Sample PDF Template - Client Intake Record for [[contact.firstname]] [[contact.lastname]]

1. First Name: [[contact.firstname]]

2. Last Name: [[contact.lastname]]

3. Age: [[contact.client_age]]

4. Email: [[contact.email]]

5. Spouse First Name: [[contact.spouse_first_name]]

6. Spouse Last Name: [[contact.spouse_last_name]]

7. Spouse Age: [[contact.spouse_age]]

8. The primary goal of the portfolio is to provide: [[contact.what_are_the_goals_and_objectives_specifically_for_the_money_you_have_invested_today_]]

9. The secondary goal of the portfolio is to provide: [[contact.the_secondary_goal_of_the_portfolio_is_to_provide_]]

10. Do you have a financial plan? [[contact.do_you_have_a_financial_plan_]]

11. Are you retired? [[contact.are_you_retired_]]

12. Is your spouse retired? [[contact.is_your_spouse_retired_]]

13. Main source of income: [[contact.main_income_source]]

14. Any other sources of income (real estate, inheritance, annuities): [[contact.other_income__how_much_]]

15. How much money do you need to cover your lifestyle today? (Annually): [[contact.how_much_money_do_you_need_to_cover_your_lifestyle_today___annually__]]

16. How much do you anticipate withdrawing from your portfolio this year to support the above-listed goals? Annual amount: [[contact.expected_annual_withdrawal_needs_from_the_portfolio]]

17. Are there any short term liquidity needs (home repair, vacations): if so, please provide anticipated date and amount: [[contact.are_there_any_short_term_liquidity_needs__home_repair__vacations__]]

18. What are your bank account balances (checking, savings, CDs, money market)? [[contact.gps_bank_account_balances__checking__savings__cds__money_market__]]

19. Do you have non-retirement investment accounts (brokerage accounts, employee stock plans, etc.)? [[contact.do_you_have_non_retirement_investment_accounts__brokerage_accounts__employee_stock_plans__etc___]]

20. Do you have retirement accounts? (401k, 403b, 457, TSP) [[contact.do_you_have_retirement_accounts___401k__403b__457__tsp_]]

21. Who are your beneficiaries? [[contact.who_are_your_beneficiaries_]]

22. Do you have an estate plan? [[contact.do_you_have_an_estate_plan_]]

23. Do you have a CPA? [[contact.do_you_have_a_cpa_]]

Please let us know if there is anything else you’d like to discuss during our meeting. [[contact.is_there_anything_else_i_should_know_]]