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Confidential Personal Profile

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					Confidential Personal Profile
Please fill out this questionnaire. Your answers will remain completely confidential, but are crucial to the planning process. Please bring a copy of this document as well as copies of all documents requested below to your meeting or fax the information to us at 314.878.2701. Please feel free to call us with any questions toll-free at 877.345.6103.

Wealth Advisory Group

Contact Information

Your Name Spouse’s Name Residence Address Mailing Address Home Phone Spouse’s Mobile Your Email

Birthdate Birthdate

Social Security Number Social Security Number

Residence Address City/State/ZIP Mailing Address City/State/ZIP Your Mobile Spouse’s Work Phone Spouse’s Email Your Work Phone Fax

Please list your preferences for our method of contacting you

Please list your children, their birth dates, and Social Security Numbers.

Occupation
Your Job Title Your Employer Years Employer Retirement Date

Your Employer’s Address (Street Address/City,State ZIP) Spouse’s Job Title Spouse’s Employer Years Employed Retirement Date

Spouse’s Employer’s Address (Street Address/City,State ZIP)

Current Professional Advisors
Accountant’s Name Attorney’s Name Insurance Agent’s Name Other Significant Advisor’s Name

Firm Name Firm Name Firm Name Firm Name

Phone Number Phone Number Phone Number Phone Number

Net Worth and Income
Net Worth (include illiquid assets) Liquid Net Worth Family Income

Concerns and Objectives Retirement Planning Please communicate your current retirement goals. Please include when you plan to retire (or if retired, when did you retire), whether or not you plan to work part-time in retirement, what employee benefits will continue into retirement (ex. Health insurance), and how much income you will want.

Estate Planning Please list probable inheritances where you or your spouse is the beneficiary. Please list who you want to inherit your estate. Include their name, Social Security number, birth date, and their relationship to you.

Education Planning Please list anyone you will be educating including their name and current year in school. Describe your goal for each (i.e. planning to pay 75% of four years at a private college.)

Liabilities Please communicate your debt situation. List the type of debt, the amount, the interest rate, and the terms of the loan (i.e. payments and expected payoff date).

Your Personal Concerns Please discuss your own personal concerns not outlined above. Are you expecting a major life change such as marriage, illness, etc.? Do you have a unique situation that requires special planning?

Business Owners What type of business do you own? Please communicate your retirement plan information. Do you have buy/sell offers or a business continuation plan?

Necessary Information Checklist Please bring copies of these documents to your meeting or fax the information to us at 314.878.2701. This is vital. Financial Statements  All investment statements.  Retirement plan statements with detailed information about investment options and company matching.  Pension information  Written information for investments without statements (i.e. savings bonds) Education Planning  Statements for all education accounts such as 529s or ESAs. Employment  One full cycle of pay stubs from your employer. Estate Planning  Wills, trusts, and power of attorney documents. Protection  Life insurance policies and statements.  Nursing home insurance policies.  Car, home, and umbrella declaration page. Retirement Planning  Social Security statements. Taxes  Tax returns for the last two years. Photographs  Please bring at least three photographs communicating what is important to you.


				
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