FINANCIAL BUDGET *if applicable, after all business expenses
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4 FINANCIAL BUDGET *if applicable, after all business expenses EXPENSES MONTHLY Comment NECESSARY/ DISCRETIONARY Garbage Gas & Electric Home Repairs/Maintenance Home Improvement (not home maintenance) Furniture & Appliance Replacement House Supply Yard Maintenance (also seasonal) Auto Loan(s) Auto Insurance Auto Related Fees (driver s license & registration) Gasoline Auto Maintenance Food & Groceries (not dining out) Apparel (necessary) Apparel (above what s needed) Telephone (primary) Mobile Phone (non-primary) Credit Card #1 Credit Card #2 Student Loans Dry Cleaning Personal Care (hair cut) Childcare (daycare & babysitters) Other Dependent Expenses (back-to-school) Cable or Satellite TV Internet Access Home Security Entertainment (not dining out) Leisure Activity/Hobby (golf, hunting, etc.) Personal/Convenience Luxury (Starbucks) Membership/Fee (Costco) Dining Out Travel & Vacation (guest) Gift (wedding, Christmas) 2
5 FINANCIAL BUDGET *if applicable, after all business expenses EXPENSES MONTHLY COMMENT NECESSARY/ DISCRETIONARY Pets, Pet Care and Pet Food Electronics (also replacement) Gym membership Beer & Alcohol Cigarettes & Tobacco Other Other Expenses TOTAL INCOME TOTAL NECESSARY EXPENSE TOTAL DISCRETIONARY EXPENSE BALANCE FOUNDATION HEALTH INSURANCE Who is covered_ What is deductible Maximum out of pocket Coverage note_ EMERGENCY FUND Balance Where deposited How many times your monthly expense LIFE INSURANCE Coverage amount Term or permanent Begin year Terms end date Cash value DISABILITY INSURANCE Coverage amount Term or permanent Begin year Terms end date Cash value LONG-TERM CARE INSURANCE Coverage amount Term or permanent Begin year Terms end date Cash value UMBRELLA POLICY Coverage amount Term or permanent Begin year Terms end date Cash value FINANCIAL GOAL 3 FINANCIAL GOAL & OBJECTIVE (pick 3 by order of importance): o Aggressive Growth o Retirement Income o Strong Growth o Keeping ahead of inflation o Conservative Growth o Building wealth for heirs o Growth & Income o Capital Preservation (current & future) RETIREMENT HORIZON: o Never o Not for at least 20 years o In 10 to 20 years o In 5 to 10 years o In less than 5 years o Immediately
6 HOLDINGS & LIABILITIES REAL ESTATE MOTGAGE INTENT CURRENT VALUE REMAINING LEASE AMOUNT EXPENSES INVESTMENT PAYMENT(%) Primary Secondary Other real estate holdings Other real estate holdings Other real estate holdings LIQUID INVESTMENT OWNER INTENT CURRENT VALUE RETURN% Cash Bonds and bond mutual funds Stock and stock mutual funds Other liquid asset RETIREMENT OWNER INTENT CURRENT VALUE RETURN% IRA IRA Qualified retirement plan (e.g., 401(K)) Qualified retirement plan (e.g., 401(K)) Annuities Other retirement assets BUSINESS CURRENT VALUE or BALANCE REPLACEMENT VALUE PAYMENT CEASE DATE Business value Equipment Inventory Other asset Other liability OTHER HOLDINGS & LIABILITES CURRENT VALUE or BALANCE INTENT REMAINING PAYMENT (%) Automobile(s) Student loan Credit card Personal debt Other asset Other liability TOTAL ASSETS TOTAL LIABILITIES BALANCE 4
7 ESTATE PLANNING Do you have updated/adequate wills? o Yes o No o Uncertain Have you established any trust? o Yes o No o Uncertain Do you have medical durable attorney? o Yes o No o Uncertain Do you have financial durable attorney? o Yes o No o Uncertain Do you have adequate life insurance? Do you have adequate disability insurance? Do you have adequate long-term care insurance? *refer to FOUNDATION/PROTECTION *refer to FOUNDATION/PROTECTION *refer to FOUNDATION/PROTECTION Will you be receiving a significant inheritance? o Yes o No o Uncertain Have you adequately considered estate tax? o Yes o No o Uncertain Have you provided adequate estate liquidity for your heirs? o Yes o No o Uncertain Is proper titling and beneficiary a concern? o Yes o No o Uncertain Do you have digital asset/estate management in place? *refer to FOUNDATION/PROTECTION 5
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