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Life Insurance Policy Review Fact Finder CLIENT NAME: ADVISOR: Approved for consumer use and for use with the general public. This resource is provided to you by AimcoR Group, LLC Information in this report should not be used in any actual transaction without the advice and guidance of a professional Financial Advisor. In some instances a Tax Advisor and/or Attorney should also be contacted for counsel. Although the information contained here is presented in good faith, it is General in nature may require additional consideration of other matters. This report is for informational purposes only. AimcoR Group, LLC is not an insurer and does not issue contracts for coverage. All rights reserved. AimcoR Group, LLC is a national marketing organization. Our affiliate agencies are member Brokerage General Agencies and AimcoR Group, LLC is not liable for any agreements or contracts between our affiliate member organizations and the financial professionals they serve.

WHAT IS A POLICY REVIEW? A Policy Review is an opportunity for you to review your existing life insurance policies against your current needs and objectives. It involves a thorough evaluation of your current life insurance policies, your current life insurance and planning needs, and your health. Why is it important for you to have your life insurance policies reviewed? Because your life insurance needs are dynamic and the economic value of your life changes over time. Revisiting financial objectives at different life stages ensures that your coverage always reflects your current priorities. OBJECTIVE The ultimate goal of Policy Review is to ensure that your life insurance policy is: Protecting your beneficiaries in the way that you intended Performing appropriately to meet your planning objectives Accomplishing your goals at the best price available to you LIFE EVENTS THAT MAY AFFECT YOUR INSURANCE NEEDS Marriage/Wedding Divorce Birth/Adoption Graduation Move/Relocate/Sell your house Home refinancing/pay off mortgage Taking an equity line of credit Job Change Financial Status Change (i.e. inheritance) Retirement Death in family Critical illness/injury/disability Enter a nursing home Start your own business Sell or close your business Win/lose a lawsuit CURRENT INSURANCE COVERAGE POLICY #1 Insurance Company Policy Type Death Benefit $ $ Policy Issue Date Death Benefit Option Underwriting Class * Policy Number (If available) POLICY #2 (if applicable) PREMIUM INFORMATION Current Premium $ $ Premium Mode Current Cash Value $ $ Paid to Date Payments Ending

Policy #1 Important Information Regarding Insured(s), Goals and Objectives: 1. What is the main objective client(s) is/are looking to accomplish with a new policy if recommendation to replace is suitable? (check all that apply) Lower Premium Higher Death Benefit Access to Benefits While Living Death Benefit Guarantees Cash Value Accumulation Income/Distributions Other: 2. Has the client s health changed since purchasing the current policy? If yes, please provide any details: Ownership Information: What is the current ownership structure of the policy? Insured / Owners are the Same Policy is Owned by a Corporation Policy is Owned by Another Individual Policy is Owned by a Trust If policy is owned by an individual or entity other than the primary insured(s) please provide ownership details below: Individual Owner(s) Trust / Entity Owner: Name of Trust / Entity: Trust Date: Tax ID: Beneficiary Information: Please provide beneficiary information for the current policy: (attach additional page if needed) Primary Contingent In the space below, please explain the initial objective of the policy. For example, the objective was to build enough cash value for us to be able to take $50,000 per year in policy loans to supplement our retirement income beginning at age 70 and provide adequate insurance protection in the meantime. Or, the objective was to provide pay for estate taxes and leave an inheritance to our children. Please include a copy of the most current annual statement when submitting this information

Policy # 2 Important Information Regarding Insured(s), Goals and Objectives: 1. What is the main objective client(s) is/are looking to accomplish with a new policy if recommendation to replace is suitable? (check all that apply) Lower Premium Higher Death Benefit Access to Benefits While Living Death Benefit Guarantees Cash Value Accumulation Income/Distributions Other: 2. Has the client s health changed since purchasing the current policy? If yes, please provide any details: Ownership Information: What is the current ownership structure of the policy? Insured / Owners are the Same Policy is Owned by a Corporation Policy is Owned by Another Individual Policy is Owned by a Trust If policy is owned by an individual or entity other than the primary insured(s) please provide ownership details below: Individual Owner(s) Trust / Entity Owner: Name of Trust / Entity: Trust Date: Tax ID: Beneficiary Information: Please provide beneficiary information for the current policy: (attach additional pages if needed) Primary Contingent In the space below, please explain the initial objective of the policy. For example, the objective was to build enough cash value for us to be able to take $50,000 per year in policy loans to supplement our retirement income beginning at age 70 and provide adequate insurance protection in the meantime. Or, the objective was to provide pay for estate taxes and leave an inheritance to our children. Please include a copy of the most current annual statement when submitting this information

This worksheet can help you get a general sense of how much life insurance you need to protect your family. This worksheet assumes you died today. Income 1. Total annual income your family would need if you died today What your family needs, before taxes, to maintain its current standard of living (Typically between 60% - 75% of total income) 2. Annual income your family would receive from other sources For example, spouse s earnings or a fixed pension.1 (Do not include income earned on your assets, as it is addressed later in the calculation) 3. Income to be replaced - Subtract line 2 from line 1 Table A Years Income Needed Factor 10 8.8 15 12.4 20 15.4 25 18.1 30 20.4 4. Capital needed for income Multiply line 3 by appropriate factor in Table A. Factor. 35 22.4 40 24.1 Expenses Table B 5. Funeral and other final expenses Typically, the greater of $15,000 or 4% of your estate) Years Before College Factor 6. Mortgage and other outstanding debts Include mortgage balance, credit card balance, car loans, etc. 7. Capital needed for college (2016-2017: average 4-year cost: Private $197,280; Public $98,440 collegedata.com) Estimated Appropriate Factor NPV 4-Year Cost in Table B Child 1 X = Child 2 X = Child 3 X = 5.87 10.75 15.65 20.55 8. Total capital required Add items 4, 5, 6 and 7 Savings / Assets 9. Savings and investments Bank accounts, money market accounts, CDs, stocks, bonds, mutual funds, annuities, etc. 10. Retirement savings IRAs, 401(k)s, SEP plans, SIMPLE IRA plans, Keoghs, pension and profit sharing plans Note: These tables help you determine Net Present Value (NPV), the amount of capital required today to satisfy future income or college cost needs, given an assumed investment return of 6%, inflation of 3% for living costs and 5% for college costs. 11. Present amount of life insurance Including group insurance as well as insurance purchased on your own 12. Total income producing assets Add lines 9, 10 and 11 13. Life insurance needed Subtract line 12 from line 8

Client Information Attach additional pages as needed. Client / Insured #1 Name: Date of Birth: State of Residence: Gender: Male Female Nicotine Use: Current Past N/A If nicotine use is current indicate type used and frequency, if past indicate type used and last date of use: Height: Weight: Weight change in last 12 months?: Are you currently or have you ever in the past been treated for any of the following?: Blood Pressure Cholesterol Diabetes Heart Disease Cancer Stroke/TIA If yes, please provide details including when diagnosed, date and type of treatment, etc. Has any member of your family (siblings and/or parents) been treated for OR died from Cancer, Heart Disease (including heart attack), or stroke prior to age 60? If so: Does the client have any other health conditions, participate in hazardous activities or participate in international travel? If Yes, provide details below: Client / Insured #2 Name (if applicable): Date of Birth: State of Residence: Gender: Male Female Nicotine Use: Current Past N/A If nicotine use is current indicate type used and frequency, if past indicate type used and last date of use: Height: Weight: Weight change in last 12 months?: Are you currently or have you ever in the past been treated for any of the following?: Blood Pressure Cholesterol Diabetes Heart Disease Cancer Stroke/TIA If yes, please provide details including when diagnosed, date and type of treatment, etc. Has any member of your family (siblings and/or parents) been treated for OR died from Cancer, Heart Disease (including heart attack), or stroke prior to age 60? If so: Does the client have any other health conditions, participate in hazardous activities or participate in international travel? If Yes, provide details below: