VPM-11 - CONFIDENTIAL
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Welcome to Your Financial Planning Journey

This confidential questionnaire helps your advisor understand your complete financial picture. Take your time — no field is required.

🔒 100% Confidential 📋 6 Sections ⏱️ ~20 min

👤 Client Profile

Single Married Divorced Widowed Separated
Male Female Prefer not to say
Yes No
Excellent Good Fair Poor
Yes No


Children & Other Beneficiaries


Client's Parents

RelationLiving?AgeHealthDependent?Potential Inheritance ($)
Client Father
Client Mother
Spouse Father
Spouse Mother

Community Property States

📋 Planning Documents & Advisors

Estate Planning Documents

Document TypeYou Have It?Spouse Has It?Date ExecutedAttorney NameNotes

Current Insurance Coverage

TypeProviderCoverage Amount ($)Annual Premium ($)Beneficiary

Professional Advisors

RoleNameFirmPhoneLast Contact

🎯 Retirement Vision & Planning

Retirement Timeline

YesNo
YesNoN/A

Where will you live?

🏠 Stay in current home 🏡 Downsize 🌎 Relocate 🏘️ 55+ Community ✈️ Split locations 📝 Other

Work in retirement?

😴 Fully retired ⏰ Part-time income 🎨 Stay active 💼 New career 🚀 Own business

Retirement activities (select all that apply)

✈️ Travel 👨‍👩‍👧 Family 🎸 Hobbies 🤝 Volunteering 📚 Education 💪 Fitness 🌿 Other


Retirement Concerns


Healthcare & Long-Term Care

YesNoIn Progress
YesNoUnsure
YesNo

Legacy & Estate Goals

YesNo
In PlaceIn ProgressNot started
YesNo

💰 Monthly Budget

Monthly Income

Total Monthly Income (A): $0

Basic Monthly Expenses

Total Basic Expenses (B): $0

Discretionary Expenses

Total Discretionary (C): $0

Monthly Summary

Total Income (A)$0
Total Basic Expenses (B)$0
Total Discretionary (C)$0
Monthly Surplus (A - B - C)$0

Savings Goals

📊 Retirement Income & Assets

Guaranteed Monthly Retirement Income

Total Guaranteed Income: $0

Assets & Investments

Asset TypeCurrent Value ($)Est. Monthly Income ($)
Total Asset Value: $0
Total Est. Monthly Income: $0

Income Gap Analysis


All Done! 🎉

Your financial planning questionnaire is complete.

🎯 Target Retirement Age
💰 Monthly Surplus
📊 Total Assets
✅ Guaranteed Monthly Income

📋 Recommended 3-Step Workflow

1 Save as PDF — Save the full professional report to your computer.
2 Upload Your Supporting Documents — Upload your supporting documents including your professional report using the green Box button below, and attach all the requested documents to be sent to your advisor.
3 Submit All Your Answers to Your Advisor — Click the green Submit button below to send all your answers directly to your advisor.

🗎️ Supporting Documents

Upload your tax returns, bank statements, insurance policies, or any other documents your advisor requested.

📎 Upload Your Supporting Documents

🔒 Secured by Box — No Box account required — Opens in a new tab

Need to change something? No problem.


🚀 Ready to Send Your Answers?

We are excited to receive your information!

We'd love to send all your answers directly to your advisor.

Once you submit all your answers, the questionnaire will reset to the first page.

🔒 This questionnaire is confidential and intended solely for use by the client and their authorized financial advisor.