FINANCIAL PLANNING QUESTIONNAIRE

Transcription

1 FINANCIAL PLANNING QUESTIONNAIRE General Information Title Mr. Ms. Mrs. First Name Middle Name Last Name Birth date MM/DD/YY Sex Smoker Y/N S.I.N. # Home Address: City: Province Postal Code: Home Phone: Work Phone: Spouse Work: Cell Phone: Address: Marital Status: 1 st Marriage 2 nd Marriage Never Married Separated Divorced Widowed Common Law Employment Information Occupation Company Employment Status (FT/PT) Client Spouse Annual Income $ $ Children Child s Full Name Birth Date MM/DD/YY S.I.N. # Current Savings in Child s Name 1. $ $ 2. $ $ 3. $ $ 4. $ $ Monthly Savings % of costs to cover Special Needs? Advisors Type Name Phone Number 1

2 Goals and Objectives? Goal 1. Maintain your standard of living in retirement Include in plan Do not include Time Frame to complete 2. Pay less tax 3. Maintain families standard of living in event of death or disability 4. Become financially independent 5. Preserve an estate for your heirs 6. Wish to Gift a charitable donation or create a scholarship 7. Provide for your children s education 8. Pay off mortgage 9. Stay ahead of inflation (after-tax rate of return) 10. Earn higher rate of return on investments 11. Buy a home or recreation property 12. Learn to invest and manage money wisely 13. Start your own business 14. Short-term goal 15. Long-term goal Notes: 2

3 Income Cash Flow Description of Inflows Client Spouse Employment Income Interest Income Dividend Income Capital Gains Other Pension / Annuity Income C.P.P. Benefits / O.A.S. Benefits RRSP/RRIF Income Non Taxable Income - W.C.B / Insurance Business/Farm Income Rental Income Child Tax Credit Savings Source Deductions & Tax Items Client Spouse Savings Client Spouse CPP/QPP contributions Registered Savings Employment Insurance Spousal RRSP Company Pension (Defined Benefit) Other Savings Union Dues Education Savings Charitable Donations Investment Loan Principal Investment Loan Interest Inv. Income Reinvested: qyes qno Expenses Shelter Amount Freq. Family Expenses Amount Freq. Rent/Mortgage Payments Food & Beverage Property Tax Clothing Maintenance Property Insurance Dependant Care Expenses Utilities (Elec, Gas, Water) Housekeeping Phone/Cell/Cable Personal Care Recreational Property Expense Medical Expenses Other Expenses Transportation Amount Freq. Personal Expenses Amount Freq. Gas/Oil Personal Loan Repairs/Maintenance Personal Loan Auto Insurance Insurance Premiums (LI/CI/DI) Vehicle Loan Holidays/Vacations Vehicle Loan Gifts Lease Payment Entertainment/Tobacco/Alcohol Miscellaneous Expenses Professional Fees Cash/Pocket Money Credit Card Payments 3

4 Net Worth Assets Personal Assets and Date Purchased Value ACB Owner Taxable? 1 $ $ 2 $ $ 3 $ $ 4 $ $ 5 $ $ 6 $ $ 7 $ $ 8 $ $ 9 $ $ 10 $ $ 11 $ $ 12 $ $ Registered Assets Value Owner Asset Type Registered Type 1 $ 2 $ 3 $ 4 $ 5 $ 6 $ Non-registered Assets Value ACB Owner Type 1 $ $ 2 $ $ 3 $ $ 4 $ $ 5 $ $ Liabilities Liability Balance Owner Payment Interest Insured? 1 $ $ Rate % q Client 2 $ $ % Client 3 $ $ % q Client 4 $ $ % q Client 5 $ $ % q Client 6 $ $ % q Client 7 $ $ % q Client Notes: 4

5 Retirement Planning Retirement Details Client Spouse Retirement Age Are you retired (Yes/No) Retirement ends at age Amount left to estate Pre tax rate of return Tax rate Current Income Needed Pre-retirement Inflation % Income needed at retirement Post-Retirement rate of return Retirement Inflation Change Income Again? (Yes/No) Change income at what age % of new income needed New Income Inflation Pension Income CPP estimate CPP Start Age Include OAS (Yes/No) Inflation % for CPP/OAS Defined Benefit Pension Start age for D.B.P. Index % for D.B.P. Other retirement income Inheritance and Major Inflows Do you expect an inheritance? Major Inflow from a business sale? Any other inflows from sales of assets? Client Amount Spouse Date Expected 5

6 Tax Unused RRSP contribution room Unused Capital Gains Exemption Age 65 plus, using the $1000 qualified pension income tax credit Capital losses carried forward Client Spouse Description and Date Purchased Life Insurance Insurance Company Insured Death Benefit Premium & Freq. Beneficiary Type: Whole Life; Universal Life; Term; Group Life Disability Insurance Description Company Insured Monthly Benefit Waiting Period Benefit Period Index Rate Taxable Premium & Frequency Type: Group LTD; Association Group; Personally Owned Critical Illness & Long Term Care Insurance Benefit Description Company Insured Amount Waiting Period Coverage Period Premium & Frequency Type: Critical Illness; Long Term Care 6

7 Estate Planning Wills Client Spouse Do you have a will? Yes No Yes No Do you have a P.O.A? Yes No Yes No Date of Last Update Location of Documents Estate Planning Checklist Client Spouse 1. Does your executor live in a different Yes No N/A Yes No N/A Province? 2. Have you reviewed your will and power Yes No N/A Yes No N/A Of attourney in the last 2 years? 3. Do you have a health care directive or Yes No N/A Yes No N/A a living will? 4. Do you have an up to date net worth Yes No N/A Yes No N/A Statement listing your assets and liabilities? 5. Have you named beneficiaries for all of Yes No N/A Yes No N/A Your registered investments (RRSPs, RRIFs, PRIFs, LIFs, LRIFs, annuities, pension plans, DPSPs) and life insurance policies? 6. Have you reviewed the pros and cons of Yes No N/A Yes No N/A Jointly registering non-rrsp assets in Your name and your spouse s name? 7. Do your family members know where to Yes No N/A Yes No N/A Locate your financial records (investment Accounts, bank accounts, tax returns, Insurance policies, safety deposit box)? 8. Do you have a succession plan for Yes No N/A Yes No N/A Your business? 9. Do you have a buy/sell agreement Yes No N/A Yes No N/A in place with your business partner(s)? 10. Do you have pets? Yes No N/A Yes No N/A 11. Do you have a safety deposit box? Yes No N/A Yes No N/A 12. Have you made your own funeral Yes No N/A Yes No N/A arrangements? 7

8 PERSONAL DOCUMENTS NEEDED FOR CONFIDNETIAL ANALYSIS 1. To make the data collection process as convenient as possible for you, please provide the following documents that pertain to you. Be sure to include these for both yourself and your partner. 2. If you do not have access to a photocopier, you can supply the original documents since we will be returning them to you. Most Recent Pay Stubs. Credit Union Statements. Most Recent Individual Income Tax Returns & Notice of Assessment. Life Insurance Policies including most recent Policy Statements and Dividend Information. Disability Insurance Policies. Critical Illness and/or long term care policies Employee Benefit Statements and Descriptions. Business/Farm Statements. RRSP Statements. Schedule of Stocks, Bonds, Mutual Funds, & Other Investments Most Recent Statements. Schedule of Term Deposits or Guaranteed Investment Certificates. Loans Principal, Interest Rate, Amortization, Payment Schedule. Canada Pension Estimation Statement. Net Worth Statement Statement of Cash Flow Copy of most recent will, power of attourney documents Any Previous Analysis Prepared Regarding Insurance, Investments, or Estate. Your appointment is Your appointment is Coldstream Ave. Vernon, BC, Canada Ph: TM TM