Announcing Our New Office in Van Wert!

Non-Branch Location (By Appointment Only)

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Financial Planning Questionnaire

We kindly ask that you complete the Financial Planning Questionnaire prior to our meeting. This will allow us to better understand your financial goals and create a tailored plan to help you achieve them.

Financial Planning Questionnaire

Name
Do you have any of the following accounts? If possible please provide a recent statement.
Do you have any of the following accounts? If so please provide a recent statement.
Max. file size: 256 MB.

Income

Fill in the following income information. Please click the + for another row.
Income
Name of Income
Type (ie. Work, Farm, Rental)
Annual Income
How long will income last (ir.. Forever, Retirement, 2045)
Cost of living adjustment?
 

Debt

Fill in the following debt information. Please click the + for another row.
Debt
Name of Debt
Type (ie. Mortgage, Auto, Credit, Line of Credit))
Balance
Monthly Cost
Interest Rate
 

Spending

Monthly amount in todays dollars. Please click the + for another row.
General Spending
Necessary/Discretionary
Current
Retirement
Homeowners/Renters Insurance
Necessary/Discretionary
Current
Retirement
Auto Insurance
Necessary/Discretionary
Current
Retirement
Health Insurance
Necessary/Discretionary
Current
Retirement
Life Insurance
Necessary/Discretionary
Current
Retirement
Property Taxes (Real Estate / Vehicle)
Necessary/Discretionary
Current
Retirement
Home Repairs / Maintenance
Necessary/Discretionary
Current
Retirement
Utilities (Gas / Electric / Water / Phone / Mobile / Internet / refuse)
Necessary/Discretionary
Current
Retirement
Groceries & Personal Goods (Toiletries / Dry Cleaning)
Necessary/Discretionary
Current
Retirement
Entertainment (Dining Out / Travel / Vacation)
Necessary/Discretionary
Current
Retirement
Clothing
Necessary/Discretionary
Current
Retirement
Gifts (Birthday / Holiday / Special Occasion)
Necessary/Discretionary
Current
Retirement
Transportation (Gas / Maintenance / Parking)
Necessary/Discretionary
Current
Retirement
Charitable Contributions
Necessary/Discretionary
Current
Retirement
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Tailored Financial Strategies for Every Stage of Life

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