Foundations Investment Advisors
Client Fact Finder
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First name
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Date of birth
Month
Day
Year
Marital status
Employment status
Retirement status
Years to retirement
| Category | Account / Institution | Value ($) |
|---|---|---|
| Liquid Cash, checking, savings | ||
| Fixed assets Real estate, automobile | ||
| Taxable brokerage TOD, joint, trust | ||
| Tax-deferred IRA, 401(k), 457, 403(b) | ||
| Tax-exempt Roth IRA, Roth 401(k) | ||
| Annuity / insurance Cash value | ||
| Total assets |
| Source | Annual amount ($) |
|---|---|
| Wages / salary | |
| Pension | |
| Rental income | |
| Social Security | |
| Annuity income | |
| Other income | |
| Other — describe | |
| Total annual income |
Current annual living expenses ($)
Expected retirement annual living expenses ($)
Total loan balances ($)· Mortgage + auto + student
Federal income tax bracket
Life insurance?
Carrier
Type
Death benefit (approx.) $
Long-term care?
Carrier
Monthly benefit (approx.) $
Annuity?
Carrier
Type
Approximate current value $
Investment real estate? (beyond primary home)
Primary retirement concerns (circle up to 3)
How important is guaranteed lifetime income?
Comfort with market volatility?
What are you hoping to learn or solve?
Best contact method
Best time to reach you
Were you referred? (name)
Client signature
Date