Plan Your Federal Retirement

Personal Data - Client A
Middle Name
The part of a person's name occurring between the first and family names.
Legal Last Name*
A surname, family name, or last name is the portion (in some cultures) of a personal name that indicates a person's family (or tribe or community, depending on the culture).
Gender
The classification of people as male or female
Date of Birth*
Date Format: MM slash DD slash YYYY

The month, day, and year you were born.
Height
Human height or stature is the distance from the bottom of the feet to the top of the head in a human body.
Weight (lbs)
Human body weight refers to a person's mass or weight in pounds.
Do You Currently Use Tobacco Products?
Tobacco use may be defined as any habitual use of the tobacco plant leaf and its products
Work Phone
Cellular Phone
Preferred Email*

Your personal email vs a work email might be better to ensure communication is received.
Address*
Home Address: Street: City: State: Zip:
Adverse Medical History We Should Know About?
An account of significant medical events and problems you may be or have been experiencing?

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Relationship Status*
Civil status, or marital status, are the distinct options that describe a person's relationship with a significant other. Married, single, divorced, and widowed are examples of such status.
What is your tax filing status?*
Filing status determines which tax return form an individual will use and is an important factor in computing taxable income. Filing status is based on marital status and family situation.
Marital Status
- No
- Yes
Personal Data - Client B
In this section, we will be collecting information about a singular person in the household. This person is referred to as "Client B".
Legal First Name*
Legal name is the name that identifies a person for legal, administrative and other official purposes. A person's first legal name generally is the name of the person that was given for the purpose of registration of the birth and which then appears on a birth certificate (see birth name) but may change subsequently through marriage, divorce or other circumstances.
Middle Name
The part of a person's name occurring between the first and family names.
Legal Last Name:*
Gender
Date of Birth*
Date Format: MM slash DD slash YYYY

The month, day, and year you were born.
Height
Human height or stature is the distance from the bottom of the feet to the top of the head in a human body.
Weight
Human body weight refers to a person's mass or weight.
Do you currently use tobacco products?
Tobacco use may be defined as any habitual use of the tobacco plant leaf and its products.
Is Your Address the Same as [Client A]?
Work Phone:
Cellular Phone:
Preferred Email:*

Your personal email vs a .gov email might be better to ensure communication is received.
What is Your Home Address?
Home Address of Client B, if different from Client A

Home Address: Street: City: State: Zip:
Adverse medical history we should know about?
An account of significant medical events and problems you may be or have been experiencing?

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Children
**DEV NOTE:** Repeater Fields
Children can refer to those that are of natural descent, adopted, foster or through a step relationship.
Do You Have Children?
- Yes
- No
First Name:
MI:
Last Name:
Gender:
Male
Female
Date of Birth:
Date Format: MM slash DD slash YYYY

College Funding:
Yes
No
The Year that College Funding will Start or has Started?
Anticipated Number of Years in School?
What is the Current Cost of Attendance Per Academic Year if Already Started?
Amount of College Funding That Has Already Been Saved?
* If you plan to have additional children, please write "Planned" in the dependent space and indicate the approximate future birth date(s).

** If you anticipate paying for your children's college education, choose Yes.

If you do not specify a cost for education in today's dollars, we will use the cost of the average public, four-year college.

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Client A:
Occupation*
Employer*
Check Here If:
- Retired
- Self-Employed
Client B:
Occupation*
Employer*
Check Here If:
- Retired
- Self-Employed
Your Financial Professionals:
If you are currently working with financial professionals such as a CPA or Law Firm, let us know. We are happy to contact them and work together for your benefit.
Financial Advisor Name/Firm:
Accountant Name/Firm:
Attorney Name/Firm:

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Client A: Federal Retirement Information
Are you a Federal Employee?*
Retirement System*
The Federal Employees' Retirement System is the retirement system for employees within the United States civil service. FERS became effective January 1, 1987, to replace the Civil Service Retirement System and to conform federal retirement plans in line with those in the private sector
Employee Type
Contingent on the type of employee you are, there are special provisions that need to be accounted for. Which employee category best fits your employment.
Federal Service Computation Date (SCD)*
Date Format: MM slash DD slash YYYY

A Service Computation Date (SCD) is a date, either actual or constructed, that is used to determine benefits and is generally based on how long the person has been in the Federal Service.
Annual Gross Salary*
Gross wages are the amount a company pays an employee before any deductions are withheld. On a W-2 tax statement, an employee's federal taxable gross wages appear in Box 1, which is located near the top-center of the form.
Hi-3 Salary*
Years of CSRS Offset*
Military Time Bought Back*
Amount of Sick Leave Saved to Date
Unused sick leave will be used in the calculation of an employee's or survivor's annuity based on retirement with an immediate annuity or on a death in service. For employees covered by the Civil Service Retirement System (CSRS), credit toward the annuity computation will be based on the full sick leave balance at retirement or death. For employees covered by the Federal Employees Retirement System (FERS), credit toward the annuity computation will be based upon a percentage of the sick leave balance at retirement or death, depending on the date the entitlement to the annuity began.
Sick Leave Per Pay Period*
Survivor Election*
CSRS Survivor Election*
FEHB Insurance*
Are you a State Employee?*
State you are Employed with?*
What Tier Are you?*
State Service Computation Date*
Date Format: DD dash MM dash YYYY
While employed, did you pay into social security?
Client B: Federal Retirement Information
Are you a Federal Employee?*
Retirement System*
The Federal Employees' Retirement System is the retirement system for employees within the United States civil service. FERS became effective January 1, 1987, to replace the Civil Service Retirement System and to conform federal retirement plans in line with those in the private sector
Employee Type
Contingent on the type of employee you are, there are special provisions that need to be accounted for. Which employee category best fits your employment.
Federal Service Computation Date (SCD)*
Date Format: DD dash MM dash YYYY

A Service Computation Date (SCD) is a date, either actual or constructed, that is used to determine benefits and is generally based on how long the person has been in the Federal Service.
Annual Gross Salary*
Gross wages are the amount a company pays an employee before any deductions are withheld. On a W-2 tax statement, an employee's federal taxable gross wages appear in Box 1, which is located near the top-center of the form.
Hi-3 Salary*
Years of CSRS Offset*
Military Time Bought Back*
Amount of Sick Leave Saved to Date:
Unused sick leave will be used in the calculation of an employee's or survivor's annuity based on retirement with an immediate annuity or on a death in service. For employees covered by the Civil Service Retirement System (CSRS), credit toward the annuity computation will be based on the full sick leave balance at retirement or death. For employees covered by the Federal Employees Retirement System (FERS), credit toward the annuity computation will be based upon a percentage of the sick leave balance at retirement or death, depending on the date the entitlement to the annuity began.
Sick Leave Per Pay Period*
Survivor Election*
CSRS Survivor Election*
FEHB Insurance*
Are you a State Employee?*
State you are Employed with?*
What Tier Are you?*
State Service Computation Date*
Date Format: DD dash MM dash YYYY
While employed, did you pay into social security?
Employer Benefits
Owner
Gross Monthly Benefits Expected
What Year Will These Benefits Start?
What Year Will These Benefits End?
Survivor Benefits | Gross Monthly Amount (%)
(Your employer can help you determine this information) If you are a Federal employee, only complete this section if you are eligible for non-federal benefits. Are you eligible to participate in an employer-sponsored retirement plan?

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What is your desired gross monthly income at retirement?

Please list the income desired for retirement after taxes, in today's dollars.
What is your desired gross monthly income at retirement?*
Please list the income desired for retirement after taxes, in today's dollars.
Average Annual Inflation Rate (if other than 4%)*
Please enter a number from 1 to 8.
Average Growth Rate*
Please enter a number from 1 to 8.
Client A:
Retirement Date*
Date Format: MM slash DD slash YYYY
Gross FULL Social Security at FRA*
Age to Start Social Security*
Please enter a number from 62 to 70.
Do you want to work part-time in retirement?
Life Expectancy*
Please enter a number from 55 to 99.
Client B:
Retirement Date*
Date Format: MM slash DD slash YYYY
Gross FULL Social Security at FRA*
Age to Start Social Security*
Please enter a number from 62 to 70.
Do you want to work part-time in retirement?
Life Expectancy*
Please enter a number from 55 to 99.

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Assets - Cash Reserves
Name of Institution
Sample description added in code.
Who Owns This Account?
Sample description added in code. 1
Account Type
Current Balance
Interest Rate
Amount of Personal Property
Personal property is a class of property that can include any asset other than real estate. The distinguishing factor between personal property and real estate, or real property, is that personal property is movable; that is, it isn't fixed permanently to one particular location.
* Personal property includes your home furnishings, autos, boats, antiques, heirlooms, jewelry, silver place settings, stamp collections, etc. that you do not want to sell to fund retirement needs. Personal property should be listed at fair market value.

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Assets - Investments
Name
Upload Investment Statement
Total Value
Account Type
Owner
Annual Rate of Return

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Assets - Insurance
Insurance Company Name
Upload Policy Statement
Owner
What Type of Insurance Policy Is It?
Insured
What is the Death Benefit of This Policy?
What is the Accumulated Value of This Policy?
How Often Do You Pay the Premium for This Policy?
What is the Premium You Pay for This Policy
Other Insurance
Existing Insurance Coverage
Insurance Policy Owner
Insurance Company
Coverage Amount
Annual Premium

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Real Estate Portfolio Detail
Property Type
Owner
Fair Market Value
What is the fair market value of this property? In its simplest sense, fair market value (FMV) is the price that property would sell for on the open market.
Equity
What is the equity in this property? Equity is the difference between the home's fair market value and the outstanding balance of all liens on the property.
Annual Property Tax
A property tax or millage rate is an ad valorem tax on the value of a property, usually levied on real estate.
Original Mortgage Amount
The original amount borrowed or financed for this property.
Date of Mortgage
Date Format: MM slash DD slash YYYY

Term (Years)
A mortgage term is the length of time, usually in years, in which the parameters of a mortgage have legal effect.
Mortgage Balance
A mortgage balance is the full amount owed at any period of time during the duration of the mortgage, and is the sum of the remaining principal owing and accrued interest.
Monthly Payment
Your monthly payment is what you pay to the lender each month to repay your loan. The amount you pay every month depends on the terms of your mortgage loan. This includes the principal, which is the actual balance on the loan, and the interest on the loan.
Interest Rate
Mortgage interest is the percentage charged on a mortgage that must be paid in addition to the principal. The mortgage interest rate is related to prevailing interest rate levels and may be fixed or adjustable. Fixed rate mortgages have identical amortized payments for the life of the loan.

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Liabilities
Item or Company
Type of debt such as "car loan".
Original Date
Date Format: MM slash DD slash YYYY

Loan Date means any date on which a loan is made to the Borrowers by the Lender pursuant to their agreement.
Original Amount
Original Loan Amount means the principal amount of the loan originally made by each Lender to Borrower, as set forth in their agreement.
Original Term
A term loan is a monetary loan that is repaid in regular payments over a set period of time. Term loans usually last between one and ten years but may last as long as 30 years in some cases.
Balance
The loan balance is simply the remaining amount you have left to pay on your loan.
Interest Rate
The loan balance is simply the remaining amount you have left to pay on your loan.
Min. Payment
The minimum payment is the lowest amount of money that you are required to pay.
Current Payment
The amount of money, if other than the minimum amount, you pay regularly.

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Housing Expenses (All Properties You Rent or Own)
Do you:
- Rent
- Own
Monthly Mortgage/Rent Payment:
Monthly HOA:
Property / Renters Insurance:
Auto Expenses for your MV
Vehicle Loan Payment:
Vehicle Insurance Payment:
Fuel Cost:
Vehicle Loan Payment:
Vehicle Insurance Payment:
Fuel Cost:
Loans for Other Items
UTV / ATV:
Boat:
Aircraft:
Other:
Other Loans
Student Loan:
Secured Loan:
Unsecured Loan:
Other:
Media
Cell Phone Plan:
Netflix / Prime / Etc:
Cable T.V.:
Internet at Home:
iTunes / App Stores:
Credit Cards
Visa:
MasterCard:
American Express:
Disconver:
Other:
Household Expenses (All Properties You Owned)
Natural Gas(Heat):
Electric:
Water:
Sewer and Garbage:
Landline (house phone):
Housecleaning:
Alarm System:
Monthly Clothing Cost
(Also including hand bags, accessories, shoes, etc):
Monthly Personal Care
(including haircuts, manicure, pedicure, makeup, beauty supplies, bath supplies):
Monthly Medications / Supplements
(also including medical and dental insurance/copy):
Monthly Life Insurance:
Monthly Child Care:
Child Expenses: The 2 and 4 legged type (including toys, kid sports, lessons, camp, etc)
Monthly Child Care:
Monthly Child Support You Pay:
Tuition to School:
Extracurricular Activities:
Pet Food:
Pet Supplies:
Pet Camps / Grommong / Boarding:
Other:
Life Style
Dining Out:
Going Out (Cocktails and Evening Out):
Gym Membership:
Personal Trainer:
Massages / Adjustments:
Movies / Theatre / Museum:
Other Memberships:

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We consider all of your lifestyle goals and what you ideally would like to achieve.

Please help us understand your goals.
I would like to plan for retirement at age
Retirement Age (Acceptable)
(acceptable), but I would be willing to take action (such as
saving more or reducing my retirement spending goals) if it would mean I could retire at age
Retirement Age (Ideal)
(Ideal).
My spouse will retire at the same time I do:
My Spouse Will Retire At The Same Time I Do:
- Yes
- No
if no, my spouse would like to target retirement at age
Retirement Age (spouse - acceptable)
(acceptable), but if they could retire at age
Retirement Age (spouse - ideal)
(ideal) we would like our
plans to include that possibility.
We would like to plan for an after-tax, monthly retirement spending of $
Monthly Retirement Spending (acceptable)
(acceptable), but if we
can increase our spending to $
Monthly Retirement Spending (ideal)
(ideal) a month that would be idea.
Which best describes your attitude about Social Security? Please check one:
- If possible, we would prefer to not be dependent on Social Security in retirement
- We would like to include estimated Social Security benefits in our investment plan
- I am currently collected Social Security in the amount of
- I expect to receive Social Security in the amount of
We would like to leave an estate worth at least $
Estate Worth at Least (acceptable)
(acceptable), but if we could increase that to
$
Estate Worth at Least (ideal)
(ideal) with minimal impact on our other goals, we would like to consider that possibility
If necessary, I would be willing to increase my current savings level by $
Increase Current Savings Level (acceptable)
(acceptable) per month, but if I
could decrease my current savings level by $
Increase Current Savings Level (ideal)
(ideal) per month with minimal impact on any other goals, that
would be ideal.

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The goal of financial analysis and investing is not simply to help you achieve financial independence at retirement. In many cases, a financial advisor can design a program for you that takes into account special considerations of needs other than retirement income. Please specify the amount in today's dollars you believe will be necessary to obtain this goal. If your specific goal is not listed, please include it on the blank lines at the end of the list.
Other Goals
Other Goals
Amount Needed
Start Date
Other Start Date
Date Format: MM slash DD slash YYYY

End Date
Other End Date
Date Format: MM slash DD slash YYYY

Additional Notes

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Additional Information

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Personal Data - Client A

Personal Data - Client B

Children

Client A:

Client B:

Your Financial Professionals:

Client A: Federal Retirement Information

Client B: Federal Retirement Information

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