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Retirement Worksheet

Please fill out the form below to the full extent of your abilities. The more information we obtain from you, the more we will be able to help going forward!

Full Name

Preferred Contact Method

Desired Retirement Age

Years Until Retirement

Life Expectancy

Social Security Income at Retirement

Expected Rate of Inflation

Desired percentage of pre-retirement income (replacement income) 

Desired dollar amount of monthly retirement income 

Do you have specific plans to assure this desired retirement income? 

Do you want to rely on Social Security? 

Do you expect your taxes to be higher now or in retirement?

Do you have a good mix of qualified, non-qualified, and tax-free retirement funds? 

Please describe your ideal retirement: 

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