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Estate Planning Fact FinderPrepared for:Table of ContentsFamily Information.2Trusted Contact Information .2Financial and Estate PlanningObjectives.3Current Estate Plan .3Post-Death Monthly Income Objectives .3Retirement Plans .4Annual Income .4Assets and Liabilities .4-5Life Insurance .5Important Information .6Confidential Estate Planning Fact FinderProvided by:
Family InformationHealth Problems orNameAgeSpecial Needs, if AnyClientSpouseChildrenResidence AddressTelephone( )Your OccupationEmployerBusiness AddressTelephoneSpouse’s OccupationEmployerBusiness AddressTelephone( )AttorneyTelephone( )AccountantTelephone( )Other Professional AdvisorTelephone( )( )Trusted Contact InformationA trusted contact who you designate can be a friend, relative.anyone you trust.Designating someone as your trusted contact does not give that person authority toaccess or control your account. Instead, it gives your financial advisor someone tocontact in the event of possible financial exploitation or suspected health issues.Trusted Contact Name:Relationship:Phone:E-Mail:Confidential Estate Planning Fact Finder2
Financial and Estate Planning ObjectivesBe specific. (Examples: survivor income; minimize estate taxes; pass the businesson to children; make a charitable bequest)1.2.3.4.Is there anything else I should know about your family, your plans and objectives,obligations or anything that is of particular concern?Current Estate PlanDo you have a will?YesNoDatedDoes your spouse have a will?YesNoDatedSimple Will, all to surviving spouseYesNoA will with provisions for a trustYesNoProvisions of your and your spouse’s wills:Were you and your spouse married in another state?YesNoIf yes, where?Do you or your spouse own a residence or business in another state?Are you, spouse or children the beneficiaries of any trust? (Describe)Describe any existing trusts or any special bequests (such as to a charity or others):Post-Death Monthly Income ObjectivesMonthly Income to Spouse/Familyfor yearsthenfor yearsPresently covered by Social Security:Self:YesNoSpouse:YesNoOther monthly income sources available? (Describe)Education Fund Per ChildEmergency FundMortgage Payoff FundOther Needs (Describe)Confidential Estate Planning Fact Finder3
Retirement PlansRetirement Monthly Income Objective:Planned Retirement Age:Qualified Plans:ClientSpouseProjected Monthly BenefitClient’s LifeSpouse’s LifeDeath ValueNonqualified Salary Continuation Plans? (Describe benefits)Other Funds Available for Retirement? (Describe)Annual Tax Bracket %Assets and LiabilitiesAssets* Jointly owned and communityproperty assets and liabilitiesare generally split equallybetween the spousesCurrent FairMarket Value ( )SelfSpouseShould thisasset bedisposed ofat 1st death?(Yes/No)Value inQuick/ForcedSaleResidenceOther Real EstateBusiness InterestMarketable SecuritiesChecking and SavingsLife Insurance Owned onYour LifeCash Value of LifeInsurance PoliciesOwned on OthersPersonal PropertyRetirement FundsRevocable TrustsFuture InheritanceOther AssetsSubtotalConfidential Estate Planning Fact Finder 0 0 04
LiabilitiesMortgage on ResidenceOther MortgagesConsumer LoansOther DebtsSubtotal 0 0 0TOTAL(Assets – Liabilities) 0 0 0Life * (P)ermanent, (U)niversal, (V)ariable, (T)erm, (G)roup, (C)redit Life, (M)ortgage Life, (S)econd-to-dieHealth InsuranceDisability Income InsuranceBenefit Period:Waiting Period:Monthly Benefit:Long-Term Care InsuranceBenefit Period:Waiting Period:Benefit Amount:Maximum Benefit:Other Health InsuranceDescribe:NotesConfidential Estate Planning Fact Finder5
Important InformationThis fact finder serves to help identify your financial needs and priorities and may beused in developing proposed solutions consistent with your needs and objectives. Incompleting this fact finder, you are entrusting our organization with certain personaland confidential financial data. We recognize that our relationship with you is based ontrust and we hold ourselves to the highest standards in the safekeeping and use of yourconfidential information.The information, general principles and conclusions presented in this report are subjectto local, state and federal laws and regulations, court cases and any revisions of same.While every care has been taken in the preparation of this report, VSA, L.P. is notengaged in providing legal, accounting, financial or other professional services. Thisreport should not be used as a substitute for the professional advice of an attorney,accountant, or other qualified professional. VSA, LPAll rights reserved (VSA ff-13 ed. 03-18)Confidential Estate Planning Fact Finder6
Confidential Estate Planning Fact Finder 6 Important Information This fact finder serves to help identify your financial needs and priorities and may be used in developing proposed solutions consistent with your needs and objectives. In completing this fact finder, you are entrusting our organization with certain personal and confidential .
