Full Name
*
Email
*
Phone
*
Date of birth
Marital Status
Single
Married
Common-Law
Other
Name (Spouse/Partner)
Age (Spouse/Partner)
Business / Operating Company Name(s)
Approximate Gross Annual Business Revenue (Annual top-line revenue)
$
Approximate Net Annual Business Income (After expenses, before tax)
$
Do you have a Holding Company (Holdco)?
Yes
No
Not sure
Do you have a partner or partners in your business?
Yes
No
Approximate amount of retained earnings moved to Holdco annually (If applicable)
$
Annual Salary Taken (Client)
$
What is your annual personal spending amount (burn rate)?
$
Annual Salary Taken (Spouse/Partner, if applicable)
$
Other compensation received (dividends, bonuses, etc.)
$
Please list your non-registered personal assets (Real estate, non-registered investments, private shares, etc.)
Approximate current value of non-registered assets
$
Approximate cost base of non-registered assets (if known) (Original purchase price / adjusted cost base)
$
Approximate RRSP Value
$
Approximate TFSA Value
$
Approximate RESP Value
$
Other Registered Plans (if applicable)
Do you have an up-to-date will?
Yes
No
Unsure
Do you have dual wills in place (personal and corporate)?
Yes
No
Unsure
Do you have Powers of Attorney in place (Property & Personal Care)?
Yes
No
Unsure
Do you currently have personal health insurance?
Yes
No
Approximately how much coverage do you currently have?
Do you have a group benefits plan for employees?
Yes
No
Not applicable
Do you have any corporate-owned insurance in place?
Yes
No
Unsure
Do you have a shareholders agreement in place?
Yes
No
Not applicable
If yes, is there a funding plan in place to support it?
Yes
No
Unsure
Are there any specific concerns, goals, or upcoming events we should be aware of? (e.g., sale of business, real estate transaction, family transition, major tax event)
Confidentiality Acknowledgement
I understand that all information provided will be handled with the strictest confidence and used solely for planning purposes.
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