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Client Financial Goals & Needs Assessment

IUL Suitability Questionnaire

1. Personal Information

First Name*

Last Name*

Email*

Date

Age

Marital Status

Number of Dependents

Occupation & Employer

Annual Income

State of Residence

2. Financial Objectives

Wealth accumulation

Retirement planning

Leaving a legacy

College funding for children

Tax-advantaged growth

Income protection for family

Business succession or key-person planning

Long-term care planning

Estate planning

3. Insurance Needs

Do you currently have life insurance? Yes No

If yes, type & coverage

Coverage you believe you need

Are you more focused on Protection Investment/Growth Both equally

4. Risk Tolerance

Very conservative (minimal to no risk)

Moderate (some fluctuations acceptable)

Aggressive (willing to take risks for higher returns)

5. Investment Horizon & Liquidity

5–10 years

10–15 years

15+ years

Need withdrawals in 5–10 years? Yes No

If yes, for what purpose?

6. Tax Planning

Are you maxing out retirement accounts? Yes No

Interested in building tax-free retirement income? Yes No

Concerned about rising tax rates? Yes No

7. Budget for Premiums

Less than $200/month

$200–$500/month

$500–$1,000/month

$1,000+/month

Are you looking for

Minimum premium / Max death benefit

Maximum premium / cash accumulation

Balanced strategy

8. Health Status

Health conditions

Medications

Ever declined life insurance?

9. Retirement Goals

Desired retirement age

Desired retirement income

Currently saving? Yes No

If yes, how?

10. Additional Considerations

Please be assured that your e-mail address will never be sold, shared or used for any other purpose without your permission.

| Contact info

CENTRAL FLORIDA
ESSENTIAL BUSINESS/REAL ESTATE

m: 8639401766

e: marissaoberrysales@gmail.com

w: https://marissaromack.webpro-realty.com

a: 1420 South Florida Ave Lakeland FL 33803

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1101 S. Winchester Blvd., Ste J-225 San Jose, CA 95128

Knowledge and Experience is the Difference

When are you looking to buy or sell?

Real estate adventures

On and around lake lanier with elisa

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