Palen Financial’s Data Gathering Form

This form must be completed and submitted before the free initial
consultation in order for the meeting to take place.
It must be completed by the household
decision maker(s) and the initial consultation must include both spouses

The following documents MUST  accompany you at your initial meeting for an accurate analysis to be completed:

  • Last Year’s Tax Return
  • Brokerage Firm Statements
  • Life Insurance/Annuity Statements & Policies
  • IRA/401k and other Investment Statements
  • Will and/or Trust Documents

    Family Information

    YesNo
    YesNo

    Personal Questions

    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo

    Financial Planning Objectives

    1 = being the least concerned5 = being the most concerned
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    Real Estate

    Select Ownership Type: H=Husband W=Wife JT=Joint or Trust
    HWJT
    HWJT
    HWJT

    Sources of Monthly Earned and Retirement Income

    You
    Spouse
    You
    Spouse
    You
    Spouse
    TOTAL

    Contact us today for an examination of your portfolio – our “Financial Fresh Look”!

    You can start your examination by filling out and submitting the Data Gathering form below.  The Expense Sheet is optional.