Personal Wealth Report (GetMotivated-OWSW) Please complete the following questionnaire to your best ability. This will help us provide the most accurate and comprehensive wealth report for you and your family. CLIENT DETAILS Question Title * Name Question Title * Email Question Title * Phone number Question Title * Date of Birth Date Date Question Title * Spouse's Name Question Title * Spouse's Date of Birth Date Date Question Title * Income (complete as applicable) Please provide current Social Security Benefit Statement (if not yet taking Social Security). Salary (gross) Self-employed income (net): Pension Investment income RMDs Rental income Other Income How many years do you want to work? How much money do you need to live on each month? Question Title * Mortgage (complete as applicable)Not including taxes or insurance. Current balance Interest rate Home value Monthly payment Question Title * Assets (complete as applicable) Cash IRAs 401(k) Company match? If so, how much? Life Insurance Annuities Question Title * Assets (complete as applicable) Cash IRAs 401(k) Company match? If so, how much? Life Insurance Annuities Please include the following information on all your debts: Question Title * Debt #1 Debt #1 - Type (Auto, Credit Card, etc.) Debt #1 - Paid To Debt #1 - Monthly Payment Debt #1 - Total Balance Debt #1 - Interest Rate Question Title * Debt #2 Debt #2 - Type (Auto, Credit Card, etc.) Debt #2 - Paid To Debt #2 - Monthly Payment Debt #2 - Total Balance Debt #2 - Interest Rate Question Title * Debt #3 Debt #3 - Type (Auto, Credit Card, etc.) Debt #3 - Paid To Debt #3 - Monthly Payment Debt #3 - Total Balance Debt #3 - Interest Rate Question Title * Debt #4 Debt #4 - Type (Auto, Credit Card, etc.) Debt #4 - Paid To Debt #4 - Monthly Payment Debt #4 - Total Balance Debt #4 - Interest Rate Question Title * Debt #5 Debt #5 - Type (Auto, Credit Card, etc.) Debt #5 - Paid To Debt #5 - Monthly Payment Debt #5 - Total Balance Debt #5 - Interest Rate Question Title * Additional CommentsWhat are the most important financial goals that you would like to accomplish? (Please prioritize with the top being your most important, and the last being the least important.) Financial goal #1 Financial goal #2 Financial goal #3 Financial goal #4 Question Title * If you were going to change anything in your financial situation, what would it be? Question Title * If we were meeting here three years from today, what has to have happened for you to feel happy with your progress? Question Title * We have been able to grow substantially through the power of referrals. If we fulfill your expectations, what method of communication may we talk to you about obtaining referrals that is most comfortable for you? Question Title * Will there be any other advisors involved in the decision making process? Done