Washington Wealth Advisors Financial Planning Data Gathering Worksheet

Transcription

1 Washington Wealth Advisors Financial Planning Data Gathering Worksheet Client: Date: Washington Wealth Advisors 300 N. Washington Street, Suite 101 Falls Church, VA (703) phone (703) fax 1

2 QUESTIONNAIRE I would like guidance in the following topics: Topic Yes No N/A Income Tax Planning & Reduction Growth in Assets Debt Reduction & Management Investment Management Investment Performance Evaluation Budget & Spending Estate Tax Planning Estate Planning (Wills, Trust and Propate Avoidance) Employment Agreements Stock Option Agreements Pension and Profit Sharing Plans, 401-K plans Deferred Compensation Agreements Business Buy-Sell Agreements Medical Insurance Life Insurance Disability Insurance Home Owners Insurance Personal Liability Insurance Professional Liability Insurance Automobile Insurance Coverage 2

3 Risk Profile and Assessment Investment Attitude: Very Conservative Conservative Moderate Aggressive Very Aggressive Investment experience: Very Conservative Conservative Moderate Aggressive Very Aggressive Identify your Time Horizon 1. In how many years do you expect to begin withdrawing money from your retirement account? 0-4 years 5-11 years years 20+ years 2. Once you begin taking money from your retirement account, for how many years do you expect the withdrawals to continue? 0-4 years 5-11 years years 20+ years 3

4 CONTACT DETAILS CLIENT Title: Surname: Pref d Name: DOB: Smoker: Yes No Health: Excellent Good Poor Marital Status: CO-CLIENT Title: Surname: Pref d Name: DOB: Smoker: Yes No Health: Excellent Good Poor Marital Status: Address: Home Phone: Client Mobile: Client Tax File No: Home Fax: _ Co-Client Mobile: Co-Client Tax File No: CHILD / DEPENDENT DETAILS DOB: DOB: DOB: DOB: YOUR OTHER ENTITIES Entity Type: Company Trust Self Managed Super Fund Entity Name: ESTATE PLANNING DETAILS CLIENT Current Will: Yes No Last Reviewed: / / Power of Attorney: Yes No CO-CLIENT Current Will: Yes No Last Reviewed: / / Power of Attorney: Yes No 4

5 OTHER ADVISOR DETAILS Do we have your authority to contact other advisors for any additional information necessary for the preparation of your financial plan? Yes No Do you wish any of these advisors to receive a copy of our recommendations? Yes No Accountant Name: Company: Address: Telephone: Attorney Name: Company: Address: Telephone: EMPLOYMENT DETAILS CLIENT Work Status: Occupation: Employer: Work Address: Work Phone: Start Date: Retirement Date: CO- CLIENT Work Status: Occupation: Employer: Work Address: Work Phone: Start Date: Retirement Date: 5

6 Schedule of Assets as of Description and Owner Cost Market Value Schedule of Liabilities as of _ Description and Owner Payment Interest Rate Current Balance 6

7 Schedule of Income as of Income Source and Owner Amount Life Insurance Information as of Insured Type Company Death Benefit Premium Other Insurance Information as of Description Daily Benefit, if Premium Amount Waiting Period, if Monthly Benefit, if Inflation Adjustment, if Benefit Period, if 7

8 Please also forward along the following documents to our office: Latest tax return Recent paystubs Employer benefit information o Pension plan or Retirement plan o Profit sharing plan o Life insurance o Disability insurance-short and Long term o Stock option plans IRA information-recent statements Investment statements-bank or Brokerage, 529 or college saving plans o List, if any, contribution amounts. Monthly or annual List of debts including the monthly payment, interest rate and balance o Mortgage o Home equity loans o Car/credit card Property taxes and insurance Current insurance information: o Life o Health o Disability o Long term care Estimate of monthly expenses 8