Pre-Appointment | Monolith Financial Group

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Meet Your Advisors
Community
Attend an Event
In the Media
Resources
Medicare
Schedule a Meeting
Client Login

Pre-Appointment Form

We are looking forward to getting together with you. If you have any questions or require special assistance prior to your visit, please call our office at 916-367-6430.

Step 1 of 13

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This field is for validation purposes and should be left unchanged.
The following items would be helpful to have at the time of our visit:
1. All brokerage firm statements
2. All life insurance & annuity policies
3. All IRA & retirement statements
4. 2 Years of Tax Returns
5. Social Security Statement (SSA.gov)
CONTACT INFORMATION
Name
First Last
Nickname
Date of Birth
Working At/Retired From:
Current/Former Occupation:
Retired?
Spouse Name
First Last
Spouse Nickname
Spouse Date of Birth
Spouse Working At/Retired From:
Spouse Current/Former Occupation:
Spouse Retired?
Home Phone:
Cell Phone:
Email Address:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Were you referred to us?
If so, by whom?

FAMILY
Number of Children
Number of Grandchildren
Do any of your children or grandchildren have special needs?
Are any of your children or grandchildren listed as joint owners on any of your accounts/assets?
Family Notes:

LEGAL ITEMS
Which of the following legal documents do you have in place?
Will
Power of Attorney (POA) Assets
Power of Attorney (POA) Health
Living Will
Living Trust

LEGAL ITEMS
Which of the following do you have in place?
Umbrella Policy
Long Term Care Insurance
Death Benefit Life Insurance
Life Insurance

CASH FLOW
Please list monthly income from each source.
Pension
You
Your Spouse
(Survivor Options)
You
Your Spouse
Social Security
You
Your Spouse
Wages
You
Your Spouse
Other Income
You
Source(s)
Total
Other Income
Spouse
Source(s)
Total
Are these amounts net or gross?
How much are your monthly expenses?
Here are some common expenses:
Mortgage, Food, Gas, Car Loan, Insurance, Utilities, Gifts/Donations, Medical, Taxes, Social Security, etc
Total

CASH FLOW
Is your current cash flow sufficient and comfortable?
Do you live off interest your investment dollars earn?
Do you anticipate any significant changes in cash flow?
Are you planning any major lifestyle changes?
Do you foresee any large purchases greater than $5,000 within the next 3 years?
Do you contribute to charity?

LIFE EVENTS
In the near future I expect to: (Please check all that apply)
- Buy a home
- Sell a home
- Improve a home
- Retire
- Care for a parent
- Start/Expand a business
- Pay off debt
- Start a part-time job
- Help fund education costs for a family member
- Sell a property
- Receive an inheritance
- Purchase a property
- Other

ASSETS
Please check off the accounts you currently hold and list the total amount in the box provided, and bring the latest statement in for your visit (Optional).
- Bank / Credit Union Accounts
$
- Mutual Funds / Stocks / Bonds
$
- Brokerage Accounts
$
- Retirement Accounts from Work
$
- CDs
$
- Business Interest
$
- Annuities
$
- IRAs / 401K / 401B / Keoghs / TSAs
$
- Life Insurance
$
- Long Term Care Insurance
$
- Promissory Notes / Contract for Deed
$
- Other Assets
$

ASSETS
Property:
Home Value $
Autos and Personal Property $
Rental/Additional Properties $

ASSETS
Description
Balance Owed
Pay Off Date
Description
Balance Owed
Pay Off Date
Description
Balance Owed
Pay Off Date

Additional Information
If you are not already retired, when do you want to retire?
How did you acquire your wealth?
How involved would you like to be with your investments?
What is most important about your money to you?
Are you more concerned about growing your assets or protecting what you already have?

Concerns
Which of the following are your top three concerns?
- Losing too much money in the stock market
- Avoid paying too much in taxes
- Considering retirement and not sure if I/we can afford to
- Not having a reliable income plan for retirement
- Concerned about giving away life savings due to a catastrophic illness
- Outliving nest egg
- Uncertainty about stock market
- Leaving a legacy to children and/or grandchildren
- Need direction with 401K and/or IRA accounts

Objectives
Which of the following describes your risk tolerance when it comes to retirement assets?
What are your Financial Objectives? (Check all that apply)
- Income Now
- Tax-Deferred Growth
- Guarantees Provided
- Pass Assets to Beneficiaries
- Growth Potential
- Other

Contact Us

916-367-6430
Fax: 916-314-0594
Email: [email protected]

Our Location

3000 Lava Ridge Ct. Suite 120
Roseville, CA 95661
Get Directions

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The Better Business Bureau membership provides no guaranteed assurance or warranty of the character or competence of the member. BBB charges a fee for BBB Accreditation. You should make financial decisions on the basis of your own due diligence.

The Women's Choice Award® Financial Advisor program was created by WomenCertified Inc., the Voice of Women, in an effort to help women make appropriate financial choices. The Women's Choice Award Financial Program is based on 17 objective criteria associated with providing quality service to women clients, such as credentials, experience and a favorable regulatory history, among other factors. Financial advisors do not pay a fee to be considered or placed on the final list of Women's Choice Award Financial Advisors, though they may have paid a program fee to cover the cost of their marketing materials. The inclusion of a financial advisor within the Women's Choice Award Financial Advisor network should not be construed as an endorsement of the financial advisor by WomenCertified Inc. or its partners and affiliates and is no guarantee as to future investment success. For more information about this award please go to https://womenschoiceaward.com/.

Insurance products are offered through the insurance business Monolith Financial Group. Monolith Financial Group is also an Investment Advisory practice that offers products and services through AE Wealth Management, LLC (AEWM), a Registered Investment Adviser. AEWM does not offer insurance products. The insurance products offered by Monolith Financial Group are not subject to Investment Adviser requirements. CA Ins. Lic. #0N14019

Investing involves risk, including the potential loss of principal. No investment strategy can guarantee a profit or protect against loss in periods of declining values. None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy a security or any insurance product.

Any references to protection benefits or steady and reliable income streams on this website refer only to fixed insurance products. They do not refer, in any way, to securities or investment advisory products. Annuity guarantees are backed by the financial strength and claims-paying ability of the issuing insurance company. Annuities are insurance products that may be subject to fees, surrender charges and holding periods which vary by insurance company. Annuities are not FDIC insured.

The information and opinions contained in any of the material requested from this website are provided by third parties and have been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. They are given for informational purposes only and are not a solicitation to buy or sell any of the products mentioned. The information is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the particular needs of an individual’s situation.

Any media logos and/or trademarks contained herein are the property of their respective owners and no endorsement by those owners of Monolith Financial is stated or implied. The appearances in Kiplinger were obtained through a PR program. The columnist received assistance from a public relations firm in preparing this piece for submission to Kiplinger.com. Kiplinger was not compensated in any way. 4374627 - 12/24

Pre-Appointment Form

Step 1 of 13

The following items would be helpful to have at the time of our visit:

CONTACT INFORMATION

FAMILY

LEGAL ITEMS

LEGAL ITEMS

CASH FLOW

Pension

(Survivor Options)

Social Security

Wages

Other Income

You

Other Income

Spouse

How much are your monthly expenses?

CASH FLOW

LIFE EVENTS

ASSETS

ASSETS

ASSETS

Additional Information

Concerns

Objectives

Contact Us

Our Location