Map Report - Financial Planning, Idaho Falls, ID

Family Data

Clients Names

Name (#1)*

First Middle Last

Goes By*

Gender*

Date of Birth*

Social Security #*

Name (#2)*

First Middle Last

Goes By(#2)*

Gender(#2)*

Date of Birth(#2)*

Social Security #(2)*

Current Home Address*

Street Address City State / Province / Region ZIP / Postal Code

Contact Information

Clients Names

Business Phone (#1)*

Cell Phone (#1)*

E-mail Address (#1)*

Home Phone (#2)*

Client 2

Business Phone (#2)*

Cell Phone (#2)*

E-mail Address (#2)*

Home Phone (#2)*

Employment Information

Client 1

Primary Employer (#1)*

Job Description*

Monthly Take Home Pay?*

Client 2

Primary Employer (#2)*

Job Description(#2)*

Monthly Take Home Pay?(#2)*

How much has your debt INCRESASED in the last year?*

Home Mortgage

Primary Residence (Current Market Value?)*

Original Loan Amount?*

Current Loan Balance?*

Interest Rate?*

Loan Term (Length in Months?)*

Minimum Monthly Payment?*

Do you make EXTRA monthly payments?*

Loan Origination Date?*

Description

1st Mort

2nd Mortgage Loan Amount?*

2nd Mortgage Interest Rate?*

2nd Mortgage Loan Term?*

2nd Mortgage Payment?*

Do you make EXTRA payments?*

Rental Property Current Value?*

Rental Property Loan Amount?*

Rental Property Interest Rate?*

Rental Property Loan Term (Length in Months?)*

Yes

No

Rental Property Payment?*

Rents*

Do you make EXTRA payments?*

2nd Mortage

Rental Property #2 Loan Amount?*

Rental Property #2 Current Value?*

Rental Property #2 Interest Rate?*

Rental Property #2 Loan Payment?*

Rents*

Rental Property #2 Loan Term (Length in months?)*

Do you make EXTRA payments?*

OTHER REAL ESTATE AND INVESTMENT PROPERTIES (Please include loan amounts, current balances, interest rates, loan terms, payments, rents, & extra payments, etc...)**

Notes: Describe your future Goals and Dreams**

Other Creditors (Autos, Credit Cards, Department Stores, etc.)

Other Loans Description*

Original Loan Amount?*

Current Loan Balance?*

Minimum Loan Payment?*

Loan Interest Rate?*

Start Date*

Loan Term (Length in months?)*

Do you make EXTRA Payments*

OTHER LOANS: (Include all other loans & credit cards w/ amounts. interest rates, payments, loan terms and EXTRA Payments in the space below)*

Description

Primary Checking (Bank Name):*

Primary Checking Balance:*

Checking (#2) - Bank Name:*

Checking (#2) Balance:*

Checking (#3) - Bank Name:*

Checking (#3) Balance:*

Money Market Acct. (Bank Name):*

Money Market Acct. Balance:*

Primary Savings (Bank Name):*

Savings (#2) - Bank Name:*

Savings (#2) Balance:*

Emergency Savings (Bank Name):*

Emergency Savings Balance:*

OTHER CHECKING & SAVINGS: (Include all other Checking & Savings Acct. in the space below with balances)*

Monthly Deposits

How much INCOME do you need annually, to live comfortably without any DEBT payments?*

Life Insurance and Fixed, Equity Indexed, & Variable Annuities:

LIFE INSURANCE & ANNUITIES: (Please list insurance company, insurance amounts, premiums, type of insurance, interest rates, terms, etc...*

Are you and your spouse smokers or Non-smokers?*

Do you have any family history of heart disease, cancer or stroke?*

Do currently have life insurance on your children? (How much?)*

Does either parent currently have disability insurance? (How much?)*

Does either parent have Long-Term Care insurance? (How much?)*

C.D.s, Stocks, Bonds, Mutual Funds, etc.:

INVESTMENTS: (Stocks, Bonds, Mutual Funds, Etc... ) Please list account balances, interest rates, companies where funds are held, fees, etc...*

Qualified Plan (Pension, 401(k), IRA, TSA, SEP) Assets:

RETIREMENT: (IRA, 401K, Pension, Roth, or Other Qualified Plan Assets) - Please list all of your RETIREMENT accounts, types, amounts invested, the interest rate, terms, current values, etc...*

Retirement Goals: (How much annual income will you need to live like you are living today, to travel, and to be happy?*

Business Interests:

BUSINESS INTERESTS: (Do you own or plan yo own your own business?)*

What type of business do your own?*

What is the Gross Revenue?*

What is your core Product or Service?*

What is the Current Value of your business?*

What are your current Expenses?*

Notes: Other Information*

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Map Report (Fact Finder)

Family Data

Contact Information

Employment Information

Home Mortgage

Description

Other Creditors (Autos, Credit Cards, Department Stores, etc.)

Life Insurance and Fixed, Equity Indexed, & Variable Annuities:

C.D.s, Stocks, Bonds, Mutual Funds, etc.:

Qualified Plan (Pension, 401(k), IRA, TSA, SEP) Assets:

Business Interests:

Map Report (Fact Finder)

Start Your Financial Plan With Us Today

Map Report (Fact Finder)

Family Data

Contact Information

Employment Information

Home Mortgage

Description

Other Creditors (Autos, Credit Cards, Department Stores, etc.)

Life Insurance and Fixed, Equity Indexed, & Variable Annuities:

C.D.s, Stocks, Bonds, Mutual Funds, etc.:

Qualified Plan (Pension, 401(k), IRA, TSA, SEP) Assets:

Business Interests:

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