Info Gathering Survey
Thank you in advance for filling out this questionnaire. Completely answering each question will enable you to get the most out of our initial meeting. The information you provide will be held strictly confidential.
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Email *
Individual #1 First Name: *
Individual #1 Last Name: *
Individual #1 Employer/Profession *
Individual #1 Job Title *
Individual #1 Date of Birth *
Individual #1 Phone Number *
Individual #1 Home Street Address *
Individual #1 City *
Individual #1 State *
Individual #1 Zip Code *
Marital Status *
(Single, Married, Committed Long-Term Relationship, Domestic Partnership, etc.)
Individual #2 First Name:
Individual #2 Last Name:
Individual #2 Employer/Profession
Individual #2 Job Title
Individual #2 Date of Birth
Individual #2 Phone Number
Individual #2 Full Home Address
(If different than Individual #1)
Please list your dependents
(Please include name(s), age(s), and relationship)
What are some of your current financial goals? *
What are the biggest challenges you have with your finances right now? *
Are there any transitions you are currently experience or likely to experience in the future? Ex: Work/career, financial, retirement, giving, leisure, vacation, education, making a big purchase, debt concerns, etc. If so, please describe the ones you are excited about or are concerned with. *
Does anyone else need to be in this meeting for you to make a decision about moving forward? *
If you answered yes to the question above, who?
Individual #1 Annual Base Salary Or Estimated Annual Wages *
Individual #1 Annual Bonus and/or Expected Commissions *
Individual #2 Annual Base Salary Or Estimated Annual Wages
Individual #2 Annual Bonus and/or Expected Commissions
Other Annual Or Future Income
(Please briefly explain. Examples include alimony, child support, rental income, trust income, inheritance, etc)
How much do you currently have in savings? *
How much debt do you have? (Please list out balances and interest rates. If this is student loan debt, please indicate if it is Federal or private). *
How much do you have in retirement accounts? *
If you have any other investments, list them here:
How did you discover Ballast Point Financial Planning? *
Anything else I should know before coming to our meeting?
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