Financial planning fact finder - Henker Financial …

1 Please list your specific Financial do you feel are the main obstacles to achieving your goals?In three years from now, looking back on your relationship with your Financial advisor, what will you have expected to have accomplished? What keeps you up at night?What are your top priorities? Some basic information about you: Prefix: q M r. q Mrs. q Ms. q D r. / /q Ye s q NoName Date of CitizenStreet addressCityStateZip codeContact numberEmailOccupationEmployerFinancial planning fact finder Our Financial planning process involves discussing your goals, gathering pertinent data, designing solutions, and delivering a cohesive plan that you can implement to help you reach your goals.

2 The process begins with understanding what you want to achieve. 2Co-Client Prefix: q M r. q Mrs. q Ms. q D r. / /q Ye s q NoName Date of CitizenStreet AddressCityStateZip CodeContact NumberEmailOccupationEmployerDependents / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan? / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan? / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan? / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan? / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan?

3 / /q Ye s q NoNameDate of BirthRelationship Type*CitizenshipAdd to Plan?*Daughter, Son, Mother, Father, etc. 3 Professional AdvisorsAttorneyBusiness NameAddressPhoneAccountantBusiness NameAddressPhoneInsurance AgentBusiness NameAddressPhoneOtherBusiness NameAddressPhoneEducationList any education goals or expenses anticipated for yourself, your children and/or your grandchildren including primary school, private school, Trade Schools, and Colleges and a r start# of yearsAnnual school costFunds available nowMonthly savingsPortion to fundStudentDescriptionYe a r start# of yearsAnnual school costFunds available nowMonthly savingsPortion to fundStudentDescriptionYe a r start# of yearsAnnual school costFunds available nowMonthly savingsPortion to fundStudentDescriptionYe a r start# of yearsAnnual school costFunds available nowMonthly savingsPortion to fund4 Document ChecklistThe following documents can assist us in creating your Financial plan.

4 You can skip the corresponding section in the fact finder for information provided in the documents. Please provide copies of the following Bank and Brokerage Statements q a. Checking Account Statements q b. Savings/CDs/Money Market Statements q c. Brokerage Account Statements q d. Loan Statements (Personal Residence, Primary Residence, Home Equity/Other Mortgage, Real Estate, Investment/Margin, Credit Card, Automobile) q e. IRA/Roth IRA Statements2. Employment Documents q a. Payroll Statements q b. Employee Benefits Statement q c. Group Term Life Insurance q d. Group Disability Coverage q e. Retirement Plan Statements (401(k), 403(b), 457) q f.

5 Pension Plan Statements q g. Section 125 Plan (Cafeteria, MSA) q h. Stock Option Plan3. Insurance Company (Most recent statement or declaration page for each) q a. Life q b. Annuity q c. Health q d. Disability Income q e. Long Term Care q f. Homeowners q g. Auto q h. Umbrella/Excess Liability q i. Professional Liability4. Tax and Legal Documents q a. Latest Income Tax Returns (Last 2 years) q b. Loan Documents q c. Wills q d. Trust Documents q e. Settlement Agreements q f. Pre- and Post-Nupital Agreements q g. Divorce Settlements (alimony and child support) q h. Powers of Attorney q i. Prepaid Legal Fees q j. Business Agreements/Loans q k.

6 Employment Contracts5. Business Documents q a. Buy-Sell Agreements q b. Deferred Compensation Plans q c. Stock Option/Stock Bonus Plan5 AssetsPersonal Assets: Please include any personal assets that you own including residences, automobiles, collections, art work, jewelry, AssetsOwnerValueInvestments: Please include all non-qualified investments such as bank accounts, brokerage accounts, and investment holdings and indicate the annual contribution you plan to make to each. InvestmentsOwnerValueAnnual ContributionCheckingSavingsCDsBrokerageR etirement Assets: Please include all qualified investments such as IRAs/Roth IRAs, 401(k), 457, and SEP accounts and indicate your annual contribution to each and contributions from your employer.

7 Retirement AssetsOwnerValueAnnual ContributionsEmployer Contributions6 Assets (continued)Real Estate Holdings: Please include all real estate holdings by location and indicate any future plans to sell the holdings. Real Estate locationOwnerCurrent Market ValueBasisPlan to sell?Business Interests: Please list all business interests for which you own part of all of the interest. Business NameBusiness Name 1 Business Name 2 Business Name 3 OwnerBusiness Type*Base ValueTax BasisPass Thru (Yes/No)*Sole Proprietorship, Partnership, S-Corp, C-Corp, Limited Liability Corp, Professional Corp Business Cash FlowBusiness Name 1 Business Name 2 Business Name 3 IncomeExpensesDistribution TypeDistribution AmountDistribution (% of income)Related Business QuestionsBusiness Name 1 Business Name 2 Business Name 3 Client active in the business?

8 Q Ye s q Noq Ye s q Noq Ye s q NoSpouse active in the businessq Ye s q Noq Ye s q Noq Ye s q No# of children involvedq Ye s q Noq Ye s q Noq Ye s q NoFuture Plansq Ye s q Noq Ye s q Noq Ye s q NoShareholder, Partnership or Operating Agreementq Ye s q Noq Ye s q Noq Ye s q NoDoes current agreement permit gifting? q Ye s q Noq Ye s q Noq Ye s q NoBuy/Sell Agreement among owners?q Ye s q Noq Ye s q Noq Ye s q NoBuy/Sell Agreement funded with life insurance? q Ye s q Noq Ye s q Noq Ye s q NoHow of coverage if applicable?q Ye s q Noq Ye s q Noq Ye s q No7 InsurancePlease list the insurance policies currently in force.

9 If you have copies of the latest statements or declaration pages, you do not need to complete this section. Life Insurance includes Group, Term, Whole Life, Universal Life, Variable, or other custom policies. Policy 1 Policy 2 Policy 3 Policy 4 Policy 5 Life InsuranceInsuredOwnerBeneficiaryFace amountAnnual premiumCash valueDisability Income includes Group and Individual policies. Policy 1 Policy 2 Policy 3 Policy 4 Disability incomeInsuredMonthly benefitAnnual premiumWaiting periodLength of benefitCost of living adjustment (COLA)8 Insurance (continued)Long Term Care insurance includes Group and Individual policies. Policy 1 Policy 2 Policy 3 Policy 4 Long Term CareInsuredAnnual premiumDaily benefitWaiting periodLength of benefitCost of Living Adjustment (COLA)COLA Method** Simple or CompoundLiabilitiesPlease list all outstanding liabilities including mortgages for your primary residence, home equity loan, real estate holdings, businesses, investment/margin, credit cards, and automobile loans.

10 LiabilityCurrent BalancePeriodic PaymentPayment FrequencyInterest RateYear of Maturity9 IncomePlease include income you receive with the exception of income related to business interests (included on page 6). IncomeClientCo-ClientJointAny anticipated changes?SalaryBonusSelf EmploymentDividends / InterestRentalsSocial Security Benefits: Please include your most recent Social Security BenefitsRetirement Monthly BenefitSurvivor BenefitsAge 62 monthly income$ _____Family Benefit$ _____Full monthly income$ _____Spousal Benefit$ _____Age 70 monthly income$ _____Retired Benefit$ _____Co-Client BenefitsCo-Client BenefitSurvivor BenefitsAge 62 monthly income$ _____Family Benefit$ _____Full monthly income$ _____Spousal Benefit$ _____Age 70 monthly income$ _____Retired Benefit$ _____Pensions: Please list all you are eligible to AgeMonthly AmountAnnual Inc.