Financial Health Survey
Thank you for participating in our Financial Health Survey. Your responses will help us understand the financial well-being of individuals in our region and shape policies to better support you. Your information is confidential, and your participation is voluntary.
I. Demographic Information
Age | |
Gender | |
Marital Status | |
Education Level | |
Employment Status | |
II. Income and Expenses
A. Household Income
Source | Monthly Amount ($) |
Employment | [0] |
Investments | [0] |
Other | [0] |
Total Income | [0] |
B. Monthly Expenses
Expense | Monthly Amount ($) |
Housing | [0] |
Utilities | [0] |
Food | [0] |
Transportation | [0] |
Entertainment | [0] |
Total Expenses | [0] |
C. Savings and Investments
Type | Presence |
Savings Account | |
Investment Portfolio | |
III. Debt Profile
Type | Amount ($) |
Mortgage | [0] |
Auto Loans | [0] |
Credit Cards | [0] |
Student Loans | [0] |
Total Debt | [0] |
Monthly Debt Payments: $1,500
IV. Financial Goals and Planning
A. Short-Term Financial Goals
Goal | Target Amount ($) |
Emergency Fund | [0] |
Vacation | [0] |
B. Long-Term Financial Goals
Goal | Target Amount ($) |
|---|
Homeownership | [0] |
Retirement | [0] |
C. Retirement Planning
Goal | Target Amount ($) |
Contributing to Retirement Accounts | [0] |
Estimated Retirement Age | [0] |
V. Financial Literacy
A. Basic Financial Knowledge:
1. Budgeting:
2. Understanding Interest Rates:
3. Investment Awareness:
B. Sources of Financial Information:
VI. Financial Well-being Perceptions
A. Self-assessment of Financial Well-being:
B. Factors Influencing Financial Satisfaction:
VII. Emergency Preparedness
A. Emergency Savings:
Savings Goal | Current Progress ($) | Target Amount ($) |
Short-Term Emergencies | [0] | [0] |
Medical Expenses | [0] | [0] |
VIII. Access to Financial Services
A. Banking Services Utilized:
B. Access to Credit:
C. Perceptions of Economic Conditions:
D. Confidence in Job Security:
Finance Templates @ Template.net
