Step 1 of 3





Client 1

Client 2


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Step 2 of 3

Client 1 Employer







Client 2 Employer









Children






















Parents


















1.

2.

3.

4.

5.

What are your biggest financial concerns? What is the best financial decision you have ever made? How do you feel about your present situation? Your Future? How do you measure you wealth?

Are you doing what you want to be doing? Potential for job change? What does your retirement look like to you?

How is your physical health? Any special needs or limitations? Any concern with Health Insurance now or in the future?

Do you take time for leisure activities? Would you like to change activities and/or increase your leisure time? What are your hobbies/interests? Volunteer/ Community services?

Marital satus? Do you expect it to change? Your immediate and extended family, where are they, are there any challenges, concerns, or needs?

Are you living where you want to live? Foreseen challenges? Any dreams for vacation home or second home? Have you considered a retirement community and the need for health care options?

Is there anything for which you feel you need to be prepared?

What has been your best investment decision? What is your greatest investment fear?

Do your documents accomplish what you want? Are there any special or unique goals? Or any charitable or philanthropic interests or goals?


Please answer the following questions so that PDS Planning, Inc. can better understand your financial goals. These goals will be discussed in more detail at future meetings of the financial planning process.

Cash Flow Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a



Tax Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a



yn?n/a

yn?n/a

yn?n/a



Educational Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a

yn?n/a

yn?n/a

/year

yn?n/a

yn?n/a

yn?n/a



Investment Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a



Insurance Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a







yn?n/a

yn?n/a

yn?n/a





yn?n/a

yn?n/a

yn?n/a

yn?n/a



Retirement Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a



yn?n/a

/year

yn?n/a

yn?n/a

/year

yn?n/a

yn?n/a

yn?n/a



Estate Planning

  • Y
  • N
  • ?
  • n/a
yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a



yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a

yn?n/a



Please provide the following preliminary financial data

Assets

Cash Equivalents


Joint


Joint


Joint


Joint

Securities


Joint

Retirement Accounts


Joint


Joint


Joint


Joint


Joint


Joint


Joint


Joint


Joint

Education Funds


Joint


Joint


Joint

Real Estate


Joint


Joint


Joint


Joint

Other Assets


Joint


Joint


Joint


Joint


Liabilities


Joint


Joint


Joint


Joint


Joint


Joint


Joint


Joint


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Step 3 of 3



Risk - Reward Questionnaire

For each of the following statements, check the box next to the number that most closely reflects your financial situation and/or investment philosophy. Please select only one.




Questions E through K refer to your own investments






Questions L through P refer to your current personal situation




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