Personal Financial Questionnaire and Information Checklist
For each person (married couples or domestic partners may answer jointly):
- Name(s)
- Social Security Number(s)
- Date(s) of birth
- Citizenship
- Employer(s)
- Home address
- Home telephone and fax
- Business phone(s) and fax(es)
- Email address(es)
For each child/dependent:
- Name(s)
- Date(s) of birth
- SSN(s)
- Dependency and health status
We will need to discuss your personal financial goals and concerns:
retirement, education, special purchase, pay off large debt, and
others.
We will need to discuss any of the following that may apply to you:
- Home ownership and mortgage
- Vacation or other real property
- Cash and savings accounts
- 401k accounts
- Keogh or other retirement accounts
- IRA accounts
- Deferred compensation accounts
- Stock options
- Other investments
Please provide copies of following documents, as applicable:
- Income tax returns, federal and state, for latest year
- Estimated income tax for this year
- Pay stub
- Will
- Family trust document
- Brokerage account statements
- Latest 401K or SEP statement
- IRA statements
- Mutual fund statements
- Latest pension or retirement statement
- Savings account statements
- Limited partnership statements
- Credit card statements
- Statements of any other debts
- Life insurance policy statement(s)
- Declarations page of all other insurance:
- Life
- Health
- Homeowners
- Auto
- Excess Liability
- Divorce decree
- Prenuptial agreements
We need to estimate your cash flow. Please estimate how much you spend
each month on each of the following:
- Rent or mortgage payment
- Transportation
- Food and beverages
- Clothing
- Furnishings
- Personal care
- Cash expenditures
- Medical
- Insurance premiums
- Debt and installment payments
- Entertainment
- Vacations and holidays
- Charitable contributions
- Utilities
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