PRIORITY PLANNING REVIEW A brief overview of your financial plans and priorities provided for by on
PERSONAL INFORMATION... Name: Date: / / Age: Birthdate: / / Smoker?: Phone: E-Mail: Home Address: O Own O Rent Employer: Position: Business Address: Business Phone: (City, State and Zip) Business E-Mail: If Married: Spouse s Name: Age: Birthdate: / / Smoker?: Employer: Position: Business Address: Business Phone: Business E-Mail: Children: Name Age Sex PERSONAL PLANNING PROFILE... Please check the circles that reflect your current planning. Yes No? I know the income my family will receive from my estate assets. Ο Ο Ο I have a current will consistent with my estate distribution wishes. Ο Ο Ο My executor is familiar with my estate plan. Ο Ο Ο A guardian has been appointed for my minor children. Ο Ο Ο I have reviewed my life insurance program in the last two years. Ο Ο Ο I participate in a tax-favored retirement plan. Ο Ο Ο I understand the impact of inflation on my retirement plan. Ο Ο Ο I maximize my annual tax-favored plan contributions. Ο Ο Ο I am satisfied with my current investment returns. Ο Ο Ο I save on a weekly or monthly basis. Ο Ο Ο My income is protected in the event I am sick or hurt and cannot work. Ο Ο Ο I am fully covered for health care costs. Ο Ο Ο I fully understand and have checked my Social Security benefits. Ο Ο Ο Priority Planning Review Page 1
INCOME: FINANCIAL INFORMATION... Please check the circles that best reflect your current situation. Your Annual Income ASSETS (excluding home): Spouse's Annual Income Ο Less than $25,000 Ο Ο $25,000 to $50,000 Ο Ο $50,000 to $100,000 Ο Ο More than $100,000 Ο LIABILITIES (excluding home mortgage): Ο Less than $50,000 Ο $250,000 to $600,000 Ο Less than $25,000 Ο $150,000 to $250,000 Ο $50,000 to $150,000 Ο $600,000 to $1,200,000 Ο $25,000 to $75,000 Ο $250,000 to $500,000 Ο $150,000 to $250,000 Ο More than $1,200,000 Ο $75,000 to $150,000 Ο More than $500,000 Value of Home: $ Home Mortgage: $ CURRENT SAVINGS AND INVESTMENTS: Ο Savings and CDs Ο Bonds Ο 401(k) Salary Deferral Ο Money Market Fund Ο Life Insurance Cash Value Ο Pension/Profit Sharing Plan Ο Mutual Funds Ο Tax-Deferred Annuity Ο Other: Ο Stocks Ο IRA or SEPP Ο Other: CURRENT LIFE INSURANCE: Your Total Spouse's Total Ο Less than $50,000 Ο Ο $50,000 to $150,000 Ο Ο $150,000 to $500,000 Ο Ο More than $500,000 Ο FINANCIAL PLANNING PRIORITIES... Please check the circles that most closely reflect your financial priorities. H = High Priority M = Medium Priority L = Low Priority N/A = Not Applicable H M L N/A Planning for my retirement is a... Ο Ο Ο Ο Protecting my family's lifestyle in the event of my death is a... Ο Ο Ο Ο Saving and investing on a regular basis are a... Ο Ο Ο Ο Providing educational funds for my children is a... Ο Ο Ο Ο Protecting my income in the event of sickness or accident is a... Ο Ο Ο Ο Providing funds to pay off my mortgage and debts in the event of my death is a... Ο Ο Ο Ο Protecting against the costs of long-term nursing care is a... Ο Ο Ο Ο Investing money in tax-favored plans is a... Ο Ο Ο Ο Low risk investments are a... Ο Ο Ο Ο Investments that offer high growth potential are a... Ο Ο Ο Ο An overall financial plan is a... Ο Ο Ο Ο Involvement of my spouse in our financial planning is a... Ο Ο Ο Ο Priority Planning Review Page 2
CURRENT PRIORITIES... Please check all items you are interested in discussing. Ο A complimentary financial analysis. Ο Planning for retirement. Ο How to pay estate taxes. Ο Ways to protect my family's lifestyle. Ο Mortgage protection coverage. Ο Insurance on myself. Ο Converting temporary insurance. Ο Ways to protect my income in the event of sickness or accident. Ο Tax-favored investments/annuities. Ο Insurance on my spouse. Ο Insurance on my children/grandchildren. Ο A systematic savings plan. Ο Existing policy review. Ο My automobile insurance (renewal date / / ). Ο My homeowners insurance (renewal date / / ). Ο Other pertinent information: FUTURE PLANS... Please check all that may apply within the next two years. Ο New home Ο Change job Ο Lose weight Ο Stop smoking Ο Pay off loans Ο Start business Ο Bonus Ο Salary increase Ο Marriage Ο Children Ο Save more Ο Retirement Ο Inheritance Ο Sell business Ο Sell property Ο Other: BUSINESS OWNERS ONLY... Please check any items of interest or concern. Ο Business Continuation Planning Ο Buy/Sell Plans Ο Key Employee Insurance Ο Qualified Pension Plans (IRS approved, 401(k), SEPP, etc.) Ο Nonqualified Retirement Plans (No IRS approval required) Ο Disability Income Ο Executive Bonus Plans Ο Group Insurance Ο Business Overhead Expense Protection Ο Business Loan Insurance Ο Payroll Savings Plans Ο Other: Priority Planning Review Page 3
INTRODUCTIONS... Others you feel might benefit by completing a Priority Planning Review... Name Telephone Number Thank you for completing the Priority Planning Review! NOTES... FF.08A ed. 1-99 LUTC All Rights Reserved