Financial Inventory Please complete the form below, or download the form as a PDF, which you can fax or mail to us. Step 1 of 4 25% Name Owner #1* First Last Name Owner #2 First Last Current Monthly Income CalculationCurrent Monthly Wages Owner #1Current Monthly Wages Owner #2Social Security Owner #1Social Security Owner #272(t)(q) Distribution Owner #172(t)(q) Distribution Owner #2Investment Income Owner #1(Including Dividends)Investment Income Owner #2(Including Dividends)Pension Plan Benefits Owner #1Pension Plan Benefits Owner #2Required Minimum Distribution Owner #1Required Minimum Distribution Owner #2Other Owner #1(Please explain)Other Owner #1 ExplanationOther Owner #2(Please explain)Other Owner #2 ExplanationSub-total Monthly Income Owner #1Sub-total Monthly Income Owner #2Total Monthly Household Income Current Household Monthly Expense CalculationsMortgage / RentUtilitiesCredit CardsAutomobileInsuranceHealth CareTaxesOther(Please explain)Other ExplanationAnticipated Monthly ExpensesTotal Monthly Income minus Total Anticipated Monthly Expenses Net Worth - Not including primary residence,automobiles or personal belongings such as jewelry or home furnishingsSavings Accounts Owner #1Savings Accounts Owner #2Checking Accounts Owner #1Checking Accounts Owner #2CDs, Money Market Accounts Owner #1CDs, Money Market Accounts Owner #2Securities Owner #1Securities Owner #2Annuities Owner #1(Not including this purchase)Annuities Owner #2(Not including this purchase)Cash Value Life Insurance Owner #1Cash Value Life Insurance Owner #2Real Estate Owner #1(Other than primary residence)Real Estate Owner #2(Other than primary residence)Retirement Accounts Owner #1Retirement Accounts Owner #2Cash Value or Loan Amounts from Life Insurance Owner #1Cash Value or Loan Amounts from Life Insurance Owner #2Other Owner #1(Please explain)Other Owner #1 ExplanationOther Owner #2(Please explain)Other Owner #2 ExplanationTotal Assets Owner #1Total Assets Owner #2Outstanding Loan Balances Owner #1(Other than primary residential mortgage)Outstanding Loan Balances Owner #2(Other than primary residential mortgage)Other Outstanding Liabilities Owner #1(Credit cards, student loans)Other Outstanding Liabilities Owner #2(Credit cards, student loans)Total Outstanding Liabilities Owner #1Total Outstanding Liabilities Owner #2Net Worth Owner #1Total Assets minus Total Outstanding LiabilitiesNet Worth Owner #2Total Assets minus Total Outstanding LiabilitiesTotal Net WorthTotal Assets minus Total Outstanding Liabilities Liquid Assets - Those assets easily converted to cash, without penalty. Does not include personal belongings such as jewelry, household furnishings or automobiles.Savings Accounts Owner #1Savings Accounts Owner #2Checking Accounts Owner #1Checking Accounts Owner #2CDs, Money Market Accounts Owner #1CDs, Money Market Accounts Owner #2Securities Owner #1(Includes stocks, bonds and mutual funds)Securities Owner #2(Includes stocks, bonds and mutual funds)Current Penalty-free Withdrawals from other Annuities Owner #1Current Penalty-free Withdrawals from other Annuities Owner #2Other Owner #1(Please explain)Other Owner #1 ExplanationOther Owner #2(Please explain)Other Owner #2 ExplanationTotal Liquid Assets Owner #1(Does not include funds used to purchase this annuity)Total Liquid Assets Owner #2(Does not include funds used to purchase this annuity)Total Liquid Assets(Does not include funds used to purchase this annuity)Date MM slash DD slash YYYY Δ