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Confidential Questionnaire

Life Stage Insights
Life Stage Insights
‪(415) 598-8566‬
Co Workers

Personal and Family

lifestageinsights

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Please answer the questions above.

age

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Birth Date

Retirement age

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Number of children

Spouse/Partner First Name

Spouse/Partner Last Name

Contact Information

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Life Stages, Priorities, and Events 

Family

Expecting to get married soon

Expecting a new child

Have young children

Have children in college or about to enter college or university

Have adult children

Have child with special needs

Empty nesting

Have grandchildren

Expecting a grandchild

Providing caregiving for a family member

Recently divorced or divorcing

Recently widowed

Work and careers

Currently working

Self-employed

Experiencing a change in job or career

Starting a business

Selling a business

Other financial events & priorities

Making significant charitable contributions

Preparing for education expenses

Managing debt (including student loans)

Receiving a significant inheritance

Expecting major health care or long-term care expenses

Significant decrease in income or net worth

Significant increase in income or net worth

Estate planning

Financial Information

Approximately what is your annual household income?

Approximately how much are your investable assets (i.e. the amount you hold in cash, bank accounts, and investment accounts)?

Submit My Information

Please check your information at the top of this form.

Your information has been submitted. Thank you!

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