Retirement Data Input
Client Information
Client Info
Spouse Info
Courtesy Title
Dr.
Mrs.
Ltc.
Mr.
Ms.
Col.
Dr.
Mrs.
Ltc.
Mr.
Ms.
Col.
First Name
Last Name
Birthdate (mm-dd-yyyy)
Occupation
Employer
Street Address
Street Address - additional
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
None
Zip Code
Phone
Email Address
Marital Status
Single
Married
+ Income Detail
Client Info
Spouse Info
Annual Income
Pay Increases
Desired Retirement Age
Age to end retirement analysis
+ Assets
Description
Estimated Value ($)
Ownership
Type
1
Client
Spouse
Joint tenancy
Traditional Qualified Plan
Roth qualified plan
Taxable investment
2
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
3
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
4
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
5
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
6
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
7
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
8
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
9
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
10
Client
Spouse
Joint tenancy
Traditional qualified plan
Roth qualified plan
Taxable investment
+ Annual Savings - Retirement Savings Info
Client Annual Saving ($)
Spouse Annual Saving ($)
Increase w/ Pay?
Qualified plans (Traditional)
No
Yes
Qualified plans (Roth)
No
Yes
Non-qualified investments
No
Yes
+ Pension
Client Info
Spouse Info
Future annual benefit ($)
Lump sum ($)
Adjust pension for inflation?
No
Yes
No
Yes
Pension Begin Age
+ Additional Retirement Receipts/Expenses
Description
Future Amount ($)
Start Age (client)
End Age (client)
Annual Increase (%)
Type
1
Expense
Receipt
2
Expense
Receipt
3
Expense
Receipt
4
Expense
Receipt
5
Expense
Receipt
6
Expense
Receipt
+ Objectives
Desired annual after-tax income during retirement ($) (% or $)
OR
Desired legacy (todays dollars) ($)
Adjust legacy for inflation?
No
Yes
Include social security in analysis?
No
Yes
Social security inflation rate (%)
+ Social Security Override
Client Info
Spouse Info
Override SS start age
(leave at 0 for retirement age)
Override monthly SS benefit ($)
(leave at 0 for system calculation)
+ Rate Assumptions
Will recommended savings increase with inflation?
No
Yes
Portfolio before-tax return pre-retirement
Portfolio before-tax return post-retirement (%)
Average tax bracket pre-retirement
Average tax bracket post-retirement (%)
Estimated Inflation Rate (%)