Financial Fact Finder

Transcription

1 Financial Services offered through Mid Atlantic Financial Management, Inc. Stein Wealth Advisors, LLC Lake View Square 4000 Washington Rd., Ste. 101 McMurray, PA Phone: Fax: Please bring the following to each meeting: Pension estimate or projection statement Employer retirement statements (401(k), 403(b), 457 plan, etc. Please include all investment options available) Social Security statement Stock option statement Deferred compensation statement Form 1040 of last year s tax return Monthly budget Current paystubs Education account statements (529 plans, custodial accounts, UGMA/UTMA accounts) Personal brokerage account statements (IRA, Roth IRA, Annuity or any miscellaneous investment statements) Bank account statements: checking, savings, money market, certificate of deposit Liability statements: mortgage, credit cards, car loans, student loans, any debt statements Updated life insurance statement and original policy Disability insurance statements and original policy Long Term Care statements and original policy Will(s), trusts & other estate planning documents Employee Benefit Handbook(s) Questions for your advisor Securities offered through Mid Atlantic Capital Corporation (MACC), member FINRA/SIPC. Advisory services offered through Mid Atlantic Financial Management, Inc. (MAFM), a registered investment adviser. Trust services offered through Mid Atlantic Trust Company (MATC), a non-depository trust company. Stein Wealth Advisors, LLC is not a registered entity or a subsidiary or control affiliate of MACC, MAFM or MATC. PAGE 1

2 What Keeps You Up At Night? Please take a minute to review the topics and related questions below. Check off any concerns you have right now. Retirement Will my money last through retirement? Do I need long-term care insurance? What are my retirement investment options? How do I manage all my retirement plans? What should I do with my employer retirement plan? Since I am retiring soon, what do I need to do now? Should I retire to a different state? When should I take Social Security? How much will healthcare cost? Education Planning How much should I save for college? When should I start planning? Will I qualify for financial aid? Where do I start? What are my college savings options? Estate Planning What should I know about estate planning? How do I protect my estate from taxes? Will my family be secure if something happens to me? How do I create a legacy for my children? Can I provide for my favorite charity when I am gone? What will my survivors need to know? Financial Basics How do I keep my records safe and organized? How do I do a better job budgeting? How do I reduce my debt? How do I teach my children about money? How do I help a young adult establish a financial strategy? How do I have financial discussions with family? Life Events Comments How do we manage our finances after getting married? What happens to my 401(k) when I change jobs? What are my options if I am laid off? I am getting divorced. What happens to my assets? How do I help my recent college grad transition into the workforce? What do I do when a loved one dies? Eldercare How does Medicare work? What should I look for in a nursing home? How do I cope with Alzheimer s disease? What happens if I have to care for my parents? PAGE 2

3 Personal Data Please complete both columns, unless you are single, widowed, or divorced. Client A - Personal Information Client B - Personal Information First Name Middle Last First Name Middle Last Nickname Date of Birth Nickname Date of Birth Social Security Number Male Female Social Security Number Male Female Citizenship U.S. Citizen Resident Alien n-resident Alien Citizenship U.S. Citizen Resident Alien n-resident Alien Birth State Mother s Maiden Name Birth State Mother s Maiden Name Driver s License Number State Driver s License Number State Issue Date Expiration date Issue Date Expiration date Home Street Address Same Address as Client A City State Zip Code If different please fill out: Home Street Address Personal City State Zip Code Home Telephone Cell Phone Marital Status: Single Married Domestic Partner Widowed Divorced Personal Anniversary Date (if married): Home Telephone Cell Phone Client A - Employment Information Client B - Employment Information Job Title Employer Job Title Employer Employer Street Address Employer Street Address City State Zip Code City State Zip Code Work Work Work Telephone Work Cell Work Telephone Work Cell PAGE 3

4 Dependent Personal Data Do you plan on having additional children? Are there any immediate or long term financial obligations for supporting parents or dependents? If yes, please explain (ie: special needs, etc.) Interview Questions Have you worked with a financial professional in the past? If yes, please provide their name: How was the experience? What are your expectations from us? What fears or potential pitfalls would you like to avoid? Who prepares your tax forms? Are you obligated to do business with anyone else? PAGE 4

5 General Questions Affiliations Are you (or a member of your immediate family) a director, 10 shareholder or policymaking officer of a publicly traded company? If yes, Company Name: Are you (or a member of your immediate family) a registered representative of a broker-dealer? If yes, specify Firm Name: Are you (or a member of your immediate family) employed by or otherwise affiliated with FINRA or any broker-dealer? If yes, specify Firm Name: Are you (or a member of your immediate family) a politically exposed person in non-u.s. country? If yes, specify: Education Objectives Instructions: Please use the section below to estimate the amount of education expenses you may want to fund for your children. The average annual cost of all schools in the United States is approximately $32,000 (Including room, board & tuition) as of School costs can vary dramatically so it is important to identify the type of school as well as the amount of education you want to fund (i.e. 100 vs 50). Child 1 Child 2 Child 3 Child 4 Name of Child Name of Child Name of Child Name of Child University, College or School of Choice University, College or School of Choice University, College or School of Choice University, College or School of Choice Expected Annual Tuition and Living Expenses Per Year Expected Annual Tuition and Living Expenses Per Year Expected Annual Tuition and Living Expenses Per Year Expected Annual Tuition and Living Expenses Per Year Expected Year to Enter College Expected Year to Enter College Expected Year to Enter College Expected Year to Enter College Number of Years of Educaton: Number of Years of Educaton: Number of Years of Educaton: Number of Years of Educaton: Undergraduate Undergraduate Undergraduate Undergraduate Graduate Graduate Graduate Graduate Do you plan to send your child(ren) to private school before college? Do you plan to send your child(ren) to private school before college? Do you plan to send your child(ren) to private school before college? Do you plan to send your child(ren) to private school before college? If yes, please provide the annual tuition amount? If yes, please provide the annual tuition amount? If yes, please provide the annual tuition amount? If yes, please provide the annual tuition amount? PAGE 5

6 Retirement Objectives Client A Target Retirement Age (what age do you want to retire?) Client B Target Retirement Age (what age do you want to retire?) What are your anticipated annual expenses in retirement? (after tax) What milestones do you see in the future for your Retirement or Financial Independence (i.e., purchase a new home, relocate, remodel the kitchen, travel more, enjoy a comfortable retirement, etc.) Where do you dream of going/do you plan to move out of state in retirement? (Did you know that the 2010 average U.S. vacation cost per day for food and lodging for two people was $244?) How do you want to make a difference to family, community, an organization or friends? Sometimes dreams and goals can include helping others. Think about the people, communities and organizations that matter to you. How do you want to support them now and in the future? Think BIG! PAGE 6

7 Estate Planning Do you have a will and/or a trust? If yes, when was it last updated? Are you expecting to receive money or property from an inheritance, a gift, judgment or lawsuit or other? If yes, please explain: Do you have any children or grandchildren with special needs or for whom you would like to make special provisions? Do you make any charitable donations? If so, to whom? Have you or your spouse been married before? If yes, are there children by a previous marriage? Have you entered into a prenuptial agreement? If yes, please provide a copy. Are both of you U.S. citizens? If no, please specify: Have you and/or your spouse made any gifts to any one individual in a calendar year in excess of $14,000 or $28,000 jointly? If so, please explain and list the years: Income Information Instructions: Please include all current and future income sources including but not limited to: Salary, Estimated Annual Bonuses, Deferred Compensation, Royalties, Social Security, Pensions, Rental Income, Annuity Payments, Business Income, Other Income. Sample: Salary $20,000 Ownership: Details: Income Type Amount (Pretax) 60 Client A Client B Currently Collecting? Does it Inflate? 3 Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? Currently Collecting? Does it Inflate? PAGE 7

8 Asset Information Banking: Checking, Savings, Money Market, CDs Sample: Checking PNC Bank $5,000 $100 Ownership: Investments: 529 Plans, Savings Bonds, 401(k), 403(b), SEP IRA s, 457 Plans, Retirement Saving Plans, Roth IRA s, Traditional/ Rollover IRA s, Annuities, UGMA/UTMA, Stock Options, Restricted Stocks, SAR s, Non-Retirement Investment Accounts, etc. Sample 1: Roth IRA Vanguard $5,000 $50 salary per month) N/A Employer Contributions Ownership: Employer Contributions salary per month) Employer Contributions salary per month) Employer Contributions salary per month) Employer Contributions salary per month) Employer Contributions salary per month) PAGE 8

9 Asset Information (Continued) Real Property: Real Estate, Cars, Jewelry, Boats, etc. Sample: Home Residence $350,000 Asset Type Current Value Asset Type Current Value Asset Type Current Value Asset Type Current Value Asset Type Current Value Asset Type Current Value Liabilities Loans and Liabilities: Mortgage, Home Equity Loan, Car Loan, Student Loan, Credit Cards, etc. Sample 1: Mortgage Wells Fargo $1,547 $ $205,547 Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance Liability Name Institution Name Minimum Monthly Payment Additional Monthly Payment Interest Rate Current Balance PAGE 9

10 Protection Planning Life Insurance Insurance Company Insured s Name Death Benefit Annual Premium Cash Value Term Whole Life Universal Life Insurance Company Insured s Name Death Benefit Annual Premium Cash Value Term Whole Life Universal Life Insurance Company Insured s Name Death Benefit Annual Premium Cash Value Term Whole Life Universal Life Insurance Company Insured s Name Death Benefit Annual Premium Cash Value Term Whole Life Universal Life Insurance Company Insured s Name Death Benefit Annual Premium Cash Value Term Whole Life Universal Life Disability Insurance Long Term Care Insurance PAGE 10

11 Health Status Client A Client B Are you a Smoker? Are you a Smoker? Please rate you overall health status. Excellent Good Fair Poor Please rate you overall health status. Excellent Good Fair Poor Are your parents living? Are your parents living? If not please provide age at time of death. Mother Father Do you take medications? If so, please list. If not please provide age at time of death. Mother Father Do you take medications? If so, please list. Have you had any major surgeries or hospitalizations in the last 15 years? Have you had any major surgeries or hospitalizations in the last 15 years? PAGE 11