Personal Financial Questionnaire and Information Checklist

For each person (married couples or domestic partners may answer jointly):

• Name(s)
• Social Security Number(s)
• Date(s) of birth
• Citizenship
• Employer(s)
• Home address
• Home telephone and fax
• Business phone(s) and fax(es)
• Email address(es)

For each child/dependent:

• Name(s)

We will need to discuss any of the following that may apply to you:

• Home ownership and mortgage
• Vacation or other real property
• Cash and savings accounts
• 401k accounts
• IRA accounts
• Deferred compensation accounts
• Family trust
• Brokerage account statements
• Mutual fund statements