Tridelta Financial Planning Questionnaire TriDelta Financial Planning Questionnaire Client Name* First Last Date* MM slash DD slash YYYY Financial Planner* IntroductionTriDelta Financial is a comprehensive financial planning firm focused on you. Our goal is to help you meet your lifestyle goals and aspirations Our role is to provide you with financial advice on a broad range of issues including investments, insurance, cash/debt management, estate and retirement planning. We believe that to be happy you must have dreams. Success however generally requires a plan. It is with this in mind that we partner with you to develop, implement and monitor the plan to ensure your dreams become a reality. Please take the time to complete the attached questionnaire and attachments. The information gathered will remain confidential and is a vital first step in laying the framework for your personal financial plan. The attached questionnaire should be accompanied by copies of the following statements where applicable: 1. Investment statements 2. Mortgage & Loan / Line of credit statements 3. Summary page of insurance policies 4. Notice of Assessment (NOA) - provided after your last tax filingPersonal InformationMarital Status Single Married Common Law Separated Divorced Widowed ClientName* First Last Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Bus. PhoneEmail* Birth Date*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SIN Citizenship Employment StatusEmployment Employed Self employed Owner of incorporated business Retired Other (e.g. Homemaker) Occupation Company Health (Rate 1 as Excellent and 5 as Poor)12345Co-ClientName* First Last Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Bus. PhoneEmail* Birth DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SIN Citizenship Employment StatusEmployment Employed Self employed Owner of incorporated business Retired Other (e.g. Homemaker) Occupation Company Health (Rate 1 as Excellent and 5 as Poor)12345ChildrenName GenderMaleFemaleRelationshipChildGrandchildDate of Birth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rust ($) WillDo you have a will?YesNoWhen was it last updated?MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Do you have a power of attorney for property and personal care?YesNoGoalsPlease identify the goals that are most important to you.Goals Ensure a comfortable retirement Reduce taxes payable Provide for a child’s education costs Reduce mortgage Reduce credit card and other personal debt Protect income in the event of disablity or death Fund an annual vacation/cruise/trip Ensure estate is in good order for heirs Preserve estate assets for heirs Create a legacy for others Your Two Greatest WishesWish 1. Time Horizon ConsiderationsWish 2. Time Horizon ConsiderationsYour Biggest ConcernWhat is the one concern most likely to keep you awake at night?Financial InformationCash FlowYesNoAre you in control of your cash flow?InvestmentYesNoDo you have a plan in place?CreditYesNoIs your debt structured efficiently and cost effectively?Protection InsuranceYesNoAre you adequately covered?Cash Flow Analysis The cornerstone of any financial strategy is the relationship between income and expenses.
