Income Questionnaire Request for Quote (#4)1. First Name2. Last Name3. Email4. Current Age5. What is your total annual household income?$6. How would you rate your risk tolerance?– Select –ConservativeModerateAggressive7. Are you married or single?– Select –MarriedSingle8. At what age do you expect to retire?9. In which state do you currently reside?– Select –AlaskaCaliforniaFloridaGeorgiaIllinoisMichiganNevadaNew HampshireNew JerseyNew YorkNorth CarolinaOhioPennsylvaniaSouth DakotaTennesseeTexasWyomingOther10. Where do you plan to reside after retirement?– Select –AlaskaCaliforniaFloridaGeorgiaIllinoisMichiganNevadaNew HampshireNew JerseyNew YorkNorth CarolinaOhioPennsylvaniaSouth DakotaTennesseeTexasWyomingOtherTotal Assets Owned11. What is the approximate value of your home?$12. What is the current total value of your stock investments?$13. What is the current total value of your bond investments?$14. What is the total value of your alternative investments (e.g., cryptocurrency, private funds)?$15. How much cash do you currently hold?$Asset LocationPlease make sure all 3 inputs add to 100%16. What percentage of your investments is in a taxable account? %17. What percentage of your investments is in tax-deferred accounts (e.g., Traditional IRA, Traditional 401k)?%18. What percentage of your investments is in tax-free accounts (e.g., Roth IRA, Roth 401k)?%Liabilities19. What is the remaining balance on your mortgage?$20. How much credit card debt do you have?21. What is the total amount of any other debts you currently hold?22. Are there any other liabilities or future expenses you anticipate? If yes, please provide an estimate.$Savings & Retirement Plans23. How much do you expect to save each year for retirement? (Annual household amount)$Retirement Expense Projections24. What do you estimate your total total annual household expenses will be per year at retirement?$Desired Retirement Spending25. What is the total annual household amount you would like to have available for spending in retirement?$Guaranteed Income in Retirement26. Do you expect to receive pension income?– Select –YesNoPension 1 – Age at which Guaranteed Income StartsPension 1 – Annual Income Amount$Pension 2 – Age at which Guaranteed Income StartsPension 2 – Annual Income Amount$27. Do you expect to receive Social Security income?– Select –YesNoSocial Security 1 – Age at which Guaranteed Income StartsSocial Security 1 – Annual Income Amount$Social Security 2 – Age at which Guaranteed Income StartsSocial Security 2 – Annual Income Amount$28. Do you expect any other annuity/guaranteed income?– Select –YesNoGuaranteed Income 1 – Age at which Guaranteed Income StartsGuaranteed Income 1 – Annual Income Amount$Guaranteed Income 2 – Age at which Guaranteed Income StartsGuaranteed Income 2 – Annual Income Amount$Additional Information29. Why do you want to work with Guaranteed Annuity Experts? (optional)Submit Form Have questions? We’re ready to help. Schedule a call and one of our experts will walk you through the best options for your situation. Contact Us
