Fact Finder - Beck Team - Five Star Financial Resources

Fact Finder Online Form

Client Information

Client Name(Required)

First Last

Client Age(Required)

Client Date of Birth(Required)

Client Social Security

If you would prefer, you may call our office at 651-464-1198 to relay this information over the phone.

Client Email(Required)

Client Home Phone

Leave Blank if None

Client Cell Phone(Required)

Client Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are You Currently Employed?(Required)

Yes

Client Employer(Required)

Client Salary(Required)

Client Employer's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Spouse's Information

Marital Status(Required)

Married

Not Married

Spouse's Name(Required)

First Last

Spouse's Age(Required)

Spouse's Date of Birth(Required)

Spouse's Social Security

If you would prefer, you may call our office at 651-464-1198 to relay this information over the phone.

Is Your Spouse Employed?(Required)

Yes

Spouse's Employer(Required)

If applicable

Spouse's Salary(Required)

If applicable

Spouse's Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If applicable

Financial Concerns & Situation

What are your primary financial concerns? Please list in order of importance.(Required)

How would you improve your financial situation if you could? Why?(Required)

Estimated Retirement Date(Required)

Checking & Savings Accounts

In lieu of entering information here, you may upload your current statements below.

Approximate Balance in Checking Account/s(Required)

Write NA if none.

Approximate Balance in Personal Saving/s Accounts(Required)

Write NA if none.

Approximate Balance in 529 Savings Account/s(Required)

Write NA if none.

Retirement Accounts

In lieu of entering information here, you may upload your current statements below.

Do you have 1 or more retirement accounts?(Required)

Yes

Yes, and I plan to upload my current statement/s below

Retirement Account #1 Type(Required)

Location(Required)

bank, broker, employer

Approximate Market Value(Required)

Retirement Account #2 Type

Location

bank, broker, employer

Approximate Market Value

Retirement Account #3 Type

Location

bank, broker, employer

Approximate Market Value

Does your employer have an 401K employee match program?(Required)

Yes

I don't know

I am not currently employed

If yes, are you participating?(Required)

Yes

Other Accounts

In lieu of entering information here, you may upload your current statements below.

Do you have 1 or more annuity, mutual fund, brokerage account or advisory accounts?(Required)

Yes

Yes, and I plan to upload my current statement/s below

Account #1 Type(Required)

Company Name(Required)

Approximate Value(Required)

Account #2 Type

Company Name

Approximate Value

Account #3 Type

Company Name

Approximate Value

Account #4 Type

Company Name

Approximate Value

Residence & Other Real Estate

In lieu of entering information here, you may upload your current statements below.

Do you own your own home?(Required)

Yes

Primary Residence(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you have an umbrella policy?(Required)

Yes

Coverage Amount(Required)

Purchase Price(Required)

Current Value(Required)

Mortgage Balance(Required)

Mortgage Interest Rate(Required)

Do you own a second home?(Required)

Yes

Secondary Residence(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Purchase Price(Required)

Current Value(Required)

Mortgage Balance(Required)

Mortgage Interest Rate(Required)

Life Insurance

In lieu of entering information here, you may upload your current statements below.

Do you have life insurance?(Required)

Yes

Yes, and I plan to upload my current statement/s below

Life Insurance #1 Type(Required)

Coverage Amount(Required)

Current Premiums(Required)

Life Insurance #2 Type

Coverage Amount

Current Premiums

Life Insurance #3 Type

Coverage Amount

Current Premiums

Upload Your Current Statements

Drop files here or

Max. file size: 50 MB.

In lieu of entering your account information above, you may upload your current statements here for our team to review.

CAPTCHA

Thank you for completing this form!

Five Star Financial Resources • 25 N. Lake Street, Suite 310, Forest Lake MN 55025 • (651) 464-1198 "Securities and investment advisory services offered through Osaic Wealth Inc., member FINRA/SIPC. Osaic Wealth Inc. is separately owned and other entities and/or marketing names, products or services referenced here are independent of Osaic Wealth Inc."

Comments

This field is for validation purposes and should be left unchanged.

Five Star Financial Resources • 25 N. Lake Street, Suite 310, Forest Lake MN 55025 • (651) 464-1198

“Securities and investment advisory services offered through Osaic Wealth Inc., member FINRA/SIPC. Osaic Wealth Inc. is separately owned and other entities and/or marketing names, products or services referenced here are independent of Osaic Wealth Inc.”

Five Star Financial Resources

Fact Finder – Beck Team

Fact Finder Online Form

Client Information

Spouse's Information

Financial Concerns & Situation

Checking & Savings Accounts

Retirement Accounts

Other Accounts

Residence & Other Real Estate

Life Insurance

Thank you for completing this form!