Financial Priorities Worksheet

Transcription

1 Financial Priorities Worksheet Representative name Account number Personal Information name Date of birth (mm/dd/yyyy) name Date of birth (mm/dd/yyyy) Employment employment status Full time Part time Self-employed Retired Homemaker Unemployed Student employment status Full time Part time Self-employed Retired Homemaker Unemployed Student Annual Income Earned income (client) Investment income (client) Other income (client) Earned income (spouse/partner) Investment income (spouse/partner) Other income (spouse/partner) Assets Cash Investment Accounts Please list any taxable investment accounts you have set aside for retirement. 1 Original value (usually the purchase price) used for tax purposes. Financial Priorities Worksheet Page 1 of 5

2 Business and Real Estate Assets (your share) Available for retirement? (your share) Available for retirement? (your share) Available for retirement? Personal Assets Do you own stock options in a public company? Retirement Accounts These accounts include IRAs, employer plans such as 401(k)s or 403(b)s, and small-business plans. 1 Original value (usually the purchase price) used for tax purposes. Financial Priorities Worksheet Page 2 of 5

3 Current Debts Loan description Type of Loan 2 Balance Payment amount Payment frequency 3 Interest rate Tax deductible? % % % % Protection Coverage How important is it for you to provide financial resources for loved ones after your death? Do you have a plan (work or individual) that provides continuing income if you are unable to work because of accident or illness? What percentage of your income will be replaced by this plan? % % How many years of coverage does the plan provide? How long could you live on your current assets if you were disabled or had a prolonged illness? 5 years 10 years To age 65 or 70 < 8 weeks 2 6 months 6 12 months > 1 year 5 years 10 years To age 65 or 70 < 8 weeks 2 6 months 6 12 months > 1 year How important is it for you to replace your earned income if you become disabled or have a prolonged illness? Have you made financial preparations for the possible costs of a long retirement, such as long-term care? 2 Primary residence, Home equity, Real estate, Business, Investment/Margin, Consumer, Automobile, Other. 3 Semi-monthly, monthly, quarterly, annual. Financial Priorities Worksheet Page 3 of 5

4 Protection Coverage (continued) Do you have a parent who could become your financial dependent? How important is it to fund long-term care for you or your loved ones? Financial Concerns When did you last review your will? How important is it for you to reduce debt? How important is it for you to consolidate debt? How important is it for you to accumulate funds for future goals other than retirement and education? How important is it for you to get assistance with reviewing your IRA choices? How important is it for you to get assistance with moving retirement funds from a previous employer? How important is it for you to get assistance with understanding your stock options? How important is it for you to get assistance with reviewing your investments? will will < 3 years < 3 years 3 7 years 3 7 years > 7 years > 7 years Retirement Preparation At what age do you plan to retire? How important is it for you to have a comfortable retirement? About what percentage of your combined after-tax income do you think you ll need after retirement? % How much impact do you think inflation will have on your retirement? Major Some Minimal t sure If you are employed, does your employer provide a defined benefit pension plan, in which you receive a specific monthly payment? Education Planning How important is it for you to help fund the education of your children, grandchildren or others? What percentage of these education needs do you want to fund? More than 66% Between 33% and 66% Less than 33% Do you feel you are adequately funding these educational needs? t sure Financial Priorities Worksheet Page 4 of 5

5 Life Events Do you anticipate any of the following life events in the next 12 months? Change of employment Start of a new business Birth of a child or grandchild Dependent starting college or graduate school Retirement Property and Casualty Insurance How important is it for you to protect your income and assets in the event of a disaster, theft, or accident? What is the amount of your umbrella coverage (extra liability insurance in addition to standard insurance amounts)? Don t have umbrella 2 million + 500,000 1 million Unsure 1 million 2 million Homeowner or Renter Do you own or rent? Own Rent What is the liability coverage of your homeowner s/renter s insurance? What is the deductible of your homeowner s/renter s insurance? Do you have coverage for the high-value objects you own? State minimum 300,000 50, , ,000 1 million , t sure Auto Do you own or lease a vehicle? What is the liability coverage of your auto insurance? (If you have more than one vehicle, give the lowest coverage amount.) What is the collision deductible of your auto insurance? (If you have more than one vehicle, give the lowest deductible.) State minimum 100,000/300,000 20,000/40, ,000/500,000 50,000/100,000 1 million , t applicable tes 2011 Charles Schwab & Co., Inc. All rights reserved. Member SIPC. CS ( ) SLS (12/11) MPCCT Financial Priorities Worksheet Page 5 of 5

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