Recession Prep Questionnaire

Your answers to these questions will be kept strictly confidential.

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* 1. Contact Information

First Name

Last Name

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* 2. Initial Information

State of Residence

Your Date of Birth

Desired Retirement Age

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* 3. Living Expenses

What are your current estimated MONTHLY living expenses? (NOTE: Do not include income taxes or debt payments)

What are your anticipated monthly living expenses in retirement? (If same as above leave blank)

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* 4. In Addition to Ongoing Living Expenses, Indicate Any Specific Financial Goals Below.

(Examples: Buy vacation home in the mountains in 2022 for $500,000 -OR- Gift $15,000 Per Year to each of my 5 Children & Granchildren)

Financial Goal (Include description, amount, and timing)

Other Financial Goal

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* 5. Assets - Include Recent Market Value

Cash (Bank Accounts, CDs, Money Market, etc.)

Investments (Non-Retirement)

Retirement Accounts (IRA, 401(k), etc.)

Annuities

Business Interest(s)

Investment Real Estate

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* 6. Allocation of Investment Accounts (Estimate)

Example: 60/40 Stocks to Bonds Overall Allocation of All Investments

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* 7. Liabilities - Include Only a Recent Balance

Mortgage(s)

Line(s) of Credit

Any Other Debts

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* 8. Sources of Income in Retirement - Include MONTHLY Amounts

Social Security

Pension Income

Annuity Income

Rental Property Income

Trust Account Income

Other Income

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* 1. Contact Information

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* 2. Initial Information

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* 3. Living Expenses

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* 4. In Addition to Ongoing Living Expenses, Indicate Any Specific Financial Goals Below. (Examples: Buy vacation home in the mountains in 2022 for $500,000 -OR- Gift $15,000 Per Year to each of my 5 Children & Granchildren)

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* 5. Assets - Include Recent Market Value

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* 6. Allocation of Investment Accounts (Estimate)Example: 60/40 Stocks to Bonds Overall Allocation of All Investments

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* 7. Liabilities - Include Only a Recent Balance

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* 8. Sources of Income in Retirement - Include MONTHLY Amounts

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* 9. Is there any other information you would like to provide or any specific questions you have for us?

* 4. In Addition to Ongoing Living Expenses, Indicate Any Specific Financial Goals Below.

(Examples: Buy vacation home in the mountains in 2022 for $500,000 -OR- Gift $15,000 Per Year to each of my 5 Children & Granchildren)

* 6. Allocation of Investment Accounts (Estimate)

Example: 60/40 Stocks to Bonds Overall Allocation of All Investments