Green Financial Resources
Client Update Form
Green Financial Client Update Form
Date
Name
Address
Street address, P.O. box, company name, c/o
City
state
Zip Code
Preferred Contact Method
Phone Email Mail
Primary Contact Number
Secondary Contact Number
Primary Email Address
Secondary Email Address
Current Employer and Occupation
If not already in retirement, when do you plan to retire?
Annual Household Income
Liquid Net Worth
Net Worth
Tax Bracket
What are your average monthly expenses?
Have there been, or do you expect, any material changes to your financial situation that could impact your investment planning over the next 3-5 years? (employment, college, marital status, children, major purchase, etc)?
Yes No
If yes, please indicate the changes here
Do you anticipate needing to make any withdrawals from your investment accounts over the next 3-5 years, outside of any you already take regularly?
Yes No
If yes, please indicate the changes here
Is an inheritance part of your overall financial planning (receiving or giving)?
Yes No
If yes, please indicate the changes here
Have you planned for unexpected loss of income via disability insurance?
Yes No
If married and both are working, do you both have coverage?
Yes No
Have you planned for unexpected nursing home/in-home care needs via LTC INS?
Yes No
If married, do you both have long-term care coverage?
Yes No
Have you planned for the financial care of your dependents via life insurance?
Yes No
If married, do you both have life insurance?
Yes No
Do you have any of the following:
Financial power of attorney
Yes No
Living will/healthcare advance directive?
Yes No
A will?
Yes No
A trust?
Yes No
Please check any topics you would like to discuss with an advisor:
Investment Allocation
Financial Protection
for Dependents
Planning for Potential Incapacity
When can I retire?
My Existing 401k
College Planning
Timing of Social Security
Saving More
Harvesting Assets for/
in Retirement
Consolidation of Investments
401K Rollovers
Impact of Changing Jobs
Dependents with Special Needs
Caring for Elderly Parents
Pensions
Mortgages/Major Purchases
Small Business
Planning/Invesments
Income Protection
Charitable Giving
Tax Deferral or Reduction
Estate Planning
Other
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Reminder note: Please make sure you have designated beneficiaries for all of your assets and review them periodically. Also it is important to have a valid will and directives in place and to ensure someone knows where to find your important documents.
Investment Advisor Representative offering securities & advisory services through Cetera Advisors LLC, a Registered Investment Advisor, Broker/Dealer, member FINRA, SIPC. Green Financial Resources, LLC is otherwise unaffiliated with Cetera Advisors LLC. Office located at 3700 Crestwood Pkwy NW, Duluth, GA 30096