Financial House Worksheet

The Financial House Worksheet | Insurance University

Client Profile

Client Full Name

Client Date of Birth

Client Employment Status

Spouse / Partner Full Name

Spouse Date of Birth

Spouse Employment Status

Advisor Full Name

Advisor Phone Number

Advisor Email Address

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Foundation — Life Insurance Protection

20× Income Rule · Coverage Gap Analysis · Disability & Health

Client Annual Income

Spouse Annual Income

Recommended Coverage (20×)

Enter income above

Existing Life Insurance — Client Include all group, employer, individual policies

Existing Life Insurance — Spouse

Foundation Gap

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Number of Dependents

Age of Youngest Dependent

Group Coverage — Portable?

Client Health Status

Disability Income Coverage

Health Insurance Status

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The Walls — Debts, Obligations & Stability

Emergency Fund · Current Liabilities · College Savings Goals

Short-Term Stability

Emergency Fund (months of expenses)

Monthly Household Expenses

P&C Coverage Adequacy

Current Liabilities

Mortgage Balance

Monthly Mortgage Payment

Vehicle Loans (total)

Credit Card Debt (total)

Student Loans

Personal / Other Loans

Business Debt / Personal Guarantees

Total Current Debt

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College & Future Obligations

Number of Children

Ages of Children

College Goal per Child

Existing College Savings

Projected College Obligation

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Total Wall Obligation

—

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The Structure — Retirement Planning

Income Gap · Tax Exposure · Savings Trajectory

Current Age

Target Retirement Age

Years Until Retirement

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401(k) / Employer Plan Balance

Monthly 401(k) Contribution

Employer Match % (capturing full?)

Traditional IRA Balance

Roth IRA Balance

Other Retirement Savings

Total Retirement Savings

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Est. Tax Rate at Retirement

After-Tax 401(k) / IRA Value

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What they actually have after taxes on pre-tax accounts

Desired Monthly Income at Retirement

Est. Social Security Benefit Monthly at full retirement age (check SSA.gov)

Monthly Retirement Income Gap

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Risk Tolerance

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The Roof — Trust & Estate Planning

Probate Exposure · Beneficiaries · Wealth Transfer

Has a Will?

Has a Trust?

Life Insurance Beneficiaries Current?

Minor Children Who Would Inherit?

Blended Family Situation?

Estimated Total Estate Value All assets — home, retirement, savings, etc.

Primary Estate Goal

Additional Estate Notes

Fill in as many fields as possible for the most complete analysis