Financial Suitability Questionnaire| cbgtoday

Book Now

HOME
ABOUT
COMPANIES
SERVICES
CAREER
CONTACT
APPOINTMENT
More

Financial Suitability

Questionnaire

Please fill out the following form to help us better understand your financial suitability.

First Name

Last Name

Age

Email Address

Initial Premium (Investment Amount)

Work Status

Owner

Retired

Employed

Unemployed

Other

Joint Owner

Retired

Employed

Unemployed

Other

Federal Tax Rate

0%

10-15%

25-28%

33+%

Financial Information

Source(s) Of Income

Salary / Wages

Social Security

Interest Income

Diviedends

Pension / IRA Payments

Other Annuites

Trust Income

Other

Approxiamte Monthly Household Income (Net After Taxes)

Approximate Monthly Household Expenses

Liquid Assets

Cash

Stocks/Bonds

CDs

Checking/Savings/Money Markets

Mutual Funds

Life Insurance cash value

IRAs/Qualified Plans

Annuities

Other

Non Liquid Assets

Value of Home

Other Real Estate

Gold, Collectibles, or other valuable personal property

Liabilities

Total Long Term Liabilities (Home Mortgage, Business Loans, etc. )

Total Short Term Liabilities (Credit Card Debt, Short Term Loans 1-5 yrs)

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!