Confidential Questionnaire

Please complete our confidential discovery questionnaire below. Feel free to omit any information you prefer not to communicate at this time. Your answers will help us make the best use of your time during our first meeting.

Personal Info

Name

First Name

Last Name

Name 2

First Name

Last Name

Email 2

Cell Phone

(###)

###

####

Cell Phone 2

(###)

###

####

Home Phone

(###)

###

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Preferred Method of Contact

Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

YYYY

Birthday 2

YYYY

Children's / Grandchildren's Names & Ages

Employment Info

Employer / Title

Please indicate if Retired or Self-Employed.

Employer / Title 2

Please indicate if Retired or Self-Employed.

General

How did you hear about Burton Enright Welch?

Are you currently working with a financial advisor?

Advisors (Tax, Legal, Insurance)

Goals / Objectives

What is motivating you to reach out to BEW? What are your primary financial goals?

What are you looking for in an advisor? What would a good relationship look like?

Financial Info

Income

Please list income sources including salaries, rental property income, pensions, etc. Please indicate bonuses or equity-based compensation.

Do you expect any major changes to income moving forward?

Real Estate Values & Mortgages

Taxable Investments

Please list all brokerage account values and/or individual stocks held outside retirement accounts.

IRAs (Traditional, Roth, SEP)

Employer Retirement Plans

Annuities / Cash Value Life Insurance Policies

Stock Options

529 Plans or Other Education Savings Accounts

Desired Annual Retirement Spending

Please estimate how much you anticipate spending in retirement.

Other / Notes

Please indicate any other details you would like to share about your financial world.