BFG PERSONAL FINANCIAL ANALYSIS FORM. Barnum Financial Group CLIENT NAME DATE ADVISOR NAME. An Office of MetLife

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1 BFG PERSONAL FINANCIAL ANALYSIS FORM CLIENT NAME DATE ADVISOR NAME

2 PERSONAL FINANCIAL ANALYSIS 1 GENERAL INFORMATION First Name Last Name Address City, State, Zip Phone Home Cell Office Date of Birth DEPENDENT INFORMATION CHILD S NAME MALE OR FEMALE DATE OF BIRTH WHAT ARE YOUR GOALS FOR YOUR FUTURE? Ensuring I have enough assets and income for retirement Providing funds for my child s education Ensuring my investments are properly allocated given my risk tolerance Protecting my family in the event of a premature death Protecting my income in the event of a disability Protecting my assets in the event of a need for long term care Ensuring my assets are passed to my desired beneficiaries : RETIREMENT GOALS Retirement Age Desired Income How do you envision your retirement?

3 PERSONAL FINANCIAL ANALYSIS 2 EDUCATION GOALS CHILD NAME SCHOOL NAME $ PER YEAR YEARS UNTIL NEEDED # OF YEARS NEEDED % TO PAY EMPLOYER INFORMATION Employer Name Length of Time Annual Income Retirement Plan Yes No Yes No Existing Balance Your Contributions Company Match Group Health Insurance Group Life Insurance Group Disability Insurance RETIREMENT INCOME SOURCES Pension Benefit Social Security Benefit Income ESTATE PLANNING CPA Attorney Do you have a will? Do you have a power of attorney? Do you have a child with special needs? Do you anticipate your parents requiring your financial assistance in the future? What other planning have you done?

4 PERSONAL FINANCIAL ANALYSIS 3 ASSETS AND LIABILITIES Assets (Obtain copies of statements if available) *CDs, IRAs, 401(k) 403(b), etc. ACCOUNT NAMES OWNER TYPE* AMOUNT MONTHLY CONTRIBUTION PURPOSE Liabilities PROPERTY PROPERTY #2 AUTO & RECREATION Market Value Market Value Market Value Mortgage Mortgage Loan Balance Rate & Term Rate & Term Rate & Term Monthly Payment Monthly Payment Monthly Payment Rental Income AUTO & RECREATION #2 OTHER DEBT OTHER DEBT #2 Market Value Type Type Loan Balance Balance Balance Rate & Term Interest Interest Monthly Payment Monthly Payment Monthly Payment INSURANCE Life Insurance COMPANY TYPE INSURED BENEFIT PREMIUM CASH VALUE Long-Term Care COMPANY INSURED BENEFIT ELIMINATION PERIOD PREMIUM TYPE Disability Income COMPANY INSURED BENEFIT ELIMINATION PERIOD PREMIUM TYPE Auto and Home COMPANY INSURED COVERAGE PREMIUM TYPE

5 PERSONAL FINANCIAL ANALYSIS 4 NOTES NEXT STEPS Client Actions: Advisor Actions: Next Meeting: / / All information provided by the client and not verified by the representative. Metropolitan Life Insurance Company, New York, NY L [exp1114][All States][DC]

6 PERSONAL FINANCIAL ANALYSIS 5 REQUIRED DOCUMENTS CHECKLIST CLIENT: DATE: The checked items are documents you will need in order to complete the Confidential Questionnaire with me. The task is easier if you assemble all your documents before we start to work. INVESTMENT STATEMENTS Stocks Bonds Mutual Funds Limited Partnerships Dividend/Interest Statements INSURANCE POLICIES Life Medical & Hospitalization Automotive & Homeowners Annuities EMPLOYEE BENEFITS Pension/Profit-Sharing Employee Stock Ownership Insurance Benefits Employee Benefit Book RETIREMENT PLANS IRA, Keogh 401(k) Social Security Verification Company Plans Annual Benefits Statement INCOME TAX RETURNS EXPENSES Checkbook & Cash Receipts Credit Card Statements Mortgage Records Auto Loans Personal/Family Budget ESTATE ITEMS Wills/Codicils Trust Agreements Trust Tax Return Gift/Estate Tax Return Power of Attorney Agreement MISCELLANEOUS DOCUMENTS Divorce Settlements Alimony & Child Support Prenuptial Agreements Appraisals of Personal Property Notes Payable Notes Receivable Purchase/Sale/Lease Pay Stubs Advisors Location on Documents BUSINESS DOCUMENTS Valuations Buy-Sell Agreements Partnership Agreement & Tax Return Employee Agreement Deferred Comp. Agreement Financial Statements Incorporation Papers By-Laws Corporate Tax Return (S-Corp, C-Corp, LLC) MetLife and its representatives do not provide tax and legal advice. Please consult your tax advisor or attorney for such guidance. Metropolitan Life Insurance Company, New York, NY L [exp1114][All States][DC]

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