Personal Financial Overview We can better tailor services to fit your unique needs if you provide us with an overview of your economic, estate, retirement and risk management needs from your point of view. Please take a few moments to fill in the questionnaire below. If you have problems submitting this form or don't feel comfortable submitting information via the Internet, you can download and print an MS-Word version of the form and mail it to us at 1364 Welsh Road, Suite C-1, North Wales, PA, 19454 or fax (215) 646-7001.   CONTACT INFORMATION      Name: Address: E-Mail: Phone: FINANCIAL OUTLOOK HINT: Use your tab key to advance more easily through this set of questions. Please indicate whether the following statements describe you. I know what I want to accomplish financially Yes No Unsure My spouse clearly understands our financial situation Yes No Unsure My spouse actively participates in our financial affairs Yes No Unsure I have my financial objectives written on paper Yes No Unsure I am good at managing my income and expenses Yes No Unsure I maintain a list of my current assets and liabilities Yes No Unsure I systematically save and accumulate money for investment Yes No Unsure I am currently saving enough to meet my financial objectives Yes No Unsure I am comfortable with the amount of risk I am taking with my current investments Yes No Unsure I am satisfied with the returns on my investments Yes No Unsure I clearly understand all my investments, goals and finances Yes No Unsure I clearly understand how my investments impact my tax liability Yes No Unsure I would like assistance in organizing my financial planning Yes No Unsure RETIREMENT PLANNING HINT: Use your tab key to advance more easily through this set of questions. Press "Y" for "Yes"; "N" for "No"; or "U" for "Unsure." Please indicate whether the following statements describe you. I have projected my retirement income needs and sources Yes No Unsure I am currently saving enough to meet my retirement needs Yes No Unsure I participate in a retirement plan through my employer Yes No Unsure My spouse participates in a retirement plan through his/her employer Yes No Unsure I have retirement savings outside my employer's plan Yes No Unsure My spouse has retirement savings outside of his/her employer's plan Yes No Unsure I understand "tax deferral," "tax deduction" and "compounded growth" Yes No Unsure I maximize contributions to all my retirement accounts Yes No Unsure I understand the effects of taxes and inflation on my savings and retirement income Yes No Unsure I have a specific distribution strategy for my retirement funds Yes No Unsure I would like assistance in organizing my retirement plans Yes No Unsure ESTATE ORGANIZATION HINT: Use your tab key to advance more easily through this set of questions. Press "Y" for "Yes"; "N" for "No"; or "U" for "Unsure." Please indicate whether the following statements describe you. I am well informed about estate planning Yes No Unsure My spouse understands our estate plans Yes No Unsure I have a current, valid will or trust in my files Yes No Unsure My spouse has a current, valid will or trust in his/her files Yes No Unsure I have appointed a guardian for my minor children Yes No Unsure I have a specific plan for distribution of my assets Yes No Unsure My beneficiary designations are up to date Yes No Unsure I maximize contributions to all my retirement accounts Yes No Unsure My powers of attorney are consistent with my will/trust Yes No Unsure I have a list of all important documents and their locations Yes No Unsure I have named an executor, who is familiar with the contents and location of my will/trust and other important papers Yes No Unsure I understand the terms "estate" and "inheritance tax" and how they affect my estate planning Yes No Unsure I fully understand the effects a premature death will have on my retirement plan assets and family lifestyle Yes No Unsure I know exactly what my heirs will receive from my estate Yes No Unsure I would like assistance in organizing my estate plans Yes No Unsure INSURANCE PLANNING HINT: Use your tab key to advance more easily through this set of questions. Press "Y" for "Yes"; "N" for "No"; or "U" for "Unsure." Please indicate whether the following statements describe you. I own and understand my current life insurance policy Yes No Unsure My spouse owns and understands his/her current life insurance policy Yes No Unsure I review my insurance policy needs regularly Yes No Unsure I understand Social Security Death Benefits Yes No Unsure I am familiar with the uses of life insurance plans beyond the death benefit Yes No Unsure I am satisfied that my current insurance agent explains things clearly Yes No Unsure I have minimized my insurance costs through long-term planning Yes No Unsure I maximize contributions to all my retirement accounts Yes No Unsure I would like assistance with my life insurance planning Yes No Unsure IN THE NEXT YEAR I PLAN TO: Graduate Buy a home Change jobs Sell property Refinance a home Purchase long-term care Get married Have a child Retire Pay off a loan Save more money Start a business Purchase/lease property Receive a promotion Receive an inheritance Start a financial plan Invest more money Other PERSONAL PRIORITIES: Review life insurance Review mortgage protection Inflation/standard of living update Retirement savings Disability income protection Business valuation/review Education funding for children Insurance for children Other PLANNING PRIORITIES: Savings and accumulation Building personal wealth Personal estate organization Pension maximization Planning for retirement Estate tax concerns Business continuation concerns Investment priority planning Other