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60 Second Survey

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When would you like to retire? *

Ex: 65

How old are you? *

Your age

What's your name? *

Number of dependent children *

Risk Tolerance? What kind of market ups and downs are you comfortable with? *

Little

Moderate

Large

What is your annual gross income? *

Include approximate salary, commissions, bonuses and real estate income.

What types of Investment / Savings accounts do you have? *Check all that apply

How much do you have in each account? *

Ex: 25k Roth IRA, 170k NQ, 960k 401k, etc.

What is your cash savings account balance? *

What is your monthly savings? *

Include how much money you put toward all your savings, investment and retirement accounts

Do you currently rent or own your home? *

Rent

Own

How much is your home worth? *

What is the remaining mortgage balance? *

What is your mortgage payment? *

What is your monthly rent payment? *

Do you have any debt? *

Yes

No

Do you currently pay for any life insurance products? *

Yes

No

What is your payment and coverage?

Ex: 20 Year Term Life Insurance, $200/month, $2M Death Benefit

What city & state do you currently reside? *

Ex: Denver, Colorado

First Name *

Last Name *

Email *

Phone *

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