Initial Information Questionnaire
Wildflower Financial LLC
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All of your information is kept confidential. Please refer to our privacy policy for more details.
Name(s)
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Birthdate(s)
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Phone number(s)
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Email(s)
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Address
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If money was no object, what would you do?
Your answer
What has been your best money decision so far?
Your answer
What was your worst?
Your answer
Please describe what motivated you to seek out financial planning advice?
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Please describe a few of your top financial concerns - is there anything that keeps you up at night?
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Is there anything else you would like to share about your expectations, motivations, goals, concerns or past experiences?
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Do you have children or other dependents?
If yes, please let us know name(s), birthdates or ages, relationship to you and where they live if they do not live with you
Your answer
Employer(s) and Job Title(s)
Your answer
What is your annual income?
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Do you have debt?
If yes, what kind and how much (approximate)?
Your answer
Please indicate which of the following assets you own, either individually or jointly
Are all of your tax return filings current?
Are any of your tax return filings on extension?
have you received a letter or notice from the IRS or Franchise Tax Board that needs to be addressed?
If yes, please describe
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Who currently prepares your tax returns?
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Do you feel confident that you have minimized your income taxes?
Do you have Health insurance?
Comments:
Your answer
Do you have Life insurance?
Comments:
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Do you have a will?
Do you have a trust?
Do you have a durable power of attorney?
Do you have a health care proxy?
If applicable, have you determined guardianship provisions for minor children?
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