Client Questionnaire

4 Laws of Discipline

Rank From Importance From 1-10

Tax - Reduce taxes

Please enter a number from 1 to 10.

Investment - Reduce volatility and taxes on investments

Please enter a number from 1 to 10.

Protection - Ensure family is taken care of at death and disability

Please enter a number from 1 to 10.

Succession - Design an exit stratedgy that maximizes value while minimizing taxes on the buy out and payments

Please enter a number from 1 to 10.

Client Name

Phone

Date Of Birth

Email

Spouse Name

Spouse Email

Spouse Date Of Birth

Spouse Employer

List All Children

Child Name

Child Date Of Birth

Primary Business Name

Primary Business Address

Business Phone

Website

Number

Business Structure

Why did you choose this structure?

% Of Ownership

Please enter a number from 1 to 100.

Additional Business Assets

Investment Advisor's Name

Length of Relationship w/ Advisor

Annual Cost of Advisor

Rating

Please enter a number less than or equal to 10.

Succession Advisor Name

Length of Relationship w/ Advisor

Annual Cost of Advisor

Rating

Please enter a number less than or equal to 10.

Protection Advisor Name

Length of Relationship w/ Advisor

Annual Cost of Advisor

Rating

Please enter a number less than or equal to 10.

Tax Advisor Name

Length of Relationship w/ Advisor

Annual Cost of Advisor

Rating

Please enter a number less than or equal to 10.

Tell us why you gave us the rating you did:

Client Annual Compensation

Client Source of Income

Spouse Annual Compensation

Spouse Source of Income

Other Income

Which of the following years best describes your future income

This Year?

Last Year?

Monthly Cost for Health Insurance

Primary Residence Value

Mortages

Monthly Cost for Health Insurance

What age do you plan on retiring

401k Balance

Please enter a number less than or equal to 125.

Other Accounts Balance

If you have time please click on this link to fill out an asset map that will help us in assessing what developed strategies we should be discussing.

View Form

4 Laws of Discipline

Schedule a Complimentary Conversation!