Financial Needs Analysis

Financial Needs Analysis

Please fill out this form as thoroughly as possible. Your information is protected by our HIPAA compliant software.

-Ladder Strategists Team

Agent Name*

Select

First & Last Name*

Spouse First & Last Name

Date of Birth*

Spouse Date of Birth

Children Names & Ages

Home Address*

Phone Number*

Email*

Goals & Dreams

Be as honest as possible here. We want to help you reach your goals!

Retirement Goals*

What age would you ideally like to retire? How much would you like to have monthly?

Housing Goals*

Are you in your forever home? Looking to buy or sell? Ideal budget?

LTC/Disability*

Do you have Long Term Care in place?

Retire Parents*

Are your parents retired? Do you need to help them financially in retirement?

Education Goals*

Do you have small children who need education funding?

Travel Goals*

How often do you travel yearly? How much do you typically spend per trip?

Dream Vacation*

Where have you ALWAYS wanted to go? Dream budget for this trip?

Other Goals

Buying a new car, boat, RV, camper, etc.? Within what timeframe?

Budget & Spending

Please try to be as accurate as possible.

Total Sources of Income - What are they?*

Average Monthly Net Income*

Annual Gross Income*

Mortgage/Rent*

HOA Dues*

Internet/Cable*

Utilities*

Cell Phone*

Lawn/Pest*

Pet Care*

Child Care*

Education/Sports*

Memberships*

Subscriptions*

Entertainment*

Health Insurance*

Life Insurance*

Other Insurance

Auto Payments*

Gas*

Auto Insurance*

Maintenance*

Groceries*

Dining Out*

Shopping*

Tithing/Charity*

Alimony/Child Support*

Travel*

Personal Loan Payment*

Student Loan Payment*

Medical Debt Payment*

Credit Card Payment*

Other

Assets

Home Equity

Mutual Funds/Stocks

Cryptocurrency

Savings*

Cash Value Life Insurance

Term Life Insurance

Inheritance/Pension

Previous Employer Retirement Accounts

Current Retirement Accounts*

Other Assets

Do you currently have an updated will?*

Select

Do you have trusts in place?*

Select

Did you receive a tax refund last year?*

Select

Refund Amount

Amount Owed

Liabilities

Please include current balance, interest rates, minimum payment, current payment, and term of the loan.

Mortgage

2nd Mortgage/HELOC

Auto Loan 1

Auto Loan 2

Credit Card 1

Credit Card 2

Credit Card 3

Credit Card 4

Student Loans

Personal Loans

Other Loans/Credit Card/Auto Loans

Credit Score

Almost done!

If a plan could be put in place to meet all of your financial goals, how much would you be able to comfortably save each month?

I could comfortably save...

Comments & Notes

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