Retirement Evaluation Checklist

______________________________________________________ ______________________
NAME                                                                                                   DATE
___________________ __________________________________________________________
YOUR AGE                                                                             EMAIL


MARRIED                       DIVORCED                            WIDOW(ER)                               SINGLE


1) Do you have a retirement plan?
    YES   NO   NOT SURE  I NEED ONE PLEASE!

2) If yes, what type(s) of plan(s) do you have?

   Check all that apply:

  IRA  Roth IRA  401(k)  Roth 401(k)  403(b) 457(b)  Simple IRA  SEP IRA  Qualified Plan
Others:________________________________________________________________________

3) Employment Status:

   Employee     Self Employed     Retired     Unemployed


4)  Please list your plan balance(s):
Plan:___________________ Balance: $________________ Firm:_______________________
Plan:___________________ Balance: $________________ Firm:_______________________
Plan:___________________ Balance: $________________ Firm:_______________________

5)  Are you required to take an RMD this year?
     YES   NO   NOT SURE  WHAT IS THAT?


6)  Have you done an IRA rollover in the past 12 months?
     YES   NO   NOT SURE  WHAT IS THAT?


7)  When did you last update your plan beneficiary designation forms?
     Within the Last Year   Over One Year  Ago   Not Sure Gee, I need to do that!

8)  Do you have an exit strategy for your IRA, 401(k) or pension plan?

    YES   NO   NOT SURE  WHAT IS THAT?

9)  When do you plan to retire?

Please explain:

         ______________________________________________________________________________


10) Are your retirment plans Multi-Generational?

   YES    NO    NOT SURE   WHAT'S THAT?

11)   Do you have a sustainable, guaranteed stream of income you cannot outlive set up for your    retirement?

    YES    NO    NOT SURE   WHAT'S THAT?


12) Have you eliminated market risk while preserving the upside of the market in your retirement plans?
     YES    NO    NOT SURE   WHAT'S THAT?


13) Would a loss of 20% - 30% in the value of your retirement accounts cause you to delay retirement?
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14) How much do you have allocated to cover a long-term care event?
___________________________________________________________________________
15) What long-term care plan or solution do you currently have in place?
___________________________________________________________________________
___________________________________________________________________________
16) Do you have and CDs? (financial instruments, not music!)

    YES    NO    NOT SURE   WHAT'S THAT?

17)  Do you have and Money Markets?

      YES    NO    NOT SURE   WHAT'S THAT?

18)  Do you have other questions about your retirment plans oe retirement in general?

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