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PIPP Trusted Partners
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Fact Find Questionnaire
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1
Identification
2
Current Value of Qualified Retirement Asset (401K, IRA, etc)
3
Non-Qualified Asset to Maximize (Optional)
4
Your Concerns
Your Name
*
First
Last
Spouse's Name
First
Last
Your Date of Birth
*
Spouse's Date of Birth
Your State
*
Spouse's State
Next
You: Traditional
Please enter amount in USD
Spouse: Traditional
Please enter amount in USD
You: Roth
Please enter amount in USD
Spouse: Roth
Please enter amount in USD
Next
You: Current Value
Please enter amount in USD
Spouse: Current Value
Please enter amount in USD
You: Basis (Amount You Invested)
Please enter amount in USD
Spouse: Basis (Amount You Invested)
Please enter amount in USD
Next
What concerns you most as a client? Please check one or more of the following:
*
Running out of money before running out of breath.
Protecting the asset from market loss.
Protecting money from the needs of extended care.
Accumulating tax-free, and providing tax-free income later.
Leaving a tax-free asset, instead of taxable asset, to beneficiaries.
Your Email Address
*
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