KingdomTrust Capital Management, Inc.

Principles Centered | Managing Capital | Protecting Wealth™

Values, Needs and Goals Assessment Questionnaire

“Where your treasures are, there will your heart be also”
–Jesus Christ

How closely aligned are your “treasures” with your values, needs and goals, i.e. your heart? The value of financial planning can sometimes be lost on peoples desire to make more money â€“for the sake of making more money.

At SmithMcClure & Co. we believe that an effective wealth management plan should reflect your values, needs and goals; for example, funding college, recreating your paycheck during retirement, transfer of your estate in the most tax efficient manner, asset protection, long term care planning, etc.

The following questionnaire will allow us to provide you with a scorecard of your values, needs and goals. Upon completing this form, we will provide you with an wealth health assessment; giving you our perspective of just how secure your current financial situation truly is.

How much consumer debt do you have?
What is the outstanding balance owed on your mortgage?
Do you owe student loans? If so, how much?
What is the value of your home?
What is your annual income?
What amount of disposable income do you have left over after you have paid your monthly bills & expenses?
Do you use the tax planning/preparation services of a Certified Public Accountant?
Do you have a WILL?
Has it been more than five years since your will was reviewed?
Do you have a Living Trust?
In the space below, please provide the current values of the following:
1. 401(K)
2. THRIFT Saving Plan
3. 403(b)
4. 457 Plan
5. IRA
6. ROTH IRA
7. SEP_IRA
Life insurance information:
1. How much life insurance do you currently have?
2. What type of policy?
Please provide the values of your "non-retirement" accounts, such as:
1. Savings
2. Checking
3. Brokerage/Mutual Funds
Are you responsible for paying tuition for college for your children, grand children, etc?
Do you currently have a comprehensive financial plan?
In the space below, please tell us what your values, needs and goals are:

So that we can provide you with a written response, please provide your contact information:

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Home Phone:

Work Phone:

E-Mail Address: