Debt-Income-Mortgage-Education

Full name *

Debt

Student Loan

Monthly *

Total *

Car Loan

Monthly *

Total *

Credit Card

Monthly *

Total *

Income

If you or your spouse could not work again, how much income would you need to sustain your current lifestyle?*

/Month

Mortgage

What do you think your house is worth (in dollars)?

What is your current balance on your home mortgage (in dollars)?

Current Balance #2 (in dollars)

Monthly Payment (in dollars)

Type of Loan *

Fixed

Adjustable

Interest Rate (in percentage)

Number of Years

Education

Would you like to provide for your children's education? *

All

Part

Approximate Cost for Education (in dollars) *

Amount Saved (in dollars) *

Current Life Insurance

Client Name *

Type *

Policy Amount *

Monthly Payment *

Client's Carrier *

Spouse Name

Type

Policy Amount

Monthly Payment

Spouse's Carrier

Our goal is to offer recommendations that, in your opinion, are better for you and your family in every way. Please schedule a day and time for us to speak to you (spouse).

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Would you be kind enough to refer our services to 8-10 people like yourself?

Yes

Date of our next meeting

Time

Debt-Income-Mortgage-Education

Debt

Student Loan

Car Loan

Credit Card

Income

Mortgage

Education

Current Life Insurance

Title

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