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Fact Finder and Net Worth Statement
Fact Finder and Net Worth Statement
Estate Planning Fact Finder and Net Worth Statement
Step 1 of 3
33%
Your Information
Name
First
Last
Phone
Email
Client's Information
Name
First
Last
Date of Birth
US Citizen
Yes
No
If No, Citizen of What Country?
Tobacco Use
Yes
No
Tobacco Use
Yes
No
Health
Poor
Fair
Good
Excellent
State of Residence
For State Estate Tax Purposes
Spouse's Name
First
Last
Date of Birth
US Citizen
Yes
No
If No, Citizen of What Country?
Tobacco Use
Yes
No
Health
Poor
Fair
Good
Excellent
Number of Children and Grandchildren for Annual Exclusion Purposes
Income Tax Bracket (Client)
Income Tax Bracket (Beneficiaries)
Capital Gains Tax Bracket (Client)
Assets
Total Assets
Growth Rate
Total Laibilities
Current Life Insurance Coverage
Individually Owned
Yes
No
Prior Planning
Amount of Previous Taxable Lifetime Gifts
Amount of Previously Committed Annual Exclusion Gifts