Retirement Assessment Worksheet

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Our Team
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Services and Processes
Our Team
Attend an Event
- Virtual Lunch n’ Learns
Media
- Media Library
Build My Asset Map
Schedule a Meeting

The following will allow us to evaluate your preparedness for retirement.

Retirement Assessment Worksheet

Step 1 of 2

50%

Email
This field is for validation purposes and should be left unchanged.
How did you hear about us?*
- Educational Workshop
- TV
- Internet
- Referral
- Other
Full Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Phone*
Email Address*
Do you have children? Name(s) Age(s)*
Are your parents still living?*
Do you have Long Term Care Insurance?*
- Yes
- No
Do you have a Current Will?*
- Yes
- No
Do you have a Living Trust?*
- Yes
- No
Do you know your current Tax Bracket?*
- Yes
- No
If yes, what is the percentage?
- <15%
- 25-33%
- >35%
Property Address(es), Present Value(s), Mortgage(s)

Retirement Information
Employment Status
Name 1
Name 2
Projected/Actual Retirement Date
Name 1
Name 2
Estimated/Actual Pensions
Name 1
Name 2
Estimated/Actual Social Security
Name 1
Name 2
Current Annual Income
Name 1
Name 2
Annual Contribution to Investments
Name 1
Name 2
Estimated Value of Investments
(IRAs, CDs, Stocks, Bonds, Annuities, Mutual Funds, etc.)
Name 1
Name 2
Other
Name 1
Name 2
What keeps you awake at night?
- Select All
- Financial issues as retirement draws near
- Do I have enough to retire?
- How long will my money last?
- Should I roll over my 401(k)?
- Which is best? Traditional IRA or Roth IRA?
- Should I consolidate my retirement plans?
- What are my 401(k) distribution options?
- Required Minimum Distributions (RMDs)
- Which asset to spend 1st, keep to last?
- Are my beneficiary designations correct?
- Should I stretch my IRA?
- Have I told my survivors my wishes?
- Do I know what I need to know about estate and inheritance taxes?
- Is my current plan maximizing my tax deductions to my heirs?
- Should I set up a trust?
- What should I do with my home at my death?
- What is IRD?
- Am i effectively managing my estate?
- How do I spend the assets I have left efficiently?
- Caring for my aging parents
- How will I be able to help a loved one with Alzheimer's disease?
- Being a caregiver
- Finding the right care facility for an older relative
- Choosing how to pay for long-term care
- When do I consider a Nursing home?
- Making sense of Medicare
- Power of attorney issues
- Executor and Executrix responsibilities
- Upcoming large expenses
- What to do when a relative dies?
- New job/career - benefits review
- 401(k) plan choices for job changes
- Life Insurance - How much is enough?
- Divorce/Spouse death: Now you're "on your own"
- Grandchildren have arrived! I want to enhance their financial future
- Organizing my financial records
- Create a household budget
- Reducing debt
- Creating a simplified "big picture" Plan
The concerns listed below were collected from people JUST LIKE YOU, and are some of the concerns we have put to rest for our clients. Please read through the list and check your top 5 concerns that “keep you up at night”, or include your own. Once you’ve completed the Retirement Assessment, please follow the instructions at the bottom of this page.
Are other concerns keeping you up at night? Let us know below!

DC:

1801 Research Blvd
Suite 540
Rockville, MD 20850
240.361.0363
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Tampa:

8875 Hidden River Pwky.
Suite 300
Tampa, FL 33637
240.361.0363
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We are an independent financial services firm helping individuals create retirement strategies using a variety of investment and insurance products to custom suit their needs and objectives.

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 is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the particular needs of an individual’s situation.

Investing involves risk, including the potential loss of principal. No investment strategy can guarantee a profit or protect against loss in periods of declining values. None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy a security or any insurance product.

Any references to protection benefits or steady and reliable income streams on this website refer only to fixed insurance products. They do not refer, in any way, to securities or investment advisory 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.

Retirement Assessment Worksheet

Retirement Assessment Worksheet

Step 1 of 2

Retirement Information

DC:

Tampa:

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