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Forms are an important part of business. They help keep track of what has been done, and what needs to be done. A strategic point questionnaire form is a great way to make sure that all the important points about a project have been covered. This form can be used by individuals or businesses to ensure that they are staying on track with their goals. filled out by both the individual and the supervisor, this form will help to keep everyone on track and organized. Having this form as a resource will help to insure success for any goal oriented project.

You may find info about the type of form you would like to fill out in the table. It can tell you the length of time you will need to finish strategic point questionnaire, what parts you need to fill in, and so on.

QuestionAnswer
Form NameStrategic Point Questionnaire
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other namesRoth, financial planning fact finder template, TODs, CollegeBoundFund

Form Preview Example

Financial Planning

Questionnaire

To complete this form by hand:

 

 

To complete this form electronically:

 

 

1

Print all pages of this form.

 

1

Save this writable PDF to your computer, then open it using Adobe’s

2

Complete the form by illing in each

 

 

 

Acrobat Reader.

 

 

 

 

 

space with black or blue ink. Do not

Or

2

Complete the form by typing into the designated ields and/or

 

use pencil.

 

 

 

checking the appropriate buttons. Tip: you can tab from ield to ield.

3

When inished, simply bring the

 

3

When inished, save the form and email it to clients@StrategicPoint.com.

 

form to your meeting.

 

 

 

Or you can bring a copy with you to our meeting.

General Information

Your First & Last Name:

 

 

 

Today’s Date:

/

/

 

 

 

 

 

 

 

 

Marital Status: Single

 

Married Partner

Separated Divorced Widowed

 

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

State:

 

Zip Code:

 

 

 

 

 

 

 

 

Home Phone: (

)

 

Email:

 

 

 

 

 

 

 

 

 

 

Your Date of Birth:

 

/

/

Your Social Security #:

Are You a U.S. Citizen? Yes No Spouse’s/Partner’s (Co-Client’s) First & Last Name:

Spouse’s/Partner’s Date of Birth:

/

/

Spouse’s/Partner’s Social Security #:

Is your Spouse/Partner a U.S. Citizen? Yes

No

 

 

 

 

 

Employment Information

 

 

 

 

 

 

 

 

Your Employment: Self-Employed

Company Owner

Employee

Retired

 

 

 

Company Name:

 

 

 

 

 

 

 

 

 

Occupation:

 

 

 

 

 

Years with Company:

 

 

Street Address:

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

State:

 

Zip Code:

 

 

Work Phone: (

)

 

Ext:

Fax: (

)

 

 

Work Email:

 

 

 

 

 

 

 

 

 

Spouse’s/Partner’s Employment: Self-Employed Company Owner

Employee

Retired

 

 

Company Name:

 

 

 

 

 

 

 

 

 

Occupation:

 

 

 

 

 

Years with Company:

 

 

Street Address:

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

State:

 

Zip Code:

 

 

Work Phone: (

)

 

Ext:

Fax: (

)

 

 

Work Email:

 

 

 

 

 

 

 

 

 

Questions? Please call (401) 273-1500.

 

 

 

 

Form continues

 

 

 

 

 

 

Financial Planning Questionnaire (CONTINUED)

Assets

Bank Accounts

Name of Account

Owner

Balance

 

 

 

Checking

 

$

 

 

 

Money Market / Savings

 

$

 

 

 

All CDs

 

$

 

 

 

Other:

 

$

 

 

 

How much of the above amount do you want earmarked for retirement?

 

$

 

 

 

Retirement Accounts

List tax-deferred accounts separately and include accounts labeled: 401(k), 403(b), 457, ESOP, SEP, SIMPLE, Proit Sharing, TSA, Annuities, Traditional IRA and Roth IRA. Please attach copies of most recent statements.

Name of Account

At

Owner

Balance

 

 

 

 

Example: Lifespan 403(b)

Vanguard

Mary

$42,000

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

Taxable Accounts

List accounts separately and include: brokerage accounts, joint accounts, trusts, TODs, PODs, non-qualiied annuities and accounts in an individual name. Please attach copies of most recent statements.

Name of Account

At

Owner

Balance

 

 

 

 

Example: Individual Account

Vanguard

John

$51,000

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

Notes

 

 

 

 

 

 

 

 

 

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Assets Held for Education

 

 

 

 

 

 

 

 

List separately for each child and include 529 Plans, Coverdell IRAs, Custodial Accounts, Education

 

 

Savings Bonds, Mutual Fund Accounts, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Account

Type

 

Owner

 

Beneiciary

 

Balance

 

 

 

 

 

 

 

 

 

Example: CollegeBoundFund

529 Plan

 

Mary

 

Julia

 

$15,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business Ownership

 

 

 

 

 

 

 

 

Include businesses in which you have direct ownership.

 

 

 

 

 

 

 

 

 

 

 

Name of Business

Owner

 

 

Business Type

Appraisal (your share)

 

 

 

 

 

 

 

Example: Peter’s Painting Co.

Peter

 

 

S-Corp

$250,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

Do you plan to sell your business to create retirement assets?

 

 

Yes No

 

 

 

 

 

 

 

 

 

If yes, in what approximate year?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Assumed annual growth rate of business:

 

 

 

 

 

 

(If left blank, we will grow your business by 8% until sold.)

 

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Personal Property

 

 

 

 

 

 

 

 

Include collectibles, boats, automobiles, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Property

 

 

 

 

 

Owner

 

Value

 

 

 

 

 

 

 

 

 

Example: Art Collection

 

 

 

 

 

Mary/John

 

$75,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Real Estate

 

 

 

 

 

 

 

 

For additional properties, please attach a separate sheet.

 

 

 

 

 

 

 

 

 

 

 

 

Property

 

 

Investment or Personal

 

Owner

 

Value

 

 

 

 

 

 

 

 

Example: 212 Windham

 

 

Personal Residence

 

Joint

 

$315,000

 

 

 

 

 

 

 

 

 

 

 

Personal Residence

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

Second Home

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

Investment Property (1)

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

Investment Property (2)

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

$

 

 

 

 

 

How much pre-tax income do you receive each year from your investment properties?

 

$

 

 

 

 

 

 

 

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Which of these real estate properties is available to be sold with the proceeds used for retirement?

In what year would you like to sell the property?

Liabilities

Mortgages

Mortgages

Balance Remaining

Term Remaining

Interest Rate

 

 

 

 

Primary Residence

$

 

%

 

 

 

 

Second Home

$

 

%

 

 

 

 

Investment Property (1)

$

 

%

 

 

 

 

Investment Property (2)

$

 

%

 

 

 

 

Other:

$

 

%

 

 

 

 

Other:

$

 

%

 

 

 

 

Home Equity Line of Credit Balance:

 

 

$

 

 

 

 

Amount Available:

 

 

$

 

 

 

 

Other Debt

Debt

Vehicle

Vehicle

All Credit Cards

Student Loans

Other:

Balance

Interest Rate(s)

$

%

$

%

$

%

$

%

$

%

 

 

Income and Retirement Analysis

 

Your Current Annual Income?

$

 

 

At what age do you expect to retire? (If you are already retired, put in your current age.)

 

(We will use this age to run your retirement projections.)

 

 

 

How much do you contribute to your retirement plans each year?

 

(Include the amount your employer adds through a proit sharing or matching program.)

$

 

 

Spouse’s/Partner’s Current Annual Income?

$

 

 

At what age does your spouse/partner expect to retire?

 

(If she/he has already retired, put in her/his current age.)

 

 

 

How much does your spouse/partner contribute to her/his retirement plans each year?

 

(Include the amount her/his employer adds through a proit sharing or matching program.)

$

 

 

How much will you need to spend each month in retirement?

 

(Include taxes and think in terms of today’s dollars.)

 

(If you leave this question blank, we will assume you will need 85% of your current income.)

$

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Additional Annual Savings:

Type of Account:

$

Pensions

Client Name

Monthly Amount at Start

Age at Start

Inlation COLA

 

 

 

 

 

Example: Mary

$1,200

65

Yes

No

 

$

 

Yes

No

 

 

 

 

 

 

$

 

Yes

No

 

 

 

 

 

 

$

 

Yes

No

 

 

 

 

 

What payout option does this pension represent? (We will assume joint and 50% survivor unless otherwise indicated.)

Single Life

Name Applicable Pension(s):

 

 

 

 

Joint and 50% Survivor

Name Applicable Pension(s):

 

 

 

 

Joint and 100% Survivor

Name Applicable Pension(s):

 

 

 

 

 

 

 

Social Security

 

 

 

 

 

Client Name

Age to Start Payments

Anticipated Monthly Payment

 

 

 

Example: John

66

$1,436

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

Other Income and Expenses

 

Do you expect to work part-time during retirement?

Yes

No

 

 

 

 

 

 

 

 

 

If yes, for how many years?

 

 

At what salary (in current dollars)?

$

 

 

 

 

 

 

 

 

 

 

Does your spouse/partner expect to work part-time during retirement?

Yes

No

 

 

 

 

 

 

 

 

If yes, for how many years?

 

 

At what salary (in current dollars)?

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is the value of any expected inheritance/gifts?

 

$

 

 

 

 

 

 

 

 

In what year would you estimate that you might receive this inheritance?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is the value of any anticipated expenses or major purchases (other than education)?

$

 

 

 

 

 

 

 

 

 

In what year should these expenses be applied?

 

 

 

 

 

 

 

 

 

 

Is there anything else we should know about when we plan for your retirement?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Notes

Insurance Analysis

For how many years will you need life insurance?

If you leave blank, we will assume until the irst year of retirement.

Life Insurance: Term Policies

Please attach your latest statement.

Face Value

Insured

Group or Individual

Term Remaining

Premium per Year

 

 

 

 

 

Example: $500,000

John

Individual

10 years

$700

 

 

 

 

 

$

 

 

 

$

 

 

 

 

 

$

 

 

 

$

 

 

 

 

 

$

 

 

 

$

 

 

 

 

 

$

 

 

 

$

 

 

 

 

 

Life Insurance: Permanent Policies

Please attach your latest statement.

 

 

Year

 

 

Premium

Face Value

Type

Purchased

Insured

Cash Value

per Year

 

 

 

 

 

 

Example: $100,000

Whole Life

1998

Mary

$10,000

$1,000

 

 

 

 

 

 

$

 

 

 

$

$

 

 

 

 

 

 

$

 

 

 

$

$

 

 

 

 

 

 

$

 

 

 

$

$

 

 

 

 

 

 

$

 

 

 

$

$

 

 

 

 

 

 

Long Term Disability Insurance

Please attach policies if available.

 

Name

Monthly Beneit

Group or Individual

Premium per Year

 

 

 

 

 

 

 

 

Example: John

$3,000

Individual

$2,100

 

 

 

 

 

 

 

 

 

$

 

$

 

 

 

 

 

 

 

 

 

$

 

$

 

 

 

 

 

 

 

 

 

$

 

$

 

 

 

 

 

 

 

 

 

$

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Long Term Care Insurance

Please attach policies if available.

Name

Daily Beneit

Inlation Rider

Term

 

Premium per Year

 

 

 

 

 

 

 

Example: Mary

$150

Yes

No

3 years

 

$1,500

 

$

Yes

No

 

years

$

 

 

 

 

 

 

 

 

$

Yes

No

 

years

$

 

 

 

 

 

 

 

Notes

Funding Needs for Children and Other Dependents

We will use the college savings information from the Assets section to determine our education funding projections.

Name

Date of Birth

College Start Year

Years to Fund

 

 

 

 

Example: Julia

2/23/2001

September 2013

4 years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Annual Cost

What is the annual cost of college you are willing to fund for each child?

Keep in mind that your children may get inancial aid or choose to take out student loans to help pay for expenses. Therefore, list only the amount you are willing to pay in current dollars. For instance, if you expect a year of college (graduate school) to cost $15,000 and you plan to pay two-thirds of that amount, then you would give “$10,000” as your estimated cost.

$

Annual expenses for other dependents (for example, parents):

$

Estate Planning

Do you have updated wills?

Yes

No

 

 

 

Do you have powers of attorney?

Yes

No

 

 

 

Have you executed health care proxies?

Yes

No

 

 

 

When were these documents last updated?

 

 

 

 

 

Questions? Please call (401) 273-1500.

Form continues

Financial Planning Questionnaire (CONTINUED)

Have you established any trusts?

Yes No

 

 

If yes, names of trust(s) you have established:

Notes

Whom may we thank for referring you?

Please bring your completed Financial Planning Questionnaire along with any appropriate attachments to the meeting with your StrategicPoint advisor.

Please DO NOT complete this section PRIOR to meeting with your advisor.

I acknowledge receipt of StrategicPoint Investment Advisor’s Privacy Policy, Form ADV Part 2,

Proxy Voting Policy and the BCP disclosure statement.

Client Signature

Print Name

Questions? Please call (401) 273-1500.

Thank You.