Retirement Forecast

Primary Contact

First Name *

Last Name *

Date of birth *

Retirement Goal (Age Desired) *

Employment Status *

Employed
Retired
In Between Jobs
Homemaker
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List is empty.

State *

Marital Status *

Married
Single
Divorced
Widowed
Common Law
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List is empty.

Gender *

Male
Female
No elements found. Consider changing the search query.
List is empty.

Income Sources

Current Income from Job (Annual Before Taxes) *

$

Other Income $ (Annual Before Taxes) *

$

Social Security Info can be found on SSA.Gov. Please take a moment to login for accurate numbers. This part is important for the Retirement Forecast

Age starting Social Security Income? *

Social Security Monthly Amount *

$

Will you receive a Pension? *

Yes

No

What age does Pension start

Monthly Pension Amount

$

Source of Pension

Total Monthly Expenses

Include All Expenses

Monthly Expense Amount *

$

Retirement Accounts and Assets

Total amount in CURRENT Employer Retirement Account (401k, 403b, 457, TSP, etc) *

$

Does your Employer Match? *

Yes

No

What Percentage does your Employer contribute?

What Percentage do you contribute?

Do you have Old Employer Retirement Accounts (401k, 403b, 457, TSP, etc) *

Yes

No

Total Amount in Old Employer Retirement Accounts (401k, 403b, 457, TSP, etc) *

$

Total Amount in Traditional IRAs *

$

Annual Contributions to Traditional IRAs *

$

Total Amount in Roth IRAs *

$

Annual Contributions to Roth IRAs *

$

Total amount in Brokerage Accounts NON IRA Funds (Stocks/ Bonds/ Mutual Funds) *

$

Annual Contributions to Brokerage Accounts NON IRA Funds (Stocks/ Bonds/ Mutual Funds) *

$

Total amount in Annuities *

$

Total amount in Checking/ Savings/ Bank Money Market *

$

Total amount in CD's *

$

Spouse Information

Spouse First Name

Spouse Last Name

Spouse DOB

Retirement Goal (Age Desired) (Spouse)

Spouse Employment Status

Employed
Retired
In between Jobs
Homemaker
No elements found. Consider changing the search query.
List is empty.

Spouse Gender

Male
Female
No elements found. Consider changing the search query.
List is empty.

Spouse Income Sources

Current Income from Job (Annual Before Taxes)(Spouse)

$

Other Income $ (Annual Before Taxes)(Spouse)

$

Social Security Info can be found on SSA.Gov. Please take a moment to login for accurate numbers. This part is important for the Retirement Forecast

Age starting Social Security Income? (Spouse)

Social Security Income Monthly (Spouse)

$

Spouse | Will you receive a Pension?

Yes

No

Spouse | What age does Pension start

Spouse | Monthly Pension Amount

Spouse | Source of Pension

Spouse Retirement Accounts and Assets

Spouse | Total amount in CURRENT Employer Retirement Account (401k, 403b, 457, TSP, etc)

$

Spouse | Does your Employer Match?

Yes

No

Spouse | What Percentage do you contribute?

Spouse | What Percentage does your Employer contribute?

Spouse | Total Amount in Traditional IRAs

$

Spouse | Annual Contributions to Traditional IRAs

$

Spouse | Total Amount in Roth IRAs

$

Spouse | Annual Contributions to Roth IRAs

$

Spouse | Total amount in Brokerage Accounts NON IRA Funds (Stocks/ Bonds/ Mutual Funds)

$

Spouse | Annual Contributions to Brokerage Accounts NON IRA Funds (Stocks/ Bonds/ Mutual Funds)

$

Spouse | Total amount in Annuities

$

Spouse | Total amount in Checking/ Savings/ Bank Money Market

$

Spouse | Total amount in CD's

$

General Notes

Submitter

Name of Person Submitting this Form *

Email of Person Submitting this Form *