SB FINANCIAL GROUP LLC FINANCIAL PLANNING SOLUTIONS PART A
Chris Scheib
Financial Advisor 2000 Aerial Center Pkwy Ste. 112 Morrisville, NC 27560 cell: 919-999-7820 fax: 919-882-9983
[email protected] Nate Brown
Financial Advisor 2000 Aerial Center Pkwy Ste. 112 Morrisville, NC 27560 cell: 404-550-5865 fax: 919-882-9983
[email protected] DISCLOSURE: Registered Representative Securities offered through Cambridge Investment Research Inc. a Broker/Dealer member FINRA/SIPC. SB Financial Group LLC and Cambridge Investment Research are not affiliated. Investment Advisor Representative Cambridge Investment Research Advisors, Inc., a Registered Investment Advisor.
Client Information Client #1
Client #2
Last Name:
Last Name:
First Name: Birth Date:
MI: -
SSN#:
DL#:
First Name: Birth Date:
-
-
SSN#:
DL#:
State:
Issue Date:
MI:
Exp:
State:
Issue Date:
Exp:
Married Single Domestic
Married Single Domestic
Address:
Address:
City:
St:
Phone: (cell)
City:
Zip: (work)
Email:
Employer:
Employer:
Address:
Address:
City:
St:
Job Description:
Child #1
Child #2
Last Name:
Last Name:
First Name:
MI: SSN#:
-
Zip: (work)
City:
Zip:
Job Description:
Birth Date:
St:
Phone: (cell)
Email:
St:
Birth Date:
MI: SSN#:
Male Female School Grade:
Male Female School Grade:
Relationship to Whom: Client #1 Client #2
Relationship to Whom: Client #1 Client #2
Both
Child #3
Child #4
Last Name:
Last Name:
Birth Date:
MI: SSN#:
-
Zip:
First Name:
-
First Name:
-
-
-
Both
First Name: Birth Date:
-
MI: SSN#:
Male Female School Grade:
Male Female School Grade:
Relationship to Whom: Client #1 Client #2
Relationship to Whom: Client #1 Client #2
Both
-
-
Both
Please list any other family members below; your whole family is important to us even if no longer living at home or away at school. Notes:
1
Documents Request To make your first appointment more effective, please bring the following documents.
Cash/Reserves
Investments
o
Pay Statements
Bring your current Investment Statements
o
Pension Statements
o
Managed Money Accounts
o
Savings Statements
o
Mutual Fund Accounts
o
Social Security, Annual Estimate for Retirement
o
Stocks, Bonds, Options
o
Individual Retirement Accounts
o
Work Retirement Plans (457/403b/401k)
o
SIMPLE, SEP IRA, SAR SEP
o
Thrift Savings Plan
Insurance
o
Stock Bonus Plan, ESOP
Bring the policy or current statement
o
Stock Options
o
Life
o
Deferred Compensation Plan
o
Annuity
o
Defined Benefit, Cash Balance Plan
o
Long Term Care
o
Target Benefit Plan
o
Health
o
REITs
o
Employer Group Insurance
o
Gas & Oil Leases
o
Disability – long and short term
o
Other________________________
Notes:
2
Tell us about yourself Hobbies/Special Interests/Clubs/Passions o Church/Religion
o Boy/Girl Scouts
o 4-H/FFA
o Hiking/Outdoor Activities
o Bicycling/Running/Fitness
o Pets (See Below)
o Local Sports Teams
o Lions/Elks/Moose Club
o Quilting/Scrapbooking
o Golf/Tennis
o Little League/AYSO/Pop Warner
o Other: What state/town/city did you grow up in? Favorite Sports Team: Vacation Favorites: If money was not an issue, what would you be doing? What is most important to you?
Critter Information Here, we are critter lovers. Please, know we include our animals as members of our family, and would love to get to know your furry (or not so furry) members of your family. Name: Breed: Name: Breed: Name: Breed: Name: Breed:
o Dog
o Cat
Age:
o Dog
Favorite Toy:
o Cat
Age:
o Dog
Age:
Notes:
3
o Bird o Reptile o Other: Favorite Toy:
o Cat
Age:
o Dog
o Bird o Reptile o Other:
o Bird o Reptile o Other: Favorite Toy:
o Cat
o Bird o Reptile o Other: Favorite Toy:
Income & Assets Client #1
Client #2
Income
Income
What is your current annual income? $
What is your current annual income? $
Income for other sources? (Rental/Trust/Business)
$
Income for other sources? (Rental/Trust/Business)
$
Income Total
$
Income Total
$
Savings
Savings
Cash on hand
Asset 1
Asset 2
Asset 3
Cash on hand
Asset 1
Asset 2
Asset 3
Checking (balance average): $
$
$
Checking (balance average): $
$
$
Savings Account:
$
$
$
Savings Account:
$
$
$
Money Market Account: $
$
$
Money Market Account: $
$
$
CD’s:
$
$
$
CD’s:
$
$
$
Other:
$
$
$
Other:
$
$
$
Total:
$
$
$
Total:
$
$
$
Tax Deferred Accounts (401k/403b/457/ira/529-College)
Tax Deferred Accounts (401k/403b/457/IRA/529-College)
Investment #1:
$
Balance
Investment #1:
$
Balance
Investment #2:
$
Balance
Investment #2:
$
Balance
Investment #3:
$
Balance
Investment #3:
$
Balance
Total:
$
Total:
$
taxable – Non retirement Accounts
Taxable – Non Retirement Accounts
List investments in Notes section.
List investments in Notes section.
$
Balance
$
Balance
$
Balance
$
Balance
$
Balance
$
Balance
$
Balance
$
Balance
Total:
$
Total:
Business Assets
$
Business Assets
Business Estimated Value:
$
Business Estimated Value:
$
Business Loans #1:
$
Business Loans #1:
$
Business Loans #2:
$
Business Loans #2:
$
Net Business Value:
$
Net Business Value:
$
Annual Gross Revenue:
$
Annual Gross Revenue:
$
Annual Gross Expenditures:
$
Annual Gross Expenditures:
$
Other:
$
Other:
$
Net Revenue:
$
Net Revenue:
$
4
Income & Assets Cont. Real Estate Assets
Real Estate Assets
Residence #1 Value:
$
Residence #1 Value:
$
Mortgage:
$
Mortgage:
$
Equity:
$
Equity:
$
Payment:
$
Payment:
$
Interest Rate:
%
Interest Rate:
Asset of: Client 1 Client 2 Other
Asset of: Client 1 Client 2 Other
Rental #1 Value:
$
Rental #1 Value:
$
Mortgage:
$
Mortgage:
$
Income:
$
Income:
$
Payment:
$
Payment:
$
Net Equity:
$
Net Equity:
$
Interest Rate:
%
Interest Rate:
Asset of: Client 1 Client 2 Other
Asset of: Client 1 Client 2 Other
Rental #2 Value:
$
Rental #2 Value:
$
Mortgage:
$
Mortgage:
$
Income:
$
Income:
$
Payment:
$
Payment:
$
Net Equity:
$
Net Equity:
$
Interest Rate:
%
Interest Rate:
Asset of: Client 1 Client 2 Other
Asset of: Client 1 Client 2 Other
Other Assets (Old Pension, Precious Metals, Coins, Collections) Asset #1 – Type:
Asset #3 – Type:
Value:
Value:
$
$
Asset of: Client 1 Client 2 Other
Asset of: Client 1 Client 2 Other
Asset #2 – Type:
Asset #4 – Type:
Value:
$
Value:
Asset of: Client 1 Client 2 Other
$
Asset of: Client 1 Client 2 Other
Notes:
5
%
%
%
Liability (Debt) Balances Primary Residence, Home Equity/Other, Real Estate, Business, Investment/Margin, Consumer, Automobile, Credit Card, Other. Liability 1 Liability 2 Liability 3 Description Loan Type Current Balance
$
$
$
Periodic Payment
$
$
$
Value
$
$
$
%
Interest Rate Tax Deductible
o Yes
o No
o Yes
Asset of:
o Client 1 o Client 2 o Other
%
o No
%
o Yes
o Client 1 o Client 2 o Other
o No
o Client 1 o Client 2 o Other
Liability 4 Liability 5 Liability 6 Description Loan Type Current Balance
$
$
$
Periodic Payment
$
$
$
Value
$
$
$
%
Interest Rate Tax Deductible
o Yes
o No
Asset of:
o Client 1 o Client 2 o Other
o Yes
%
o No
o Client 1 o Client 2 o Other
Notes:
6
%
o Yes
o No
o Client 1 o Client 2 o Other
Safety Nets Please bring the policy and a current statement to the next appointment. Policy 1 Policy 2 Policy 3
$
$
$
$
$
$
$
$
$
Policy 1 Policy 2 Policy 3
$
$
$
$
$
$
$
$
$
Client #3 (Children or Other) Life Benefits Policy 1 Policy 2 Policy 3
$
$
$
$
$
$
$
$
$
*Group, Term, Whole Life, Universal Life, Variable Life, Other **Client #1, Client #2, Irrevocable Trust, Community, Third Party
7
Monthly Expense MONTHLY EXPENSE SHEET
Please
in your average monthly expenses for each item. Mortgage/Rent
Debt Payments
2nd Mortgage
Charity
HOA Fees
Child Care
Home Insurance not covered in mortgage
Kids Activities
Vehicle(s) Loans Lease
Eating Out
Vehicle(s) Repairs/Upkeep
Groceries
Vehicle(s) Registrations
Entertainment
Vehicle(s) Fuel
Vacation Savings
Vehicle Insurance
Gym Membership
Utility Bills
Personal Care Products
Internet/TV/Phone Bill
Car Washes
Cell Phone Bill
Pet Food and Care
Newspaper/Mag. Sub.
Gifts
Landscaping Services
Miscellaneous spent at Target, Home Depot, etc.
Kids Miscellaneous
Pest Control House Cleaner
Liability Insurance
Pool Maintenance
Health Insurance
Professional Fees
Dental Co-Pays
Home Furnishings
Medical Co-Pays
Clothing
Medical Bills/Debts
Dry Cleaning
Prescriptions
Other:
Other:
Other:
Other:
Total
Total Grand Total
Notes:
8