Book your Financial Awareness session

Your progress

Your Accounts

Real Estate and Business

What You Already Have in Place

Health and Long-Term Care

Income You Can Count On

Where Your Money Goes

Family and Legacy

A Couple Last Things

Getting Ready for Our First Meeting

In our first meeting we’ll walk through your whole picture together, so the more you can fill in ahead of time, the more we can do with you in the room.

A good estimate is fine anywhere on this form. If something doesn’t apply, leave it blank and we’ll talk it through.

Worth bringing to the meeting

Your most recent statement for each account
Your Social Security statement, and any pension statement
The declarations page for each insurance policy
A copy of your will or trust, if you have one

A Little About You

About you

First name

Last name

Your email

Best phone number

Date of birth

We use this to line up ages and required withdrawal dates.

State of residence

Marital or household status

Married

Partnered

Single

Widowed

Divorced

Are you working, retired, or aiming for a date?

Currently working

Retired

Aiming for a date

Target retirement date

What’s driving that date?

About your second person (optional)

For a spouse or partner you’re planning with. Leave blank if it doesn’t apply.

First name

Last name

Date of birth

Are they working, retired, or aiming for a date?

Currently working

Retired

Aiming for a date

Target retirement date

What’s driving that date?

What brought you here

What made you want to sit down with us now?

If this plan works exactly how you hope, what does life look like?

Anything you’re trying to make sure happens for your kids or grandkids?

Household and Dependents

Children or other dependents, and their ages

Include anyone who relies on you financially, such as an adult child or a parent.

Is one of you managing things at home full-time?

Yes

Education savings (a 529 or similar)

Roughly what’s in them, and who they’re for.

Your Accounts

Add one entry for each account: retirement accounts, brokerage, savings, CDs, annuities, and anything else that holds money. Rough balances are fine. Statements are even better if you have them.

Account 1

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Account 2

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Account 3

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Account 4

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Account 5

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Account 6

Whose name is it in?

Account type

Where is it held?

Approximate balance

How is it invested?

Mostly stocks

A mix

Mostly bonds

Mostly cash

Not sure

Are you still adding to it?

Yes

About how much, per month?

Employer match? Up to what percent of pay?

Is there an account that doesn’t fit these boxes, or one you’re not sure how to describe?

Real Estate and Business

Add your home and any other property. Your home mortgage goes here, so you can skip it in the debts section.

Do you own a home or any other property?

Yes

Property 1

Type

Who owns it?

Approximate value

Mortgage balance

Leave blank if none.

Mortgage interest rate

Monthly mortgage payment

Monthly rent that comes in (rentals)

Any other properties? Type, value, and mortgage details

Business ownership

Do you own all or part of a business?

Yes

What kind of business?

Your share

Its rough value

Do you expect to sell it or step away? If so, when?

What You Already Have in Place

The declarations page for each policy has most of these answers. If you don’t have them handy, say “not sure” and we’ll find out together.

Life insurance

Do you have any life insurance, through work or on your own?

Yes

Not sure

Policy 1

Whose life is it on?

Who provides it?

Employer group plan

A policy we bought

Type

Approximate death benefit

Does it continue after you leave or retire?

Yes

Not sure

Any other life insurance policies? Whose life, type, and benefit

Disability income — first person

Who provides it?

Employer

Your own policy

None

What does it pay?

A percent of pay or a monthly amount.

Are the premiums paid with pre-tax dollars?

Yes

Not sure

Disability income — second person

Who provides it?

Employer

Your own policy

None

What does it pay?

Are the premiums paid with pre-tax dollars?

Yes

Not sure

Auto, home, and rental property

Do you have auto, home, renters, or rental property insurance?

Yes

Not sure

Policy 1

Policy type

Which company is it through?

Deductible

Medical payments coverage limit

Rental property: owned personally or in an LLC?

Personally

In an LLC

Other auto, home, or rental policies?

Umbrella liability

Do you have an umbrella policy?

Yes

Not sure

Coverage limit

Does it include any rental property?

Yes

Not sure

Health and Long-Term Care

Coverage for medical costs now, and for care later in life.

Health coverage — first person

Current coverage

Which Medicare parts do you have?

Include a Supplement or Part D if you carry one.

If you plan to retire before 65, do you know how you’ll be covered until Medicare starts?

Yes

Not sure

Doesn’t apply

Health coverage — second person

Current coverage

Which Medicare parts do you have?

If they plan to retire before 65, do you know how they’ll be covered until Medicare starts?

Yes

Not sure

Doesn’t apply

Long-term care

Do you have a long-term care policy?

Yes

If yes, company and benefit amount

If no, how would you want to pay for care if you needed it?

Anything from your family’s experience that shapes how you think about this?

Optional.

Income You Can Count On

Your Social Security statement at ssa.gov and any pension statement will have most of these numbers.

Work, Social Security, and pension — first person

What do you do for work?

Current gross pay per year

Social Security status

Not yet applied

Applied, not claiming yet

Currently claiming

Estimated monthly benefit at full retirement age

It’s on your statement at ssa.gov.

Age you plan to start claiming

Your current monthly benefit (if claiming)

Do you have a pension?

Yes

Estimated monthly amount

Age it starts

What would a spouse or partner receive if you were gone?

A percent, or “not sure”.

Does it adjust for inflation?

Yes

Not sure

Is a lump-sum option offered?

Yes

Not sure

Work, Social Security, and pension — second person

What do they do for work?

Current gross pay per year

Social Security status

Not yet applied

Applied, not claiming yet

Currently claiming

Estimated monthly benefit at full retirement age

Age they plan to start claiming

Current monthly benefit (if claiming)

Do they have a pension?

Yes

Estimated monthly amount

Age it starts

What would a spouse or partner receive if they were gone?

Does it adjust for inflation?

Yes

Not sure

Is a lump-sum option offered?

Yes

Not sure

Other income

Any other income we should know about?

Roughly how much per month, and for how long.

The monthly number

Please answer after taxes, in today’s dollars.

The minimum monthly income that lets you sleep at night

The monthly income you’d want for the life you described, including travel and extras

Where Your Money Goes

This shows us where each month’s income ends up. Round numbers are fine.

A typical month for your household

Taxes each month

Federal, state, and payroll. Last year’s total tax line works too.

Saved or invested each month

Include payroll contributions.

Everyday living each month

Not counting taxes, saving, or debt payments.

Debts

Leave your home mortgage out; it’s in the real estate section.

Do you have any debts besides your home mortgage?

Yes

Debt 1

Type

Balance

Interest rate, if you know it

Monthly payment

Do you carry a card balance from month to month?

Yes

Student loans: federal or private? Any forgiveness program?

Any other debts? Type, balance, rate, and payment

Tax obligations

Do you have any unpaid tax obligations, such as a payment plan with the IRS or your state?

Yes

Family and Legacy

A quick look at what’s in place. We’re not asking for dollar amounts here, and we don’t prepare legal documents. An estate attorney does that.

Documents

Do you have a will?

Yes

Roughly what year was it last updated?

Do you have a trust?

Yes

Not sure

Do you have powers of attorney in place?

Yes

Not sure

Beneficiaries

When did you last review the beneficiaries on your retirement accounts and life insurance?

Within the last 3 years

More than 3 years ago

Not sure

Who is named as primary and as backup?

Names or relationships are enough.

Wishes

What would you like to happen with your home when you’re gone?

Are there causes or organizations you care about?

Do you have a giving approach in mind, such as yearly gifts, a gift in your will, or nothing yet?

A Couple Last Things

If you’re leaving an employer

Are you planning to leave an employer, or retire from one, in the next two years?

Yes

Your expected last day, or your best guess

Do you know what happens to your health coverage after that?

Yes

Not sure

Does your employer savings plan have any deadlines or windows for deciding what to do with the money?

If you have a pension, is there a date an election is due?

Do you expect a severance, a payout, or retiree benefits? If so, what?

Anything else

Is there anything else you’d like us to know before we meet?

That’s everything. Bring whatever you have, skip what you don’t, and we’ll take it from there together.

Your information is kept private and used only to prepare your plan and our conversation.

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Phone - (404) 244 6675

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Cook Pierce Financial Management, serving Decatur and the greater Atlanta area since 1989. None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy any service or any insurance product. Neither the firm nor its agents or representatives may give tax or legal advice. Individuals should consult with a qualified professional for guidance before making any purchasing decisions. Any references to protection benefits, safety, security, steady and reliable income, or lifetime income streams on this website refer only to fixed insurance products. Annuity guarantees are backed by the financial strength and claims-paying ability of the issuing insurance company. Annuities are insurance products that may be subject to fees, surrender charges and holding periods which vary by insurance company. Annuities are not FDIC insured. The information and opinions contained in any of the material requested from this website are provided by third parties and have been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. They are given for informational purposes only and are not a solicitation to buy or sell any of the products mentioned. The information contained on this website is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the needs of an individual's situation.

The Leak Report

One story a month for people who want to understand what is really happening to their money.

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Email - hello@cookpierce.com

Phone - (404) 244 6675

Cookie Policy

The Leak Report

One story a month for people who want to understand what is really happening to their money.

[data-framer-form] input[name=framer-noscript] { position: absolute; transform: scale(0); }Enable JavaScript to submit this form.

Email - hello@cookpierce.com

Phone - (404) 244 6675

Cookie Policy

None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy any service or any insurance product. Neither the firm nor its agents or representatives may give tax or legal advice. Individuals should consult with a qualified professional for guidance before making any purchasing decisions. Any references to protection benefits, safety, security, steady and reliable income, or lifetime income streams on this website refer only to fixed insurance products. Annuity guarantees are backed by the financial strength and claims-paying ability of the issuing insurance company. Annuities are insurance products that may be subject to fees, surrender charges and holding periods which vary by insurance company. Annuities are not FDIC insured. The information and opinions contained in any of the material requested from this website are provided by third parties and have been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. They are given for informational purposes only and are not a solicitation to buy or sell any of the products mentioned. The information contained on this website is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the needs of an individual's situation.