The Financial Advisors, LLC
26 Essex St. Andover, MA 01810 • 40R Merrimac St. Newburyport, MA 01950
Client Questionnaire
26 Essex Street
Andover, MA 01810
Phone 978-475-3242
Fax 888-974-0397
Email
www.the-financial-advisors.com
40R Merrimac Street, Ste. 101
Newburyport, MA 01950
Phone 978-463-6660
Fax 888-974-0397
The Financial Advisors, LLC Client Questionnaire
2
Financial Information:
To effectively advise you on financial decisions and make the best use of meeting time, we will
need complete information about your financial life. The first step in the financial planning process is
data collection. To facilitate the data collection and make our initial meeting more productive, we
ask that you to complete our client questionnaire.
We ask that you please return the completed questionnaire to us by regular mail, fax, or electroni-
cally via ShareFile (link is on our web site). Please do not hesitate to call us with any questions
prior to getting started.
Confidentiality:
Confidentiality and protection of your personal information is of the highest importance to our firm.
We will not disclose any information about you to anyone -- including your employer, accountant,
attorney, or family -- without your permission.
The Financial Advisors, LLC Client Questionnaire 3
Referred by:
Date completed:
Clients – Personal and Contact Info
Family Data
Client 1
Client 2
Full Legal Name (First, MI, Last)
Preferred nickname
Home Street Address
City, State, Zip
Home Telephone
Mobile Telephone
Email
Date of Birth
Social Security Number
U.S. Citizen (Yes / No)
Gender
Marital Status:
Single/Married/Divorced/Widowed
Employment
Occupation / Job Title
Self-Employed (Yes/No)
Employer Name
Employer Address
Work Telephone
Work Email
Years w/ Current Employer
Communication Preference
How should we contact you:
home or work, email or mobile, etc.
The Financial Advisors, LLC Client Questionnaire
4
Clients – Children & Dependents Info
Please list additional names or details on a separate page
Children / Dependents
Client 1
Client 2
Child / Dependent
Full Name
Relationship
Date of Birth
Social Security Number
Marital Status
Spouse / Partner Name
Spouse / Partner DOB
Children names & DOB
Child / Dependent
Full Name
Relationship
Date of Birth
Social Security Number
Marital Status
Spouse / Partner Name
Spouse / Partner DOB
Children names & DOB
Child / Dependent
Full Name
Relationship
Date of Birth
Social Security Number
Marital Status
Spouse / Partner Name
Spouse / Partner DOB
Children names & DOB
The Financial Advisors, LLC Client Questionnaire 5
Goals and Objectives
What are your areas of financial concern (check all that apply)
Cash Flow and Budgeting
Investment Review
Tax Planning
College Planning
Retirement Planning
Estate Planning
Insurance Review
Home Purchase
Other (Please describe)
What is your picture for financial security 5 years from now?
The Financial Advisors, LLC Client Questionnaire
6
Please list your major financial obligations and planned expenditures.
Present (within the next 2 years)
Future
How comfortable are you managing your finances? (very, somewhat, not at all)
How satisfied are you with the performance of your investments?
Please note any health or other family circumstances that may impact your financial planning.
The Financial Advisors, LLC Client Questionnaire 7
Income
Client 1
Client 2
What is your gross annual income?
How often are you paid?
Are you considering a career change?
Do you anticipate major changes in income within the next 3
years*?
* If yes, please describe the expected changes.
Retirement Planning
Client 1
Client 2
At what age do you expect to retire?
What are your expected annual income needs in retirement?
How much do you contribute each year to your retirement plan(s)?
How much does your employer contribute each year to your
retirement plan(s)?
During retirement how much monthly income do you expect to receive from:
Social Security
Employer Pension(s)
Please describe any special considerations regarding your retirement plans:
Employer Stock Plans
The Financial Advisors, LLC Client Questionnaire
8
Client 1
Client 2
Do you participate in an employer stock option plan (non-qualified
or incentive)?
Do you participate in an employer stock grant plan (restricted
stock)?
Do you participate in an employee stock purchase plan (ESPP)?
Insurance
Client 1
Client 2
Do you have life insurance? If so how much is the coverage?
Do you have short term disability insurance?
Do you have long term disability insurance?
Do you have long term care insurance?
Do you have medical insurance? If so is it through your employer?
Do you have homeowner or renter insurance?
Do you have umbrella liability insurance? If so how much is the
coverage?
Do you have ID Theft Protection coverage?
Do you have auto insurance?
Estate Planning
Client 1
Client 2
Were you previously married?
Do you have a Will?
Do you have a Durable Power of Attorney?
Do you have a Health Care Proxy?
Do you have a Trust?
Did you file a Homestead Declaration when you bought your
home?
Are you the beneficiary of any Trust?
The Financial Advisors, LLC Client Questionnaire 9
Statement of Net Worth
Item
Client 1
Client 2
Joint
Total
ASSETS
Cash
Checking and Savings
Money Market funds
CDs
US Savings Bonds
Other
Total Cash
Taxable Investments
Stocks, Bonds, Mutual Funds
Investment Real Estate
Other Taxable Accounts or Assets
Total Taxable Investments
Retirement Investments
IRA: Traditional or Rollover
IRA: Roth, SEP or SIMPLE
Employer Plans: 401K, 403B, 457
Other Retirement Plans
Pension
Total Retirement Investments
Education Investments
529 / Tuition Savings Plans
UTMA / UGMA Custodial Accounts
Total Education Investments
Personal Property
Primary Residence
Vacation Property
Vehicles / Boats
Jewelry / Art / Antiques
Household and Other property
Total Personal Property
TOTAL ASSETS
The Financial Advisors, LLC Client Questionnaire
10
Item
Client 1
Client 2
Joint
Total
DEBTS
Debts / Liabilities
Primary Residence Mortgage
2
nd
Mortgage, Equity Loan,
or Line of Credit (HELOC)
Education Loans
Auto Loans
Credit Card Balances
401K or Retirement Plan Loans
Any other loans or debts
TOTAL DEBTS
NET WORTH (assets – debts)
DETAILS OF DEBTS / LIABILITIES
Creditor
Original
Amount
Current
Balance
Interest
Rate
Term of
Loan
Monthly
Payment
1.
2.
3.
4.
5.
Total:
The Financial Advisors, LLC Client Questionnaire 11
Bucket List (Please list a few of your non-financial goals, as they may be related to your financial plan)
Notes to Your Advisor (Please list any additional points of interest or concern)
