Financial Data Questionnaire
Welcome to our Financial Data Questionnaire. Your responses will guide our comprehensive financial planning process. Please provide accurate details to help us tailor strategies to meet your unique financial goals and aspirations.
Full Name: | [Your Name] |
Date of Birth: | [Month Day, Year] |
Social Security Number: | [Your SSN] |
Address: | [Your Address] |
Phone: | [Your Phone Number] |
Email: | [Your Email] |
Marital Status: | |
Number of Dependents: | [2] |
Ages of Dependents: | [8, 10] |
Income Information
Employment Income
Employer Name: | [Your Company Name] |
Job Title: | [Your Job Title] |
Gross Salary: | $[0] per year |
Additional Compensation: | $[0] annual bonus |
Other Income
Rental Income: | $[0] per month |
Business Income: | $[0] |
Investment Income: | $[0] per quarter |
Other Sources of Income: | $[0] |
Expense Information
Monthly Expenses
Housing Costs: | $[0] |
Utilities: | $[0] |
Transportation: | $[0] |
Groceries: | $[0] |
Insurance Premiums: | $[0] |
Loan Payments: | $[0] |
Childcare and Education: | $[0] |
Discretionary Spending
Entertainment: | $[0] |
Dining Out: | $[0] |
Travel: | $[0] |
Hobbies: | $[0] |
Assets
Real Estate
Primary Residence: | |
Other Properties Owned: | [None] |
Financial Assets
Bank Accounts: | |
Investment Accounts: | |
Retirement Accounts: | |
Stocks and Bonds: | |
Mutual Funds: | |
Personal Property
Liabilities
Debts
Mortgage(s): | $[0] |
Auto Loans: | $[0] |
Credit Card Debt: | $[0] |
Student Loans: | $[0] |
Other Liabilities: | $[0] |
Insurance
Insurance Policies
Life Insurance: | |
Health Insurance: | |
Property Insurance: | |
Other Insurance Policies: | |
Risk Tolerance
Risk Assessment
Comfort Level with Investment Risk: | |
Risk Tolerance Questionnaire: | |
Declaration and Authorization
I hereby authorize the use of the provided information for financial planning. I acknowledge receipt of the privacy policy.
Client's Signature:
Date: [Month Day, Year]
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