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Services
Investment Advisory
Comprehenive Financial Planning
Tax Strategy & Planning
Family Governance & Education
Insurance & Risk Management
Estate Planning & Legacy
Alternative Investments
Accredited Investors
Collectibles
Commodities
Hedge Funds
Qualified Purchaser
Private Equity
Private Credit/Debt
Company
About FWM
Meet John Fremont-Smith
Process
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Clients
Our Friends
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FWM Confidential Questionnaire
About You
NAME
(Required)
NAME
Last
Nickname
(Required)
Date Of Birth
(Required)
MM slash DD slash YYYY
HOME PHONE
Mobile Phone
EMAIL
(Required)
HOME ADDRESS
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Personal Status
(Required)
Personal & Family Information
Single
Married
Long-Term Relationship
Divorced
Widowed
PLACE OF BIRTH
Gender
CHILDREN’S NAMES
First
Are you planning to have more children?
ARE YOU PLANNING TO HAVE MORE CHILDREN?
Yes
No
How many?
Your Goals & Objectives
Let’s discuss your goals / objectives:
(Required)
Let’s discuss your goals / objectives:
Short-Term: (3-5 Years)
Mid-Term: (4-10 Years)
Long-Term: (10+ Years)
Are there any special considerations that relate to the future of your children?
Are there any special considerations that relate to the future of your children?
Education
Special Talents
Disabilities
Tell me about your extended family (parents, grandparent, brothers, sisters, names, ages, jobs)
Tell me about your extended family (parents, grandparent, brothers, sisters, names, ages, jobs)
INDIVIDUAL
SPOUSE
MOTHER
FATHER
BROTHERS
SISTERS
Is there anyone you are supporting now, or will be in the future, who may affect your financially?
Is there anyone you are supporting now, or will be in the future, who may affect your financially?
YES
NO
Who?
EMPLOYEMENT
Employement
INDIVIDUAL
SPOUSE
Name of Employer?
How long have you worked here?
What is your title?
Specific Job Duties? |
Future Career Plans?
INTEREST / HOBBIES:
Interest / Hobbies
INDIVIDUAL
SPOUSE
Activities / Organizations?
Anything Dangerous?
On a scale of 1-10, how important are the following?
Funding your children's education
Funding a comfortable retirement
Providing for your family in the event of death
Providing long-term care needs
Properly addressing your estate settlement needs
Evaluating your investment portfolio
SAVINGS PHILOSOPHY:
What is the MOST important thing you’ve learned about money and investing?
When have you been the best saver in your life?
Do you consider yourself a disciplined saver?
What % of your total income do you feel should be set aside to meet your financial goal?
What does this mean in dollars annually?
Are you currently doing this?
If not, what would help you save more?
Who manages your finances and pays your monthly expenses?
EDUCATION:
Tell me about your educational background
School / Major / Activities
How did you fund your education?
Children / Private or Public Education?
What do you believe the costs will be?
Do you intend to partially or fully fund their education?
How would you feel if you couldn’t provide this?
How important is it to provide this you you died / disabled?
RETIREMENT:
What thoughts do you have regarding retirement?
How do you feel about your current plans?
At what age would you like to be in a position to NOT have to work?
If you retired today, would you continue your current lifestyle / spending?
How much after-tax monthly income would you need today to support this lifestyle?
To what age would you like this income to continue?
Does this amount consider the cost of health insurance in retirement?
What will you do if your retirement goal is not met? (Work longer/retire on less)
How would you fund your retirement if you were to become sick or disabled?
INHERITANCE:
Are you and/or your spouse anticipating any inheritance? If so, how much?
Should we include this amount in your resources towards your retirement goal?
Are you currently covered by Social Security?
ASSETS / LIABILITIES / INCOME
Taxable Assets:
Taxable Assets:
INDIVIDUAL
SPOUSE
Savings:
CDs:
Mutual Funds:
Stocks:
Private Equity / Credit / Alts:
Real Assets: Art / Baseball Cards / Jewelry etc.
Tax-Deferred Assets:
Tax-Deferred Assets
INDIVIDUAL
SPOUSE
401k / TSP:
Annuities:
IRAs
529 Plans
Pension:
PERSONAL / BUSINESS
Residence:
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Autos:
Personal Property:
Business Interest:
LIABILITIES
Home Mortgage:
Equity Loans:
Personal / Student Loans:
Auto Loans:
Credit Cards:
TOTAL LIABILITIES: $__________________ ASSETS (-) LIABILITIES = TOTAL NET WORTH: $_____________________
What are your general thoughts/feelings around debt?
Do you have a broker or someone you turn to for financial advice?
What have you liked most about your previous investment experience?
What have you liked least about your previous investment experience?
Are there any investments you currently hold that we have not discussed?
INCOME
Salary:
Bonus:
Other Income:
Spouse:
At what rate do you expect your income to grow long term?
Do you anticipate any changes in your total income in the future? (special bonus etc.)
Do you feel it is important to save all or part of your future raises?
What % of your total income do you pay in income taxes?
Do you normally receive a tax refund? (How much?)
What is your monthly take-home pay?
What is the amount of your monthly living expenses?
How is the difference being used for your benefit?
RISK MANAGEMENT Survivor Income
What are your thoughts around life insurance in general?
Tell me about your existing life insurance coverage (employer / personal)
Existing Debt / Final Expenses
What amount would you want to provide to pay off
What amount would you want to provide to pay off
Mortgage
Existing Debt
Cost of Education:
How much?
How many children?
Income Needs:
If the mortgage, final expenses, and education are taken care of, how much after tax monthly income would your family need to maintain their current lifestyle?
Minus serving spouses monthly income
The approximate auditional capital you would need to achieve your survivor income goal is
How do you feel about this number?
Have you ever lost someone close to you?
What impact did life insurance have in that situation?
HEALTH
How is your health?
Tell me about your health insurance:
Do you regularly see doctor?
When was your last physical examination?
Blood Pressure / Cholesterol / Medications?
Other than regular visits, have you had to see other physicians?
Have you used tobacco or any form of nicotine in the past 3 years?
DISABILITY INCOME
How do you feel about your current disability insurance coverage?
Note: Employe’s plan is taxable to the employee (Typically 60% taxable)
Does your current coverage include bonus income and/or commissions?
Is it reasonable to assume that if you were sick or injured and unable to work, your family would need the same amount of income you currently earn?
What would this mean in monthly after-tax income?
What concerns do you have regarding protecting your income against loss due to injury or illess?
Long-Term Care Tell me about your current long-term care insurance coverage (employer provided / personal)
Employer
Personal
Spouse:
Employer
Personal
Do you know anyone who has needed long-term care services at home or in a facility?
Please tell me about it.
Have you considered long-term care yourself?
Who would you consider capable and willing to take care of you?
How would this impact that caregivers lifestyle?
Have you considered the impact to your lifestyle if a parent of in-law became dependent on you for long-term care?
Are you familiar with the approximate costs of long-term care?
Costs win a nursing home typically range from $100-$300 per day. How much would you like to plan for?
If you or your spouse needed long-term care, how would this impact your family?
Should I use current or retirement income to offset any long-term care costs in my analysis?
WEALTH PRESERVATION & DISTRIBUTION / WILLS
Do you have a written Will?
When and where was your will executed?
Who will be the guardian of your children?
Are you the chosen guardian for someone else?
Are you a US citizen?
Have you worked with an attorney? (name/firm)
Do you have any distribution strategies for your estate? (Trusts / Gifting / Charitable Giving)
TITHING
Are you currently making any charitable or educational gifts / pledges?
If yes, to what organizations?
Would you like to see them continue if something happened to you?
Have you made other substantial gifts in the past?
If yes, what organizations?
How do you feel about making gifts to avoid estate taxes at your death?
INVESTOR PROFILE
How comfortable are you with the topic of investing?
Tell me about the best financial decision you’ve ever made.
Tell me about the worst financial decision you’ve ever made.
What is the primary goal for these invested assets?
How many years do you plan to invest these assets before anticipating making withdrawals?
How long do you plan to make withdrawals on these assets in retirement? (years)
At times, conservative investments may earn less than the rate of inflation. This may result in the loss of purchasing power. How do you feel about this, and how do you feel about the risk associated with investing to keep up with the rise of inflation?
Should I take into account your other secure assets, such as permanent cash value life insurance, personal savings accounts, pension, and fixed income assets, when determining my asset allocation model for you?
Let’s discuss risk, and the potential amounts of risk you are willing to take when investing. (refer to Investor Risk Profile form)
What best describes your philosophy and strategy towards investing?
What best describes your philosophy and strategy towards investing?
I am unaffected by short-term market movements and stay focused on my long term strategy of capital appreciation and growth.
Although I may have some concerns, I am typically a very patient investor with a wait and see attitude in regards to my long-term growth strategy.
I can get anxious during market swings and at times may change my strategies.
am uncomfortable with market volatility, which is why I typically focus on preservation of capital and current income.
Recommended Risk Profile: (based on age, income, assets/liabilities, psychology, experience)
Date
MM slash DD slash YYYY
Time
Hours
:
Minutes
AM
PM
AM/PM
Place
Expectations
FAVORABLE INTRODUCTIONS
How did you feel when I first called you to set this appointment?
Now that you’ve seen the process to this point, how do you feel about it? Why?
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