Financial Planning Intake Form

Confidentiality Statement

Client’s Name

Age

Spouse Name

Age

Number of Dependents (Names and Age)

Age

Address

Primary Phone

What is your household’s combined annual gross income?

2. As a holistic family financial planning firm, we need to understand your current financial situation, please provide the following

i. Investment Objectives: What are your financial goals? Are you saving for retirement, education, or other specific purposes?

ii. Experience: How familiar are you with investing? Have you invested before, or is this your first time?

iii. Time Horizon: How long do you plan to invest? Short-term, medium-term, or long-term?

• Long-Term Goals (10+ years)

• Mid-Term Goals (5-10 years)

• Short Term Goals (1-5 Years)

• Emergency Funds

iv. Risk Tolerance: How comfortable are you with market fluctuations? Are you willing to accept higher risk for potentially higher returns

3. Which investment profile best reflects your risk tolerance level?

The pie charts are a visual breakdown of how you might allocate your portfolio based on your level of risk tolerance:

Very Conservative Profile: Here, you'll notice that 75% is invested in bonds and 15% to cash reserves, with only a small portion in stocks. This is the 'safety-first' approach, ideal for those who prioritize capital preservation and who have only very short time horizons.
Conservative Profile: Similar to the very conservative profile but with a slightly higher allocation to stocks. This setup provides a bit more potential for growth while still focusing on stability. While still emphasizing bonds (65%), this profile allows for some growth through a 25% allocation in stocks. The cash reserve remains significant at 10%.
Moderate Profile: A balanced mix, with 50% in bonds and 45% in stocks. This middle-of-the-road approach aims for a blend of growth and income.
Aggressive Profile: In this profile, a significant two-thirds is allocated to stocks, with bonds making up the smaller share. This is for those willing to take on greater risk for the potential of higher returns.
Very Aggressive Profile: Here, stocks dominate the portfolio at nearly 80%, and the cash reserve is the lowest among all profiles. This is for the high-risk, high-reward investor who is largely unperturbed by market volatility.

a. Current Financial Status: Current Savings Account Balance: Stocks - Name: Qty: Total Value: Stocks - Name: Qty: Total Value: Bonds - Name: Qty: Total Value: Mutual Funds: Qty: Total Value: Real Estate: Qty: Total Value: Other Assets: Qty: Total Value:

Debts Mortgage: Car Note Balance(s): Credit Card(s): Student Loans: Debt 5: Debt 6: Debt 7:

Insurance Planning:

Current Insurance Policies:

Whole Life Insurance Face Value: Age of Policy: Face Value: Age of Policy: Face Value: Age of Policy:

Term Life Insurance Face Value: Expiration Date: Face Value: Expiration Date: Face Value: Expiration Date:

Health Insurance Company: Expiration Date:

Other Life Insurance Face Value: Expiration Date:

c. Family Legal Documents (Trust, Wills, Power of Attorney): Do you need a:

i. Will

ii. Power of Attorney

iv. Other Legal Documents

4. Additional information you would like to provide