Gordon E.Hughes CFP
Smart Choice Life
Work (506) 454-3346 or 4LIFE INsurance or Cell 261-2125
Email: Gordon@SmartChoiceLife.com

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Financial Planning Questionnaire
 
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We use a code to protect your personal information. You give us your name address phone number and date of birth before you complete the questionnaire and you get assigned an ID code at that time. 

Got your ID code? Then you are ready to complete the confidential questionnaire below .

We don't ask for name, address or exact date of birth on this on-line form. You can further protect your information by signing up for a free email address with hotmail, yahoo or other service provider for this purpose only. Don't use your name in that email address. That way all your information is totally anonymous, and means nothing to anyone else, only you and I know who it belongs to.
 
(supplied by phone or email- this is an additional safeguard to keep your personal information private)  (if you don't have a code yet email us at Gordon@SmartChoiceLife.com or call 1-800-471-0411).
  Age and Martial Status
 
 Your age:

 Your spouse's age:   Married:  Separated:
 Your sex: M F  Your spouse's sex: M       F   Single:  Divorced:
               
  Occupation
 
Your occupation   Spouses occupation
Duties   Duties
 Annual income earned  Annual income earned
  Annual unearned income   Annual unearned income
source(s)
(Net rental income/ business income/investment income)		  source(s)
 (Net rental income/ business income/investment income)
       
Do you own or rent your home? Y N
Monthly rent/mortgage payment
If it's a mortgage payment, does that include taxes? Y N
   
       
Family/dependants (may include children, disabled adults or parents needing care)

First Name:
First Name:
First Name:
First Name:
First Name: 		 
Age:
Age:
Age:
Age:
Age:

I/we have the following concerns; ( In most cases not every item will be a concern, pick the ones that and most important to you)
 
I am concerned about:      
           
Getting sound investment advice Y N saving enough money to buy a home/cottage. Y N
saving money for other significant purchases Y N my spouse not having enough to live on after my death? Y N
how to get ahead financially with so many bills to pay? Y N how could we survive financially if I/my spouse fell ill? Y N
which is the best way to provide for children's education? Y N how to get the most from investments without big risks Y N
outliving my/our savings? Y N how much tax I/we pay now? Y N
how much tax my/our heirs may have to pay on our estate? Y N how my/our assets would get distributed when I/we die? Y N
paying large amounts of interest on a mortgage? Y N      
           
list others concerns
           
 Plans Goals
I/we would like to:

Buy a business in     years

Buy a vacation property in years

Which type real estate?
(commercial,  residential   or land speculation )

Will you have a pension from work? Yes No

 


Buy a home in years

Invest in real estate in years

Retire in years with % of my earned income.
If `Yes' is it a percent of your income or is it the accumulated amount?

Annual income expected from pension $
How about your spouse? Pension: Yes No
Type percent of income or accumulated amount ?
Annual amount expected $


 
Invest in my child's education -

they will attend university/college in years.

How many years will that child attend
university/college?
How much annual tuition? $
Room and board? $
Supply details of other children also


Current status - your starting point is now.

Assets Liabilities
$ RRSPs RRSP loans $
$ Savings/bonds Mortgage home $
$ Investment funds Other Mortgages $
$ Stocks Automobile loans $
$ Private business
 Education loans $
$ Rental Property
Line(s) of credit $
$ Personal home Investment
 loans $
$ Automobile(s) Credit cards $
$ Other real estate Furniture/store loans $
$ Education Plan(s) Other $
$ Other Other $
 
Fundamental finances
 
Review of our life insurance

I have $ personal life insurance (Type = Term, Whole life, Universal life)

Other policies

I have $ group insurance with my employer's plan.

I have $ covering my/our mortgage, car loans, line of credit, etc.

My spouse has $ personal life Ins. (Type = Term, Whole life, Universal life)

Other policies
My spouse has $ group insurance with his/her employer's plan.

My spouse has $ covering her/his/our mortgage, car loans, line of credit, etc.
 
 I would like to:
 
make sure my family can continue on financially should I die. Yes No
make sure we can continue on financially should my spouse die Yes No
have our incomes continue in the event of our disability Yes No
Checklist:
I have renter's insurance Yes No
or
I have home-owners insurance Yes No
My/our automobiles are insured Yes No
My business/rental property has public liability insurance Yes No
My business/rental property is insured: fire, vandalism etc. Yes No

My deposits are creditor protected
(usually investments inside a life insurance company offer additional protection over banks and credit unions against seizure by creditors)

Yes No
My deposits are guaranteed up to $100,000 Yes No
I have critical illness insurance Yes No
I have long term care insurance Yes No
       
Did you know that:      
you can hold your own mortgage inside your own RRSP

(this offers so many advantages to you and disadvantages to lenders and sellers of RRSPs that you may not have heard of it before.

Ask us about CRA guidelines and about the advantages - it could save you ten's of thousands of dollars if your RRSPs are larger than your mortgage-even if your RRSPs are only ½ the size of your mortgage it's worth investigation)
Yes No  
       
you can save up to 45% of your money used for education investing rather than using the 20% government grant - (this strategy is not suitable for all investors) Yes No  
you can reduce your estate taxes to zero? Yes No  
new laws allow you to split some income after age 65? Yes No  
there are many benefits to using a financial planner? Yes No  
the difference between a financial planner and an accountant? Yes No  
the diff between a financial planner and an investment advisor? Yes No  
 
NOTE: How do you prefer to be contacted should we require additional information?
 
By phone or email?
(Please provide phone or email information when you get IDF code - not here)

You can email the form to us. Most people do as it is all anonymous. But if you prefer you can fax it to my attention at 506-458-1154 or mail it to:

Gordon E. Hughes ELP, CFP
YorkFinancial Services Inc.
494 Queen St. Suite 400
Fredericton, NB E3B 1B6
 
 
*** End of Form ***
Gordon Hughes @ Smart Choice Life 454-3346 4LIFE INsurance
440 York St. Fredericton, NB E3B 3P7