| Planner's Name: __________________________________________________
Company: _______________________________________________________
Address: ________________________________________________________
Phone: __________________________________________________________
Date: ___________________________________________________________
1. Do you have experience in providing advice on the topics below? If
yes, indicate the number of years.
- Retirement planning
- Investment planning
- Tax planning
- Estate planning
- Insurance planning
- Integrated planning
- Other
2. What are your areas of specialization?
What qualifies you in this field?
3. a. How long have you been offering financial planning advice to clients?
- Less than one year
- One to four years
- Five to 10 years
- More than 10 years
b. How many clients do you currently
have?
- Less than 10 clients
- 10 to 39
- 40 to 79
- 80 +
4. Briefly describe your work history.
5. What are your educational qualifications?
Give area of study.
- Certificate
- Undergraduate degree
- Advanced degree
- Other
6. What financial planning designation(s) or certification(s) do you
hold?
- Certified Financial
Planner™ or CFP®
- Certified Public Accountant/Personal Financial Specialist (CPA/PFS)
- Chartered Financial Consultant (ChFC)
- Other
7. What financial planning continuing education requirements do you fulfill?
8.What licenses do you hold?
- Insurance
- Securities
- CPA
- J.D.
- Other
9. a. Are you personally licensed or registered as an Investment Adviser
with the:
- State(s)?
- Federal Government?
If no, why not?
b. Is your firm licensed or registered
as an Investment Adviser with the:
- State(s)?
- Federal Government?
If no, why not?
c. Will you provide me with your disclosure
document Form ADV Part II or its state equivalent?
If no, why not?
10. What services do you offer?
11. Describe your approach to financial planning.
12. a. Who will work with me?
b. Will the same individual(s) review
my financial situation?
If no, who will?
13. How are you paid for your services?
- Fee
- Commission
- Fee and commission
- Salary
- Other
14. What do you typically charge?
a. Fee:
Hourly rate $ _________
Flat fee (range) $ _________ to
$ _________
Percentage of assets under management
_________ percent
b. Commission:
What is the approximate percentage
of the investment or premium you receive on:
stocks and bonds _________
mutual funds _________
annuities _________
insurance products _________
other _________
15. a. Do you have a business affiliation with any company whose products
or services you are recommending?
Explain:
b. Is any of your compensation based
on selling products?
Explain:
c. Do professionals and sales agents
to whom you may refer me send business, fees or any other benefits to
you?
Explain:
d. Do you have an affiliation with a
broker/dealer?
e. Are you an owner of, or connected
with, any other company whose services or products I will use?
Explain:
16. Do you provide a written client engagement agreement?
If no, why not?
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