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Personal Attention

    Please complete the following questions so that The Smart Money Gal, Jean Ann Dorrell, CEP®, can better evaluate your needs and provide you with the very best personalized attention possible!

        Contact information

     

    Your Name*:

    Your Spouse's Name:

    Your Email*:

    Home Phone:

    Cell Phone:

    Address:

     

    City* State* Zip*:

        Work & Family Information

     

    Occupation:*

    How many Children do you have?*    How many Grandchildren?*

    Do you have a Retirement Plan with your work?

     

    YesNo

    If yes, which Financial Institution Administers it for your office?    

    Do you have a Retirement Plan outside of your work?

     

    YesNo

    If yes, at which Financial Institution is it located?    

        Financial Objectives

     

         Please rank the following according to your level of concern, where 1 is not concerned and 10 would be Very Concerned

    Planning for Children, Grandchildren

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    Reducing Current Income Taxes

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    Increasing Current Income

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    Estate Planning

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    Desire for Professional Management

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    Maximum Growth

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    Combined Growth & Income

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    Simplifying My Investments

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    Preservation of Assets

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    Questions or Comments

     

    What is your biggest concern with regard to your Estate Plan?*