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Questionnaire

Questionnaire

Step 1 of 8 - Contact Information

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  • Section 1 - Family

  • Date Format: MM slash DD slash YYYY
    mm/dd/yyyy

  • Second 2 - Secondary Phone Break

  • Section 2 - End

  • Please enter a number from 300 to 850.

  • Do you have a significant other?

  • Date Format: MM slash DD slash YYYY

  • Section 3 - End

  • Section 4 - Children

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
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  • Currently Employed Section

  • Employment information

  • Please enter a number from 0 to 100.

  • Employed Section End

  • Other Section Income End

  • Spouse Information

  • Currently Employed Section

  • Employment information

  • Please enter a number from 0 to 100.

  • SO Employment Section End

  • Other Income Section

  • SO Other Income Section End

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  • Start Own Section

  • Section Break

  • End ownership section

  • Mortgage section

  • i.e. 30 year fixed
  • Please enter a number from 0 to 100.
    Percent
  • Date Format: MM slash DD slash YYYY

  • Extra payment section

  • Other homes real estate section

  • If home or real estate

  • Section property 1

  • Mortgage section property 1

  • i.e. 30 year fixed
  • Please enter a number from 0 to 100.
    Percent
  • Date Format: MM slash DD slash YYYY

  • Extra payment section - property 1

  • Section property 2

  • Mortgage section property 2

  • i.e. 30 year fixed
  • Please enter a number from 1 to 100.
    Percent
  • Date Format: MM slash DD slash YYYY

  • Extra payment section - property 2

  • Section property 3

  • Mortgage section property 3

  • i.e. 30 year fixed
  • Please enter a number from 1 to 100.
    Percent
  • Date Format: MM slash DD slash YYYY

  • Extra payment section - property 3

  • Section property 4

  • Mortgage section property 4

  • i.e. 30 year fixed
  • Please enter a number from 1 to 100.
    Percent
  • Date Format: MM slash DD slash YYYY

  • Extra payment section - property 4

  • If renting

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  • Information 401k section

  • Enter the information of the selected 401k option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information 401k company matching funds section

  • Enter the information of the selected 401k company matching funds option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Annuities section

  • Enter the information of the selected Annuities option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information CDs section

  • Enter the information of the selected CDs option
  • Please enter a number from 0 to 100.
    %
  • Please enter a number from 0 to 100.
    %
  • Please enter a number from 0 to 100.
    %

  • Information Checking section

  • Enter the information of the selected Checking option

  • Information Deferred Comp section

  • Enter the information of the selected Deferred Comp option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information ETFs section

  • Enter the information of the selected ETFs option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information IRA section

  • Enter the information of the selected IRA option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Money Market section

  • Enter the information of the selected Money Market option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Mutual Funds section

  • Enter the information of the selected Mutual Funds option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Pensions section

  • Enter the information of the selected Mutual Funds option

  • Information Child account section

  • Enter the information of the selected Child account option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Savings section

  • Enter the information of the selected Savings option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information SEP section

  • Enter the information of the selected SEP option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information SIMPLE section

  • Enter the information of the selected SIMPLE option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Stocks/Bonds section

  • Enter the information of the selected Stocks/Bonds option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.

  • Information Other section

  • Enter the information of the selected Other option
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
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  • Enter information of the option "Credit cards" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "Auto loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "Bank loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "Boat loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "RV loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "College loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "HELOC" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Enter information of the option "Other loans" selected.
  • Please enter a number greater than or equal to 1.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
  • Please enter a number from 0 to 100.
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  • Information Critical Illness section

  • Enter policy information Critical Illness

  • Information Disability section

  • Enter policy information Disability
  • Please enter a number from 1 to 65.
    Please enter a number less than or equal to 365.

  • Information Homeowners section

  • Enter policy information Homeowners

  • Information Liability Umbrella section

  • Enter policy information Liability Umbrella

  • Information Life Insurance section

  • Enter policy information Life Insurance

  • Information Long Term Care section

  • Enter policy information Long Term Care
  • Please enter a number from 1 to 65.
    Please enter a number less than or equal to 365.

  • Information Medical section

  • Enter policy information Medical

  • Information Medicare Supplement/Advantage section

  • Enter policy information Medicare Supplement/Advantage

  • Information Renters section

  • Enter policy information Renters
  • Please enter a number from 0 to 99999.
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  • Section 7 - GoalsDocs

Save and Continue Later

  • Section 8 - Monthly Cash Flow

  • Monthly Budget

    This section is to collect your monthly expenses so we can project those expenses to, and through, retirement adjusted for inflation. Please input your best estimate of budget numbers in any categories that apply to you. Please also note our calculations will only be as accurate as the budget data you provide!
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(530) 886-8550

garrett@ifcins.com



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