Raymond James Financial Services, INC

Raymond James Financial Services, INC.

Short Beach Financial Partnership

An Independent Firm

Confidential

Financial Planning

Data Organizer

FOR

______

144 North Main Street

PO Box 843

Branford, CT06405

Phone: 203.488.4787; Toll Free: 888.538.6433; Fax: 203.678.0454

Securities and Investment Advisory Services offered exclusively through

Raymond James Financial Services, Inc.®Member FINRA/SIPC

Today’s Date ______

Introduction

Please complete this questionnaire and bring it to your initial consultation, so we can maximize the efficiency and productivity of our time together during the appointment. Also, please bring a recent copy of documents listed at the end of this organizer..

Client Information / Spouse’s Information
Name: / Name:
Address:
Home Phone: / Home Fax:
Cell Phone: / Cell Phone:
Home E-Mail: / Home E-Mail:
Age/DOB: / Age/DOB:
Occupation: / Occupation:
Employer: Years: / Employer: Years:
Salary: Bonus: / Salary: Bonus:
Location (City/State): / Location (City/State):
Work Phone: / Work Phone:
Work E-Mail: / Work E-Mail:
Anticipated retirement age: / Anticipated retirement age:
Wedding Anniversary (if applicable):
Hobbies & Recreational Interests: / Hobbies & Recreational Interests:

Family Information

Children’s/Grandchildren’s Name(s) / Gender / City/State of
Residence / Age/DOB / Comments
Parent’s Name(s)
(if alive) / Age/ DOB / City/State of
Residence / Health/
Comments
Client
Client
Spouse
Spouse

Are there any particular concerns you have about your parents, children, their spouses or grandchildren that, we should be aware of in addressing your financial planning affairs? ______

______

Assets

YOUR INFORMATION

AssetsQuantity (if applicable)Company Name/Location Approx. Total Value

Savings______$______

Checking ______$______

CDs______$______

Mutual Funds______$______

Stocks/Bonds______$______

IRAs (please specify IRA: Traditional, Roth, etc.):

______$______

401(k); 403(b)______$______

Does your employer offer matching contributions? YES NO

If so, what percent? ______

Life Insurance (please specify:Term, Group, Universal, etc.):

______$______

Long Term Care Insurance______$______

YOURSPOUSE

AssetsQuantity (if applicable)Company Name/Location Approx. Total Value

Savings______$______

Checking ______$______

CDs______$______

Mutual Funds______$______

Stocks/Bonds______$______

IRAs (please specify IRA: Traditional, Roth, etc.):

______$______

401(k); 403(b)______$______

Does your employer offer matching contributions? YES NO

If so, what percent? ______

Life Insurance (please specify:Term, Group, Universal, etc.):

______$______

Long Term Care Insurance______$______

FINANCIAL OBJECTIVES

1. Rank the top three objectives that are most important to you. (1 is most important)

___ Income now

___ Income at retirement in ____ years

___ Income sufficient to maintain current lifestyle during retirement

___College expenses beginning in ____ years

___ Income tax relief

___ A review of your estate planning, wills and trusts

___ Assurance that your investments are properly positioned

___ Protection against risks, such as death, nursing home costs, etc.

2.What do you believe is a reasonable rate of return on your investment portfolio before taxes?

___ 10% or higher

___ 8 – 10%

___ 6 – 8%

___ Less than 6%

___ Rates of returns do not concern me. I am more interested in preservation of principal.

3. Do you foresee any major expenditure in the next five years? YES NO

Please check all that apply:

Education

Retirement

Real Estate

Vehicles

Other (please specify):______

Investment & Financial Planning Questions

Explain how you have made investment decisions in the past:

Income Taxes / Yes / No / N/A

Are income taxes a major concern to you?

Do you have investments generating taxable income which you are not spending?

Do you anticipate a major increase or decrease in your tax liabilities in the near term? If so, explain ______

Please give us the name of your tax accountant ______

Firm Name ______Phone number ______

Does your tax accountant provide proactive tax minimization advice?

Retirement Planning / Yes / No / N/A

Are you fully utilizing any employer-provided retirement plans?

Do you plan to work part time during retirement? If so, estimated annual income ______. If so, how long? ______

Are you receiving or will you receive a monthly retirement pension (other than social security) at retirement? If so, list source and amount. ______

Will you receive a significant inheritance, which should be considered in meeting your retirement needs? If so, describe ______

Have you performed a retirement cash flow analysis in the past? (applicable for both retired and working persons)

Insurance Planning

Do you feel adequately insured in all areas? (Life, disability, health, auto, property, umbrella, etc.) If not, list areas of concern ______

Do you have, or are you considering the purchase of, nursing home and home care insurance?

Estate Planning

Do you have a current will?

List the date your will was last written or reviewed. ______
your spouse’s will? ______

Please give us the name of your estate planning attorney ______

Firm Name______Phone number______

Estates over $2.0 million can utilize family/marital trusts in order to reduce taxes. Have you implemented this approach?

Monthly Cash Receipts

It is important to evaluate how much income you need from your investments (if any) and/or how much money is available to save annually. While the specific details of spending patterns are not as important as the bottom line, the categories listed below are to assist you in estimating cash flow. Please provide us with your best estimates if more accurate numbers are not available.

Please ignore the details of disbursements (listed below) if you have an approximate monthly total for the following: annual general living expenses (exclusive of mortgage principal and interest payments) $______; annual principal and interest payments $______; annual travel and luxury expenditures $______.

Salary and Wages: / Yours / Spouse’s / Joint
Gross pay per month / $ / $ / $
Less: Federal taxes withheld
State taxes withheld
401k withholdings
Other deductions
Net take home pay
Commissions, bonuses and tips
Interest and dividends
Real estate income
Social security
Pensions
Note payments received
Other: Describe
Total / $ / $ / $
Monthly Cash Disbursements
Housing:
Mortgage payments (PI only) / Personal Expenses:
Home improvements/ maintenance / Alimony/Child Support
Landscape maintenance / Charitable contributions
Property taxes / Child care/support of dependents
Gas/Electric / Educational
Water / Household expenses
Vacations/Other / Home furnishings
Carry forward from prior page / $ / Carry forward from prior page / $
Food: / Personal Expenses (cont’d):
Groceries / Memberships (non business)
Dining out / Personal services (barber, etc)
Other: / Medical, Dental & Prescriptions- not reimbursed:
Transportation: / Insurance:
Automobile-non reimbursement / Life
Payments / Medical
Maintenance / Disability/long-term care
Entertainment: / Homeowner’s
Cable/Satellite TV / Automobile
Pet expenses / Other: (Umbrella etc.)
Sub-Total / $ / Sub-Total / $
Clothing: / Financial:
Purchases / Legal, accounting & advisory
Laundry and dry cleaning / Debt repayment (credit cards, not home & auto)
Miscellaneous:
Domestic help
Major discretionary purchases
Sub Total / $ / Sub-Total / $
Personal Assets:
Residence
Vacation home
Other (collectibles, cars, jewelry, etc.)
Sub-Total / $
Total Assets / $
Liabilities: / Estimated
Interest Rates / Total
Charge accounts and credit balances / $
Installment credit
Real estate
Auto loans
Margin account loans
Life insurance policy loans
Other
Total Liabilities / $
Net Worth (Total Assets Minus Total Liabilities) / $

Please provide any additional information you may find relevant to your financial picture now or in the future.

BRING THE MOST RECENT REPORT OF THE FOLLOWING RECORDS OR SEND THEM PRIOR TO THE MEETING:

Last Year’s Tax Report

Statements of brokerage accounts

Wills and Trust

Details of Partnerships, Businesses

Life & Disability Income Policies

Pensions, IRAs, Profit Sharing Plans, 401ks, etc.

Other Insurance Policies—Homeowners, Umbrella, Medical

Divorce Decree

Bank Statements