortable with mostly lower-risk investments Prefer lower-risk investments 1 is associated with a very conservative investor who prefers the stability of fixed income investments and wants to minimize equity risk in his or her portfolio. Rate Your Investment Knowledge Novice Expert *Information required to complete the Retirement Income Planner _08_bro_Workbook_TEM.indd 8

11 fold at perforation and Detach appendix household budget worksheet (Optional if Section 2 is completed) To give us a clear understanding of your anticipated retirement expenses please use this Household Budget Worksheet to provide estimates of essential expenses the things you need to live (mortgage/rent food utilities) and discretionary expenses the things you d like to have (vacations hobbies). Retirement Living Expenses (Monthly) Check if Essential Housing Monthly expense Homeowner s Insurance Household Improvement and Maintenance Mortgage Property Tax Rent/Condo Fees Other Utilities Electric Oil/Gas Telephone/Cable/Internet Fees Water/Sewer Other Estimate Number of Years for Expense. Leave Blank if Ongoing. Subtotal Housing and Utilities Check if Essential Personal Monthly expense Estimate Number of Years for Expense. Leave Blank if Ongoing. Clothing Groceries Laundry/Dry Cleaning Personal Care (such as health and beauty aids) Other Subtotal Personal _08_bro_Workbook_TEM.indd 9

12 household budget worksheet (continued) What Are the Estimated Expenses for Health Care Coverage? For the average person age 65 we estimated monthly health care expenses to be 673. This figure is based on the breakdown of expenses listed below. Please note that you may select other Medigap levels of coverage which may increase or decrease the monthly expenses listed here. For more information about Medicare visit Medicare A premium* 0 Medicare A deductible 27 Medicare A co-pay 6 Medicare A skilled care 9 Medicare B premium 96 Medicare B deductible 8 *There is usually no cost for Medicare A premium if you qualify. This breakdown of health care expenses was estimated using Fidelity s Health Care Cost Calculator. Health Care and Insurance Medicare B co-pay 96 Other/miscellaneous 34 Dental/vision/hearing 45 Medigap 244 Prescriptions 108 Total per month 673 Are you currently insured through an employer? Yes No Monthly Check if Essential Expense Estimate Number of Years for Expense. Leave Blank if Ongoing. Dental Vision and Hearing Care Medical Medicare Premiums and Expenses Medicare Supplemental/Medigap Premiums Other (such as co-payments deductibles prescriptions etc.) Long Term Care Insurance Premiums Disability Insurance Life Insurance Premiums Subtotal Health Care and Insurance Check if Essential Family Care Monthly expense Estimate Number of Years for Expense. Leave Blank if Ongoing. Support for Parent(s) Support for Children or Grandchildren Other Obligations Subtotal Family Care Costs of health care can increase dramatically during retirement. In 2013 an Key average 65-year-old should have planned for at least 673 per month 1 in Risk health care expenses _08_bro_Workbook_TEM.indd 10

13 fold at perforation and Detach household budget worksheet (continued) Check if Essential Routine Transportation Monthly expense Auto Loan or Lease Payment Do you expect to keep the same car and not Yes No have a payment? Excise Tax/Registration Fees Gasoline Insurance Routine Maintenance Other Commuting Expenses Subtotal Routine Transportation Check if Essential Recreation Monthly Expense Club Memberships Hobbies Travel and Vacation Estimate Number of Years for Expense. Leave Blank if Ongoing. Estimate Number of Years for Expense. Leave Blank if Ongoing. Subtotal Recreation Check if Essential Entertainment Monthly expense Dining Out Movies/Theater/Sporting Events Estimate Number of Years for Expense. Leave Blank if Ongoing. Subtotal Entertainment _08_bro_Workbook_TEM.indd 11

14 household budget worksheet (continued) Check if Essential Other Monthly expense Estimate Number of Years for Expense. Leave Blank if Ongoing. Charitable Donations (tax-deductible) Gifts (non-tax-deductible) (such as birthdays holidays etc. and any gifts that you foresee giving on an annual basis) Other (such as credit card charges) Subtotal Other Total Essential Expenses: Total Discretionary Expenses: Total Monthly Expenses: Please input these totals in Section 2. Retirement Income Planner is an educational tool. If any of the expenses you list have an end date that is prior to the end of your plan please be sure to indicate that information to the Fidelity Workplace Planning and Guidance Consultant you work with or go online to the retirement planning tools and edit the appropriate information indicating any fluctuation for the expenses you indicated. Note: Retirement Income Planner makes different tax assumptions for the various types of accounts/assets entered. More detailed information regarding these assumptions can be found within the online version of this tool under Methodology or can be provided by the Fidelity Workplace Planning and Guidance Consultant who contacts you. Please consult your tax advisor if you have any questions regarding the taxability of your assets. 1 Estimate based on an aggregation of internal and external sources including Kaiser Family Foundation The Commonwealth Fund and Medicare for retired individuals at age 65 in Fidelity Brokerage Services LLC Member NYSE SIPC 900 Salem Street Smithfield RI _08_bro_Workbook_TEM.indd 12

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Retirement Income Planning Worksheet

Retirement Income Planning Worksheet Build Preparations for Your Retirement A Straightforward Resource to Help Gather the Data You Need Use this simple worksheet to get started on your retirement income