Table of Contents. Personal Information

Transcription

1 Estate Planning Fact Finder Table of Contents Personal Information 1 Income Information 5 Estimate Net Worth (Assets less Liabilities) 2 Life Insurance 5 Estimate Planning Goals 2 Qualified Plan/IRA Assets 5 Business Ownership 3 Current Estate Plan 6 Assets 4 Advisors and Fiduciaries 7 Personal Information Date of Birth: U.S. Citizen? Yes No Occupation: Own a business? Yes No Gender: Male Female Relationship to Spouse Domestic Partner Other Date of Birth: U.S. Citizen? Yes No Occupation: Own a business? Yes No Gender: Male Female Relationship to Spouse Domestic Partner Other Street Address: City/State/Zip: Phone No.: Do you have a prenuptial or other written agreement regarding the division of assets between the two of you? Yes No Children Children of: Grandchildren Grandchildren of: This fact finder is provided to help you and your insurance professional better understand your goals and objectives. Please return the information to your insurance professional and not to Pacific Life or Pacific Life & Annuity as we cannot and do not provide financial, legal or tax advice. Pacific Life Insurance Company is licensed to issue individual life insurance and annuity products in all states except New York. Product availability and features vary by state. Individual life insurance and annuity products are available in New York through Pacific Life & Annuity Company. VLCM-43D VLNYCM-43B Investment and Insurance Products: Not a Deposit Not FDIC Insured Not Insured by any Federal Government Agency No Bank Guarantee May Lose Value

2 Estimated Net Worth (Assets less liabilities) Combined: Estate Planning Goals What do you want to do with your assets and/or business when you die: What are your biggest concerns when it comes to your estate? Do you have parents, siblings or children that have special needs or considerations?: Yes No If yes, what are they? Do either of you have any continuing obligations under a divorce decree or property settlement?

3 Estate Planning Goals (continued) Do you have any schools, charities, hospitals or other special organizations you want to remember in your estate planning? The next questions will be about your assets and how they are owned. Before we start, what else do you want to tell me about your plans for your estate? Business Ownership Company Name: In business since: Entity: C Corp S Corp Limited Liability Company Partnership Sole Proprietor Other: What type of business is it? (describe) Who started the business? Number of employees: Annual Revenue: $ Annual Cash Flow: Ownership: Client #1 Client #2 Both Percentage Ownership: 100% % If less than 100%, who are the other owners and how much do they own? What are your plans for the business when you retire? If you become disabled, what happens to the business? Are any other family members involved in the business? How are the other family members affected if you die? In the event of your death, what happens to the business? Is there an existing buy-sell agreement? Yes No What type? How is the purchase price determined?

4 Business Ownership (continued) If more than one company owned, complete the following: Company Name: In business since: Entity: C Corp S Corp Limited Liability Company Partnership Sole Proprietor Other: What type of business is it? (describe) Who started the business? Number of employees: Annual Revenue: $ Annual Cash Flow: Ownership: Client #1 Client #2 Both Percentage Ownership: 100% % If less than 100%, who are the other owners and how much do they own? What are your plans for the business when you retire? If you become disabled, what happens to the business? Are any other family members involved in the business? How are the other family members affected if you die? In the event of your death, what happens to the business? Is there an existing buy-sell agreement? Yes No What type? How is the purchase price determined? Assets Asset Owner 1 Market Value Liability Growth Rate Residence Real Estate Securities Business Cash Vehicles Personal Property C1=Cli percentage of ownership. C1 C1=Cli=Client #1 C1=Cli

5 Income Information Income Source Client #1 Client #2 Salary/Bonus Other Income Income Tax Bracket Life Insurance Insured Type 2 Owner 3 Death Benefit Surrender Value Annual Premium Beneficiary Client #1 Client #2 Joint 2 Type: Permanent, Term, Group Term, Survivorship 3 C1=Client #1, C2=Client #2, J=Joint Tenants, CP=Community Property, IT=Irrevocable Trust Plan 1 Qual Plan IRA Acct. Qualified Plan/IRA Assets Plan 2 Qual Plan IRA Acct. Plan 3 Qual Plan IRA Acct. Plan 4 Qual Plan IRA Acct. Participant Client #1 Client #2 Client #1 Client #2 Client #1 Client #2 Client #1 Client #2 Community Property Plan Type Current Balance Beneficiary Annual Contributions Continue Contributions for Years Percent Increase in Contribution per Year Assumed Earnings Rate Defined Benefit Plan Benefit Amount Payable Number of Years Benefit Payable

6 Current Estate Plan Client #1 Client #2 Existing wills? Yes No Yes No When was your will last updated? Existing revocable living trust? Yes No Yes No When was your revocable living trust last updated? Does your will or revocable trust establish a credit shelter trust or otherwise use your estate tax exemption amount? Yes No Yes No Have you determined how your estate will be divided at death? (Use % of estate or specific $ amount) Client #1 What are the provisions for Client #2? What are the provisions for the children? Do you want to equalize children s inheritances? Yes No Other: Client #2 What are the provisions for Client #1? What are the provisions for the children? Do you want to equalize children s inheritances? Yes No Other: Have you used any of your lifetime exemption amount? If yes, please indicate specific amount. Client #1 Client #2 Existing powers of attorney for financial matters? Yes No Yes No Existing powers of attorney for health care? Yes No Yes No Current Gifts:

7 Advisors and Fiduciaries Attorney Name: Telephone Number: Accountant Name: Telephone Number: Guardians Initial: Telephone Number: Successor: Telephone Number: Executors/Trustees Initial: Telephone Number: Successor: Telephone Number: Notes

8 Life Insurance Division Address: 45 Enterprise, Aliso Viejo, CA (800) Life Insurance Division Mailing Address: 45 Enterprise, Aliso Viejo, CA (888) Pacific Life Insurance Company is licensed to issue individual life insurance and annuity products in all states except New York. Product availability and features vary by state. Individual life insurance and annuity products are available in New York through Pacific Life & Annuity Company. Each company is solely responsible for the financial obligations accruing under the policies it issues, and its product and rider guarantees are backed by that company s financial strength and claims-paying ability. Variable insurance products issued by Pacific Life Insurance Company and Pacific Life & Annuity Company are distributed by Pacific Select Distributors, Inc. (member FINRA & SIPC), a subsidiary of Pacific Life and an affiliate of Pacific Life & Annuity, and are available through licensed third-party broker-dealers. Pacific Life Insurance Company s and Pacific Life & Annuity Company s individual life insurance products are marketed exclusively through independent third-party producers, which may include bank-affiliated entities. Insurance Professional s Name State Insurance License Number (or affix your business card) VLCM-43D /08 VLNYCM-43B