Insurance Service Center DePere - Financial Security Checklist

Money When You Need It Most
Your Greatest Asset . . . Your Ability to Earn an Income!

Client Name*

First NameLast Name

Email Address

Your Annual Income

Years to Retirement

You Will Earn

Your Spouse's Annual Income

Spouse's Years to Retirement

Your Spouse Will Earn

Isn't it important to protect at least part of this asset?

Protection: When you die, your paycheck dies with you.

	Self	Spouse
Final Expenses: Experts recommend at least $10,000
Emergency Fund: For unexpected expenses and disasters
Home Mortgage: Keep family secure in their home
Other Debts: Leave loved-ones debt free
Educational Fund: Guarantee the opportunity is there
Family Income: Experts recommend 4-6 times income
Total needed if you die:
Existing Insurance:
Insurance Need Today:

If we could show you a plan that would cover all or part of these needs, how much can you budget for this plan?

Retirement:

All that will be there is what you send ahead.

A financially secure retirement is built upon the ability to save money, and keep it saved.

Are you satisfied with the amount of money you have set aside for retirement so far?

Experts recommend a systematic plan to set aside 10% of your income to provide this financial security.

I have personally reviewed the answers above. I understand that this checklist is not meant to imply, in any manner, that these are the ONLY items that may be of concern to me. I understand it is my responsibility to advise Insurance Service Center of any special circumstances or insurance needs I may have.

Client Signature*

Date*

MonthDayYear

Enter the message as it's shown*

Send to*