Wealth Planning Fact Finder Date: Information First Name Last Name Date of Birth Gender Retirement Age Marital Status Marital Date Citizenship Address Province Phone Number Will (Yes/No) Date of Last Will Power of Attorney (Yes/No) Employmnet Status Business Address Occupation Company Family Members Dependant 1 Dependant 2 Dependant 3 Dependant 4 Relationship First Name Last Name Date of Birth Retirement Age Citizenship Residency Tax Free Savings Account (TFSA) Historical Data As of end or previous year. TFSA Overcontribution Balance Unused TFSA Contribution Room Net income for RESP Prior year. To determine Learning Bond availability. RESP Subscribers net income last year (line 236 of tax return) RESP Historical Data As of end of previous Prior year. Child 1 Child 2 Child 3 Total RESP Contributions from All Subscribers CESG eligibility carry forward Total CESG Payment Received RRSP Historical Data Refer to CRA Notice of Assessment. Prior Year s Pension Prior Year s Earned Income Adjustment RRSP Overcontribution Balance Unused RRSP Deduction Limit (not RRSP room)
Lifestyle Assets e.g., residence, cottage, personal use property,personal listed property, etc. Description Market Value Purchase /Adjusted Cost Base (ACB) Liabilities Accounts Accounts Description Account Type Owner Market Value Cost Base Rate of Return Pre-Retirement Retirement Savings / % of salary Goal (Retirement, Major Purchase, Education) Description Balance Interest Rate Morgage Line of Credit Personal Loans Debt Payment / Payment Type (principal & interest, interest only etc.) Account 1 Account 2 Account 3 Account 4 Account 5 Account 6 Account 7 Account 8 Description Account Type Owner Market Value Cost Base Rate of Return Pre-Retirement Retirement Savings / % of salary Goal (Retirement, Major Purchase, Education) Account 9 Account 10 Account 11 Account 12 Account 13 Account 14 Account 15 Account 16
Current Expenses Exclude savings, liability payments, insurance (life and disability premiums only) and income tax. Description Index % Start End Incomes Pre-tax. (use net rental income as needed) Description Type Start End Defined Benefit Pensions Indicate indexing rate if applicable. If still contributing, provide copy of most recent pension plan statement. CPP/QPP & OAS Retirees current monthly Pre-tax income from: Type Member Retiree s current monthly benefit Estimate Annual (today s $) Type CPP/ QPP Pension 1 OAS Pension 1 If not yet retired, have you contributed to CPP/QPP most of your adult life? What will your CPP/QPP retirement benefit be at age 65? Are you considering taking your CPP earlier or later than age 65? Service Canada 1-800-277-9914 Notes/Assumptions (i.e., Pension Bridge Benefits, CPP Benefit Start Age, etc ). Insurance Life Insurance Description Policy Type Expiry Date Payor Insured Beneficiary Death Benefits Premium Cease Date Cash Surrender Value Insurance 1 Insurance 2 Insurance 3 Insurance 4
Insurance cont. Critical Illness Insurance Insurance 1 Insurance 2 Disability Insurance Policy Type Payor Insured Waiting Benefits Maximum Benefit Benefit Premium Cease Date Long-term Disability Short-term Disability Policy Type Insured Owner Benefit Benefit Taxable % Benefit Premiums Payer Cease at age/cease on Date Index Premium Refund % Financial Goals Retirement Expense Exclude life insurance premiums, liability payments, savings strategies, and income tax. Description Member Start Year End Year Index % Retirement Income Exclude Investment income, CPP/QPP, OAS and company pensions already stated. Description Income Member Start Year End Year Education Are specific assets reserved for this goal? If so, please specify. Description Child s Name Start Year Annual Cost Index % # years to pay Major purchase Are specific assets reserved for this goal? If so, please specify. Description Member Target Date Index %
Personal Holding Company Corporation Details Corporation Name Province of Incorporation Province of Taxation Corporate year end Unanimous Shareholders Agreement (USA) Consider the estate implications if only one director/officer. Does one exist (if yes: date signed) List signatories Buy/sell provisions (shot gun?) Payment terms key provisions (attach list) Tax Account Values Retained earnings per financial statements RDTOH CDA No capital loss cfwd Capital loss carry over Value at end of previous year Outstanding shareholder loans to the company Current loan Balance Estate Details Note # 1 You should consider preparing a separate worksheet for each company in the group. Share options at first death Share options at second death/or death in a same year Estate Freeze date & notes Family Trust Settlor Trustee(s) Date settled Nature of the trust (Intervivos, testamentary) Beneficiaries interest (fixed, discretionary) Capital Beneficiaries Income beneficiaries Beneficiaries locations (attach list) Listing of assets owned and details Legal and tax advisors
Personal Holding Company cont. Corporation Details Family Trust Total Common Shares # of shares Estimated Fair value PUC ACB Date issued Family Trust Preferred Shares # of shares Estimated Fair value PUC ACB Date issued Corporation Details Investment Acct (1) Investment Acct (2) Real Estate Equipment IPP RCA Subsidiaries Note #1 Subsidiaries s Current Value Cost Base Growth Rate Contributions (INTER-COMPANY dividend) Withdrawals (Manual dividends) Purpose Insured (Y/N) Policy Type Benefit Beneficiary Premium
Will and Estate Advisor / Personal Representatives Provide name/address/phone for the following advisors/personal representatives. Power of Attorney for Property Personal Care Power of Attorney / Mandate / Representation Agreement Accountant Lawyer/Notary Broker/Portfolio Manager Life Insurance Agent Executor You Your / Partner Power of Attorney Is the Power of Attorney enduring? No Yes If more than one attorney must they act together No Yes Have you had any estate planning advice from lawyers or accountants that should be considered? No Yes Safety Deposit Boxes Sole Joint Box. No: Location address Powers of Appointment Do you hold a Power of Appointment over any assets? No Yes (if yes, please provide details) Interest in other Estate and Trusts If you are a beneficiary of an existing estate or trust, please provide details. Assets Held for s Do you have assets registered in your name which are held on behalf of others? (e.g. assets held by you as a trustee or asset held under a Power of Attorney.) No Yes (if yes, please provide details) Detailed Asset Information (i) Are there any U.S. securities owned directly? No Yes If yes, what is the value of those securities? $ (ii) Are there any other foreign securities held directly? No Yes If yes, what is the value of those securities? $ what is the value of those securities? $ In what country are they situated? Additional Personal Information Are you or have you ever been a US citizen? No Yes SIN Have you renounced the family Patrimony? (Quebec only) Ever Divorced? If divorced, any continuing financial obligations? Ancillary services such as insurance and risk planning are provided by affiliated companies such as National Bank Insurance Firm Inc. These products are not protected by CIPF. National Bank Financial is an indirect wholly-owned subsidiary of National Bank of Canada which is a public company listed on the Toronto Stock Exchange (NA: TSX). National Bank Financial is a member of the Canadian Investor Protection Fund (CIPF).