234 Kinderkamack Road Oradell, NJ 07649 201.262.1040



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Financial Planning Organizer 234 Kinderkamack Road Oradell, NJ 07649 201.262.1040 www.tfgllc.com

Personal Data Summary Date Prepared / / Client Spouse 1. Full Name Social Security # Date of Birth / / / / Age: Retirement Age 2. Primary Residence Address Telephone # ( ) - ( ) - Cell Phone # ( ) - ( ) - Fax # ( ) - ( ) - E-mail Address 3. Employer Name Title Telephone # Date Employed 2

Family Profile Name Soc. Sec. # Date of Birth Age Occupation Children Other Dependents Living Goals - Financial Independence Retirement Age: Client Retirement Age Date Spouse Retirement Age Date Annual Income Desired (Current ) at Retirement (After Taxes) Disability Income Needed: Client Spouse Inflation Rate 3

Document Checklist Below is a list of documents usually needed to complete our analysis. Please furnish copies of the documents when possible. Tax returns Federal returns for last 2 years State return for last year All gift tax returns Applicable? (yes/no) Included? (yes/no) Investments Latest brokerage/mutual funds statements Documents on mortgages/notes receivable Personal insurance policies & premium notices All personal life insurance Personal health & disability Homeowners/tenants coverage/umbrella Auto insurance Miscellaneous personal documents Wills, Power of Attorney, Living Wills Trust documents: Latest 2 pay statements from employers Mortgage statement Other loan agreements or statements Employee benefits Booklets on group insurance coverage Booklets on retirement, thrift, etc., plans Employment agreement Deferred compensation agreement Stock option plans Keogh or IRA documents Business documents Partnership agreements & latest K-1's Federal tax returns for last 3 years Retirement profit sharing, etc. documents Stock redemption/buy-sell agreements Financial statements (balance sheet, profit/loss statement, etc.) 4

Advisors Name Institution Telephone May We Contact? Attorney (YES/NO) Accountant (YES/NO) Trust Officer (YES/NO) Banker (YES/NO) Insurance Agent (YES/NO) Investment Advisor (YES/NO) Stockbroker (YES/NO) Other (YES/NO) 5

Assets - Cash and Bank Balances Ownership: C=Client, S=Spouse, J=Joint Ownership Current Balance Interest Rate Institution Maturity Date (C,S,J) % Checking Accounts (C,S,J) % (C,S,J) % Savings (C,S,J) % Accounts (C,S,J) % (C,S,J) % Other(Money Market,CD s, (C,S,J) % Etc.) (C,S,J) % (C,S,J) % (Office use) 6

Investment Accounts (Include Brokerage Statements) Description Ownership Current Value () Annual Yield% Cost() Plannned Annual Additions (C,S,J) (C,S,J) (C,S,J) (C,S,J) (Office use) Less: Margin Loans 7

Assets - Retirement/Employee Benefits (Include Statements from Social Security & Company Benefits) Type Estimated Annual Benefit Age When Benefits Will Begin Cost of Living Adjust. Office Use Social Security Benefits (H) Social Security Benefits (S) Pensions (H) or (S) % Pensions (H) or (S) % Amount Vested Account Balance Annual Contribution Employer Match Profit Sharing (401K) Profit Sharing (401K) Employee Savings Plan Deferred Compensation IRA IRA Roth IRA Roth IRA Keogh Plan Stock Options - No. Shares (attach details) Conditions: Options Price Current Value 8

(Include Brokerage Statements) Residential Real Estate Primary Residence Secondary Residence Address Date Acquired: / / / / Ownership:(Circle one) (C,S,J) (C,S,J) *C=Client S=Spouse J=Joint Cost: Cost of Major Improvements: Total Cost: Estimated Market Value: Original Mortgage Original Mortgage Original Amount: Original Term(yrs.) & % Rate Type:(Fixed/Variable) Current Mortgage Balance Monthly Payments Date of First Payment yrs % / / yrs % / / Second Mortgage Second Mortgage Original Amount: Original Term(yrs.) & % Rate Type:(Fixed/Variable) Current Mortgage Balance Monthly Payments Date of First Payment yrs % / / yrs % / / 9

Assets- Miscellaneous Home Furnishings/ Personal Property Current Value () Automobiles Jewels & Furs Collections (Art, Etc.) Boats, RV s etc. Intangible Property Annual Income Expiration Current Value (Office Use) Patents Trademarks Copyrights Other contract rights: Give details of prospective profits, liabilities and values involved 10

Other Debts/ Liabilities Payment Balance Years Rate Monthly Minuimum Remaining Payments Payment Residence MTG Yrs % Credit Card Balances Yrs % Auto Loans Yrs % Boats, RVs, etc. Yrs % Life Insurance Policy Face Name of Company Type Insured Amount Owner Beneficiary Cash Value Key: Type T = Term W = Whole Life V = Variable U = Universal Beneficiary ILIT = Trust(ILIT) C = Client S = Spouse 11

Other Insurance (Include Copies of Policies) Inflation Rider Beneficiary Amount Yrs. of Coverage Disability Long Term Care Long Term Care Sources of Income (AMOUNT) (AMOUNT) FICA Status Taxable Non Taxable 5-Year Projection Source Client Spouse *S/E Amount Amount (%) Gross Salary Bonus Commission Interest Dividends Net Rents Royalties Business Profits Annuities Trust Income Alimony Other Income (Partnerships, Etc.) (Office use) 12

Cost of Living (Indicate monthly or annually) Non-Discretionary Item Monthly Annually Food, groceries, etc... Home mortgage... Home equity loans... Rent for residence... Property taxes - Home... Vacation home... Miscellaneous... Utilities Gas & Electric Telephone... Water/sewer... Cable/Internet.. Insurance - Home... Husband s Life... Wife's Life... Children's Life... Medical... Disability... Long Term Care... Education... Professional Dues... Medical /Dental Expenses... Life insurance loans... Other installment loans... Alimony... Term Years Child support. Term Years 13

Domestic Help/Babysitting Childcare/Daycare. Auto: Loan Pmt./Lease Pmt(Circle One)... Fuel Repair & Maintenance... Insurance Subtotal Non-Discretionary ============= ============ Discretionary Clothing and Personal Items.. Dry Cleaning/Laundry. Lessons (Music/Dancing)... Club Dues... Entertainment & Dining Books /Papers/ Subscriptions... Home Maintenance/Property Improvement/Repairs... Yard Maintenance... Pool Maintenance/Repairs... Vacations... Home Furinshings... Gifts/Birthdays/Holidays... Charitable donations... Subtotal Discretionary ============= ============ Total Expenses (before income taxes) ============= ============ 14

Special Income/Expenses Description Annual Amount Increase Rate Start Year # of Yrs % % % % Educational Funding % 1. 2. 3. 4. (A) Current Years Annual Child School Cost Balance Saved In School Contributions 15

Traphagen Risk Assessment Questionnaire Time Horizon: 1. What is your current age? Less than 45 (5) Your current situation and 45 to 55 (4) future income needs 56 to 65 (3) 66 to 75 (2) Older than 75 (1) 2. When do you expect to start drawing income? Not for at least 20 years (5) In 10 to 20 years (4) In 5 to 10 years (3) Not now, but within 5 years (2) Immediately (1) Score: out of 10 Short-Term Risk Attitudes: 3. Which of these statements would best describe Who cares? One calendar quarter means nothing (5) Attitude toward short-term your attitudes about the next three months I wouldn t worry about losses in that time frame (4) volatility performance on investments? If losses were greater than 10%, I d be concerned (3) I can only tolerate short-term losses (2) I d have a hard time accepting any losses (1) 4. Which of these statements would best describe I don t mind if I lose money (5) your attitudes about the next three years I can tolerate a loss (4) performance on investments? I can tolerate a small loss (3) I d have a hard time tolerating any losses (2) I need to see at least a little return (1) Score: out of 10 Long-Term Goals/Expectations: 5. What is your investment goal? Aggressive Growth (5) View on how investments should Moderate Growth (4) perform over the long term Growth & Income (3) Income (2) Capital Preservation (1) 6. Assuming normal market conditions, what Keep pace with the stock market (5) would you expect from investments over Slightly trail stock market, but make a good profit (4) the long-term? Trail stock market, but make a moderate profit (3) Have some stability, but make modest profits (2) High degree of stability, but make small profits (1) 7. Suppose stock market performs poorly over To lose money (5) the next decade, what would you expect To make very little or nothing (4) from investments over the long-term? To earn a little gain (3) To earn a modest gain (2) Little effect by what happens in the stock market (1) 8. Long-term expectations for stock returns? 0 to 2% (1) 3 to 5% (2) 6 to 8% (3) 9 to 10% (4) 10% + (5) 9. Long-term expectations for bond returns? 0 to 2% (1) 3 to 4% (2) 5 to 6% (3) 7 to 8% (4) 8% + (5) Score: out of 25 16

Traphagen Risk/Investment Assessment Returns Category Score Results Stable Value Capital Preservation Balanced Moderate Growth Growth/ Aggressive Growth Time Horizon*** out of 10 2 to 3 4 to 5 6 to 7 8 to 9 10 Short-Term Risk Attitudes Long-Term Goals & Expectations Expected Stock Return (Answer #8 Average) Expected Bond Return (Answer #9 Average) Total Expected Return (Stock + Bond) *** Time Horizon helps identify portfolio risk limits Instructions: out of 10 2 to 3 4 to 5 6 to 7 8 to 9 10 out of 25 5 to 9 10 to 14 15 to 19 20 to 24 25 x.10 = x.40 = x.60 = x.75 = x.85 = x.90 = x.60 = x.40 = x.25 = x.15 = 1) Tally scores from Risk Questionnaire and input into the score section 2) Circle corresponding values based off scores inputted. 3) Results from Short-Term and Long-Term Risk/Expectations will determine portfolio for expected return. If results are different, continue with steps 4 and 5 for both portfolios to provide an expected return range. (i.e. Short-Term = 7 and Long-Term = 16, you are Balanced) or (i.e. Short-Term = 5 and Long-Term = 15, you are both Capital Preservation and Balanced) 4) Thus, using the examples above, take the average return expectations from question 8 and 9 and input into the corresponding portfolio based off previous input, in this case Capital Preservation and Balanced Portfolio. (i.e. Stocks 6 to 8 (average = 7) and Bonds 0 to 2 (average = 1) 5) Last, multiply average expected returns by the corresponding portfolio s weightings, adding the two figures together for your Total Expected Return. (i.e. Balanced (7x.60 = 4.2%) + (1x.40 =.4 ), therefore Total Expected Return 4.6%) (i.e. Capital Preservation (7x.40 = 2.8) = + (1x.60 =.6), therefore Total Expected Return 3.4%) Traphagen Portfolio Summary Stable Value: Ultra conservative allocation. Appropriate for investors who can tolerate very little volatility, wish to minimize the risk of capital loss, and have a very short term time horizon (less than 2 years). Designed for wealth protection with income as a secondary objective. Capital Preservation: Very conservative allocation. Appropriate for conservative investors or investors with a short term investment horizon (2-3 years). Designed for income, wealth protection, and liquidity with growth as a secondary objective. Balanced: Moderately conservative allocation. Appropriate for conservative investors or investors with a short / intermediate term investment horizon. Designed for income, wealth protection, and growth. Moderate Growth: Moderate Investment Allocation. Appropriate for moderately risk tolerant investors with an intermediate to long term investment horizon (5-10+ years.) Designed for growth and income. Growth: Aggressive Allocation. Appropriate for investors with a long term investment horizon and a high tolerance for risk. Predominately designed for growth with income as a secondary objective. Aggressive Growth: Most aggressive allocation. Appropriate for very aggressive investors with a long term investment horizon (10 years +). Designed for growth. 17

Goals - Death or Disability 1. How do you want your estate distributed among your beneficiaries? 2. What is your spouse's minimum income requirement? 3. What income would you want him/her to have if possible? 4. What is the minimum income required for your family until all the children are no longer dependant? 5. Will any child be dependant after attaining maturity? Give details. 6. To what degree is spouse capable of managing financial affairs? 7. Will spouse continue to live in present home? 8. Should mortgage be paid off? 9. Should spouse be protected against possible senility, second spouse, caprices, etc.? Additional Information 1. Do you or your spouse expect an inheritance? 2. Is it important that you retain full control of your assets during your lifetime 3. Any additional considerations? Goals - Children 1. Should your children be permitted to consume capital or income only? 2. When and how should capital be distributed? 3. Should any special problems be considered and special allowances made, i.e. for example, for physical defects, personality, ability, etc.? 4. What educational and business opportunities do you wish to be provided for them if possible? 18

Your Financial Goals Indicate any other goals you wish to obtain and your outlook on your financial future. 1. 2. 3. 4. 5. 6. 7. 8. 19