Home
What is Financial Health?
Welcome
Ethos
Products and Services
Blog
Our Team
Support and FAQ
Home
What is Financial Health?
Welcome
Ethos
Products and Services
Blog
Our Team
Support and FAQ
INFORMATION SHEET
Name
*
First Name
Last Name
Email Address
*
Phone
*
(###)
###
####
Date of birth?
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Annual income
$
What are the top three things you want financially that you don't have now?
*
What are the top two reasons you don't have those things?
*
If you keep doing what you're doing now, will you accomplish those three things?
Desired retirement age?
*
Desired % of current income at retirement (assuming no debt)?
*
Do you have a trust?
Yes
No
Do you have an attorney?
Yes
No
Do you have a CPA?
Yes
No
What type of life insurance do you have?
Term
IUL
GUL
VUL
Whole Life
Other
None
Total death benefit of all policies?
$
Section 2: Assets
Total amount of qualified retirement savings? Ex. 401k, 403b, TSP, etc.
$
Please explain if and/or how your employer matches your retirement savings?
Total amount of Roth IRA savings?
$
Total amount of liquid savings? Ex. checking, savings, money market, CDs, cash value life insurance available, etc.
$
Total amount of stocks, bonds, and/or mutual funds owned?
$
Approximate value of primary residence?
$
Section 3: Liabilities
Amount of first mortgage?
$
Amount of second mortgage?
$
Principal balance of car loan 1?
$
Principal balance of car loan 2?
$
Principal balance of car loan 3?
$
Principal balance of any other secured loans? Ex. boats, trailers, RVs, four wheelers, etc.
$
Principal balance of all credit cards and/or other unsecured debts?
$
Principal balance of all student loans?
$
Comments or questions?
Thank you!