Wealth Planning Worksheet

How Did you Hear about us?
Which advisor would you prefer to meet with?
Client Information
Are you interested in*
- Investment Advisory
- Financial Planning
- Both
Investment Advisory: Investment advisors primarily offer advice on investment strategies and may manage investment portfolios on behalf of clients. They often charge fees based on the assets under management (AUM). Financial Planning: Financial planners provide comprehensive financial advice, often through consultations and personalized financial plans. They may charge fees for their services based on a one-time fee, hourly rate, or a percentage of AUM.
Number of People registering?*
- One Person
- Two People
Client Profile
Name*
First Last
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone*
Work Phone
Occupation/Employer
If Retired, Provide Year of Retirement
Fax
Preferred Method of Contact
Date of Birth
MM slash DD slash YYYY
Client Profile 2
Name*
First Last
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone*
Work Phone
Occupation/Employer
If Retired, Provide Year of Retirement
Fax
Preferred Method of Contact
Date of Birth
MM slash DD slash YYYY
Financial Goals & Objectives
(Examples: Buy a vacation home, fund childrens’ education, charitable gifting, retire in comfort, remodel kitchen)
Why are you seeking a financial advisor?
Have you had any previous financial advisors?
- Yes
- No
If yes, how many?
Why did you terminate the relationship?
How often do you wish to hear from us?
What is your main objective for this appointment?
Family & Children/Dependents
Please list children & other dependents
Dependent
Any Dependants?
- Yes
- No
Number of Dependents?*
- One Dependents
- Two Dependents
- Three Dependents
- Four Dependents
- Five or More Dependents
Dependent One
Name
First Last
Relationship
Date of Birth
MM slash DD slash YYYY
City, State
Dependent Two
Name
First Last
Relationship
Date of Birth
MM slash DD slash YYYY
City, State
Dependant Three
Name
First Last
Relationship
Date of Birth
MM slash DD slash YYYY
City, State
Dependant Four
Name
First Last
Relationship
Date of Birth
MM slash DD slash YYYY
City, State
Dependant Five
Name
First Last
Relationship
Date of Birth
MM slash DD slash YYYY
City, State
Parents
Any Living Parents?
- Yes
- No
Number of Parents
- One Parent
- Two Parents
- Three Parents
- Four Parents
Parent One
Name
First Last
City, State
Age
Parent Two
Name
First Last
City, State
Age
Parent Three
Name
First Last
City, State
Age
Parent Four
Name
First Last
City, State
Age
Investment Experience
Stocks/Equities
- None
- Limited
- Moderate
- Extensive
Years of Experience
Bonds/Fixed
- None
- Limited
- Moderate
- Extensive
Years of Experience
Mutual Funds
- None
- Limited
- Moderate
- Extensive
Years of Experience
Annuities
- None
- Limited
- Moderate
- Extensive
Years of Experience
Income and Net Worth
Annual Income*
Annual income refers to the total amount of money earned within a one-year period, including all sources of income, such as wages or salaries, business profits, rental income, investment income, and any other forms of earnings received during the course of a year.
Net Worth*
Net Worth = Total Assets - Total Liabilities: Total Assets include everything of value, such as cash, investments, real estate, vehicles, personal belongings, and any other assets. Total Liabilities encompass all financial obligations and debts, including mortgages, loans, credit card balances, and any other money owed to creditors.
Retirement Accounts
IRA, RIRA, 401k, 403b, 529, Deferred Comp--Other Tax Advantaged Accounts
Number of Retirement Accounts
- One
- Two
- Three
- Four
- Five
- Six
Account One
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Contributions
Annual Distributions
Account Two
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Three
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Four
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Five
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Six
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Non-Retirement Accounts
Brokerage Account, Individual, CDs, Trust, Checking--Other After Tax Accounts
Number of Non-Retirement Accounts
- One
- Two
- Three
- Four
- Five
- Six
Account One
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Two
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Three
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Four
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Five
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Account Six
Account Type/Registration

401(k), IRA, 403(b), etc.
Owner

John, Jane, Joint
Value
Annual Distributions
Annual Contributions
Retirement Income
Social Security, Pensions, Rental Property Income, Annuities etc
Number of Retirement Income
- One
- Two
- Three
- Four
Retirement Income One
Description/Type

Checking, Brokerage, Trust
Owner

John, Jane, Joint
Growth COLA %
Monthly Distribution
Annual Distributions
Retirement Income Two
Description/Type

Checking, Brokerage, Trust
Owner

John, Jane, Joint
Growth COLA %
Monthly Distribution
Annual Distributions
Retirement Income Three
Description/Type

Checking, Brokerage, Trust
Owner

John, Jane, Joint
Growth COLA %
Monthly Distribution
Annual Distributions
Retirement Income Four
Description/Type

Checking, Brokerage, Trust
Owner

John, Jane, Joint
Growth COLA %
Monthly Distribution
Annual Distributions
Real Estate
Primary Residence, Vacation/Secondary Property, Rental Property
Properties Owned
- Just Primary Residence
- Primary Residence and Vacation/Secondary Property
- Primary Residence, Vacation/Secondary Property, and Rental Property
Primary Residence
Value
Balance Owed
Interest Rate %
Term
YR
Incept. Date
MM slash DD slash YYYY
Vacation/Secondary Property
Value
Balance Owed
Interest Rate %
Term
YR
Incept. Date
MM slash DD slash YYYY
Rental Property
Value
Balance Owed
Term
YR
Interest Rate %
Incept. Date
MM slash DD slash YYYY
Insurance Risk Management
Life, disability, long term care, homeowners, umbrella insurance
Number of Insurance Policies
- 1
- 2
- 3
- 4
Insurance One
Person/Object/Entity Covered
Benefit/Coverage Amount
Cash Value (if applicable)
Premium
Insurance Two
Person/Object/Entity Covered
Benefit/Coverage Amount
Cash Value (if applicable)
Premium
Insurance Three
Person/Object/Entity Covered
Benefit/Coverage Amount
Cash Value (if applicable)
Premium
Insurance Four
Person/Object/Entity Covered
Benefit/Coverage Amount
Cash Value (if applicable)
Premium
Taxes & Estate Planning
Who prepares your tax return?
Who completed your estate planning documents?
Number of estate planning documents?
- 1
- 2
- 3
- 4
- 5
- 6
Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Estate Planning Document One
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Estate Planning Document Two
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Estate Planning Document Three
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Estate Planning Document Four
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Estate Planning Document Five
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Estate Planning Document Six
Kind

Will, Living Trust, Durable/Financial Power of Attorney, Advance Healthcare Directive, Living Will, Other documents
Client
Client
Date Created?
MM slash DD slash YYYY
Notes & Other
What types of investments are you most or least comfortable?
What concerns, if any, do you have about your finances and your future?
Please list any additional goals, objectives or items you would like Financial Insights team to consider.

Client Information

Client Profile

Client Profile 2

Financial Goals & Objectives

Family & Children/Dependents

Dependent

Dependent One

Dependent Two

Dependant Three

Dependant Four

Dependant Five

Parents

Parent One

Parent Two

Parent Three

Parent Four

Investment Experience

Income and Net Worth

Retirement Accounts

Account One

Account Two

Account Three

Account Four

Account Five

Account Six

Non-Retirement Accounts

Account One

Account Two

Account Three

Account Four

Account Five

Account Six

Retirement Income

Retirement Income One

Retirement Income Two

Retirement Income Three

Retirement Income Four

Real Estate

Primary Residence

Vacation/Secondary Property

Rental Property

Insurance Risk Management

Insurance One

Insurance Two

Insurance Three

Insurance Four

Taxes & Estate Planning

Estate Planning Document One

Estate Planning Document Two

Estate Planning Document Three

Estate Planning Document Four

Estate Planning Document Five

Estate Planning Document Six

Notes & Other