Personal Financial Snapshot
Please complete to the best of your ability. This will save time and give us the necessary background for our session.
Email *
Appointment Date *
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Full Name *
Spouse's Full Name (if applicable)
Street Address *
City / Town *
State *
Phone Number *
Preferred method of contact for initial consultation? (Note that full promotional sessions will be held via Video Conference) *
Your age *
Spouse's age (if applicable)
Your occupation *
Spouse's occupation (if applicable)
Have you been through Financial Peace University (FPU)? *
Number of children/dependents *
How did you find Beantown Money? *
INCOME
What is your monthly net take-home pay ($)? *
Do you have an irregular or inconsistent income? *
Do you create a financial plan (budget) each month? *
SAVINGS
How much cash on hand do you have in total ($)? Generally this means cash in checking, savings, and money market type accounts but would not include your 401(k) or retirement accounts. *
Are you currently investing for retirement? *
If so, what is your total current balance in all retirement accounts ($)?
If so, what is you monthly contribution ($)?
HOUSING
Do you rent or own? *
Are you current on your housing payment? *
What is the total of your monthly housing payment ($)? *
If you own, how much is your home currently worth ($)?
If you own, what is the balance of your mortgage ($)?
Do you have a Home Equity Loan or second mortgage? *
If so, what is the balance of the loan ($)?
CONSUMER DEBT
Do you have any vehicle loans? *
If so, are you current on your vehicle payments?
Clear selection
What are your total vehicle monthly payments ($)?
What is the balance of the vehicle loans ($)?
How many credit cards do you have? *
What is the total balance on credit cards ($)?
What is the total balance on any student loans ($)? *
Do you owe any back taxes? *
Is so, what is the balance ($)?
OTHER
Is there anything else you would like to mention or feel should be included to fully understand your personal financial situation?
FOCUS
What primary issues should we focus on? *
Required
Please list the top concerns or questions related with the question above. *
FINANCIAL COACHING AGREEMENT
Please confirm that you have read and agree with the Financial Coaching Agreement available at BeantownMoney.com/resources. (Revision 20200817). Note: Session cancellations less than 24-hours in advance may be subject to a $50 fee.
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