Confidential Financial Form

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Financial Advisors of America Inc.

CONFIDENTIAL PERSONAL PROFILE

Please fill this form completely. The more information I have, the better I will be able to help you. Rest assured this is completely confidential.

First Name Last Name Email Address Phone (cell preferred) Occupation / Job Title

Gender

Male Female

Age

Married?

Yes No

Spouse Information

Spouse Full Name

Spouse Age

Spouse Occupation / Job Title

Spouse Income ($)

Are you a Homeowner?

Yes No

Property Details

Property Address

Estimated Property Value ($)

Current Mortgage Balance ($)

Interest Rate (%)

Monthly Payment ($)

Any late payments, forbearance, or foreclosure concerns?

Do you have Savings/Retirement plans (IRAs, 401(k), etc.)?

Yes No

Savings & Retirement Details

Types (check all that apply)

401(k) Traditional IRA Roth IRA SEP/SIMPLE Brokerage/Mutual Funds Other

Total Current Balance ($)

Monthly Contribution ($)

Risk Tolerance Any old 401(k)s or IRAs you might want to roll over?

How soon are you looking for financial guidance? I agree to be contacted by Financial Advisors of America (email/SMS/call) regarding my inquiry. I can unsubscribe anytime.

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