Retirement Planning

Client Intake

About 5–10 minutes. Estimates are completely fine. If you do not know an answer, choose Not sure or leave it blank. Your advisor will review everything with you.

What happens next:
1. Answer the questions.
2. Click Complete My Form at the end.
3. Your answers will be submitted securely.
4. Your advisor will review them and contact you to schedule your meeting.

You do not need to calculate anything perfectly.

Please do not enter: Social Security number, bank/routing/account number, driver's-license/passport number, passwords, or medical records.

1. About You

Basic information so your advisor knows who the plan is for.

Your name

Best email address

Best phone number

Your age

Spouse / partner name

Spouse / partner age

State

Marital status

Your work status

Spouse / partner work status

When would you like to retire?

Number of people financially dependent on you

Occupation / work role

2. Your Monthly Picture

Round numbers are fine. This helps us see what is comfortable and sustainable.

About how much does your household earn per year before taxes?

About how much comes home each month after taxes?

About how much do you spend each month?Include normal living expenses. An estimate is fine.

Total monthly debt paymentsMortgage, vehicles, cards, loans, etc.

Cash you could access fairly quicklyChecking, savings, HYSA, money market, or similar.

How much could you comfortably set aside each month for long-term goals?

Do you have a one-time amount you may want to reposition or invest?

Where would those one-time funds come from?

Retirement Accounts & Other Assets

Only add the accounts that matter. You do not need exact balances.

Debts

Add major debts. If you do not know the exact APR, leave it blank.

3. Retirement Income

Think about the monthly lifestyle you would like to maintain.

Desired monthly retirement income

Estimated monthly Social Security — you

Estimated monthly Social Security — spouse

Planned Social Security start age

Other guaranteed monthly income before Social Security

What is it?

Other guaranteed monthly income after Social Security

What is it?

Housing

Mortgage type

Approximate mortgage balance

Mortgage interest rate %

Years remaining

Monthly principal & interest payment

4. Family Protection & Existing Products

This helps your advisor understand whether insurance protection is part of the conversation.

Current total life-insurance coverage

If you know it, estimated additional coverage needed

Do you want some life insurance to last your entire life?

Highest credit-card/personal-loan APR %

Tobacco / nicotine useFor preliminary life-insurance illustration assumptions only. No medical details are requested.

Would this potentially replace existing life insurance?

Simple family protection estimate

Debts you would want paid off for survivors

Annual income survivors may need replaced

How many years might that income be needed?

Education / family funding goal

Final expenses

Legacy / inheritance goal

Liquid assets available to survivors

Main protection need

5. What Matters Most to You?

There are no right or wrong answers.

How do you feel about market ups and downs? How important is having predictable or guaranteed retirement income? How important is easy access to your money?

Primary financial goal

Biggest financial concern

Main retirement-income objective

Could you need to move long-term funds early?

About what % of proposed long-term funds might you need within one year?

If a lump sum is used, how would you prefer it to be allocated?

Financial-product experience

Approximate tax bracket %

Approximate liquid net worthCash and investments you could reasonably access without selling a home or business.

Any major financial change expected?

Existing annuity information, if applicable

Approximate value of existing annuities

Years of surrender charges remaining, if known

Have you exchanged/replaced an annuity before?

When would you want retirement income to begin?

If income is needed, should it cover one person or both spouses?

Anything else you want your advisor to know?

6. Review & Complete

You are almost done.

Do not worry about blanks or estimates. Your advisor will review your answers with you before discussing options.

After clicking the green button: your answers will be submitted securely to your advisor. There is nothing to download or email back.

I confirm that I did not enter an SSN, full bank/routing/account number, driver's-license/passport number, password, or medical record.