1. Do you Rent or Own?
   select Rent Own
2. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
3. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up
4. Have you considered life insurance?
   Select Yes No We have talked about it Subject never came up
5. Do you or your spouse have Student Loans?
   Select No Yes-less than 25K Yes-25K-50K Yes 50K-75K Yes 75K+
6. Do you plan on traveling together?
   Select Yes Globetrotting when we can Yes before we have kids No more than the average couple No I am ready to settle down
   

1. Do you Rent or Own?
   select Rent Own
2. Do you have any children from a previous marriage?
   Yes No
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
3. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
4. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up
5. Have you considered life insurance?
   Select Yes No We have talked about it Subject never came up
6. Do you or your spouse have Student Loans?
   Select No Yes-less than 25K Yes-25K-50K Yes 50K-75K Yes 75K+
7. Do you plan on traveling together?
   Select Yes Globetrotting when we can Yes before we have kids No more than the average couple No I am ready to settle down
   

1. When is your wedding date?
   
2. Is this your first Marriage?
   Yes No
   
3. Are traveling for your honeymoon?
   Select Yes-locally Yes-In the US Yes-the Caribbean or Mexic Yes-Europe Yes-Asia Yes-Africa, Yes South America Yes-Australia Yes-The pacific Islands or Hawaii No-Planning small intimate honeymoon
   
4. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
5. Do you have any children?
   Yes No
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
6. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up

1. Is this a Purchase or Rental?
   purchase rental
2. Is your new place a House, Apartment, Condo, or other Multi Family Unit?
   Select House Apartment Condo or other Multi Family Uni
3. Have you consider a new Home Owners or Renters Insurance?
   Select Home Owners Renters Insurance
4. If this is a New Home purchase are you a first time buyer?
   Yes N o
5. Are you married?
   Yes N o
6. Do you have any children?
   
Yes No

Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
7. Why did you move?
   Select work school downsizing upsizing lateral

1. Are you newly married?
   Yes No   If no, how many years have you been married?
2. Is your new home and existing home or a new construction?
   Select New construction existing home
3. Are you planning on making any structural changes to your new home (i.e.-Finish Basement, re-model kitchen or add a bath)?
   Yes No
4. Do you have a pool?
   Yes No
5. Do you have any children?
   Yes No
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female

1. How many children do you have?
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   
2. How many kids are in or entering college, Armed Services or Trade Schools?
   
   Kid 1 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 2 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 3 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 4 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 5 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   
3. Are you planning on downsizing your home?
   Yes No
   
4. Have you met your financial retirement goals?
   Yes No
   
5. If no, do you use a financial professional or manage your retirement planning yourself?
   Select Financial professional myself
   
6. Do you plan to travel more often, about the same, or less?
   Select More often about the same less

1. What is your anticipated due date? / /
   
2. Are you planning on nursing or bottle feeding your new baby?
   Select Nursing Bottle Feeding
   
3. If you have learned the gender, are you expecting a boy or a girl?
   Select boy girl Don’t know
   
4. Is this your first child?
   Yes No   If no how many other children do you have?
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female

1. Is your change of job your decision or part of a downsizing?
Select my choice downsizing
2. Are you planning on looking for a new job in your present career or looking to start a new career?
Select Same career New career
3. What will be your #1 reason for taking a new job?
Select Increased Salary Better Benefits Personal Satisfaction Best long term opportunity
4. Will you be handling any changes to your retirement portfolio or have you hired an Investment Professional?
Select Myself Professional
5. Will you need to go back to school to learn new skills to assist you in your job search?
Select Yes No Yes I am learning a whole new career

1. What is your first goal upon retirement?
Select Spend time with family travel relax learn new hobbies other
2. In making your decision to retire, did you achieve your financial retirement goals?
Yes No
3. Did you use a financial professional or yourself to manage your retirement?
Select Myself Professional
4. Do you own or plan to own a second residence?
Select Own Plan to own No
5. Are you planning on selling your current residence to downsize?
Yes No
6. Have you considered a Reverse Mortgage to supplement your retirement income?
Yes No

If caring for elder parent(s), what solution have you chosen?

1. Do you Rent or Own?
   select Rent Own
2. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
3. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up
4. Have you considered life insurance?
   Select Yes No We have talked about it Subject never came up
5. Do you or your spouse have Student Loans?
   Select No Yes-less than 25K Yes-25K-50K Yes 50K-75K Yes 75K+
6. Do you plan on traveling together?
   Select Yes Globetrotting when we can Yes before we have kids No more than the average couple No I am ready to settle down
   

1. Do you Rent or Own?
   select Rent Own
2. Do you have any children from a previous marriage?
   Yes No
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
3. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
4. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up
5. Have you considered life insurance?
   Select Yes No We have talked about it Subject never came up
6. Do you or your spouse have Student Loans?
   Select No Yes-less than 25K Yes-25K-50K Yes 50K-75K Yes 75K+
7. Do you plan on traveling together?
   Select Yes Globetrotting when we can Yes before we have kids No more than the average couple No I am ready to settle down
   

1. When is your wedding date?
   
2. Is this your first Marriage?
   Yes No
   
3. Are traveling for your honeymoon?
   Select Yes-locally Yes-In the US Yes-the Caribbean or Mexic Yes-Europe Yes-Asia Yes-Africa, Yes South America Yes-Australia Yes-The pacific Islands or Hawaii No-Planning small intimate honeymoon
   
4. When do you plan to have children?
   Select 1st year 2nd year 3rd year 4th year 5th year+ whenever it happens
5. Do you have any children?
   Yes No
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
6. Have you started Financial Planning together?
   Select Yes No We have talked about it Subject never came up

1. Is this a Purchase or Rental?
   purchase rental
2. Is your new place a House, Apartment, Condo, or other Multi Family Unit?
   Select House Apartment Condo or other Multi Family Uni
3. Have you consider a new Home Owners or Renters Insurance?
   Select Home Owners Renters Insurance
4. If this is a New Home purchase are you a first time buyer?
   Yes N o
5. Are you married?
   Yes N o
6. Do you have any children?
   
Yes No

Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
Age Gender Please Select Please Select Male Female
7. Why did you move?
   Select work school downsizing upsizing lateral

1. Are you newly married?
   Yes No   If no, how many years have you been married?
2. Is your new home and existing home or a new construction?
   Select New construction existing home
3. Are you planning on making any structural changes to your new home (i.e.-Finish Basement, re-model kitchen or add a bath)?
   Yes No
4. Do you have a pool?
   Yes No
5. Do you have any children?
   Yes No
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female

1. How many children do you have?
   
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   
2. How many kids are in or entering college, Armed Services or Trade Schools?
   
   Kid 1 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 2 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 3 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 4 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   Kid 5 Please Select College-Freshman College-Sophomore College-Junior College-Senior College-Post-Grad Armed Services Trade Schools
   
3. Are you planning on downsizing your home?
   Yes No
   
4. Have you met your financial retirement goals?
   Yes No
   
5. If no, do you use a financial professional or manage your retirement planning yourself?
   Select Financial professional myself
   
6. Do you plan to travel more often, about the same, or less?
   Select More often about the same less

1. What is your anticipated due date? / /
   
2. Are you planning on nursing or bottle feeding your new baby?
   Select Nursing Bottle Feeding
   
3. If you have learned the gender, are you expecting a boy or a girl?
   Select boy girl Don’t know
   
4. Is this your first child?
   Yes No   If no how many other children do you have?
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female
   Age Gender Please Select Please Select Male Female

1. Is your change of job your decision or part of a downsizing?
Select my choice downsizing
2. Are you planning on looking for a new job in your present career or looking to start a new career?
Select Same career New career
3. What will be your #1 reason for taking a new job?
Select Increased Salary Better Benefits Personal Satisfaction Best long term opportunity
4. Will you be handling any changes to your retirement portfolio or have you hired an Investment Professional?
Select Myself Professional
5. Will you need to go back to school to learn new skills to assist you in your job search?
Select Yes No Yes I am learning a whole new career

1. What is your first goal upon retirement?
Select Spend time with family travel relax learn new hobbies other
2. In making your decision to retire, did you achieve your financial retirement goals?
Yes No
3. Did you use a financial professional or yourself to manage your retirement?
Select Myself Professional
4. Do you own or plan to own a second residence?
Select Own Plan to own No
5. Are you planning on selling your current residence to downsize?
Yes No
6. Have you considered a Reverse Mortgage to supplement your retirement income?
Yes No