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SECURE Act Workup Questionnaire
Step
1
of
11
9%
Please complete the following form in full. After completion, a member of our team will be in touch to schedule a time with you to review your workup.
Name
*
First
Last
Married?
*
Yes
No
Spouse's Name
*
First
Last
Email
*
Preferred Phone
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
My/Our Marginal Income Tax Rate
*
Goals
*
Check all that apply.
Select All
I want my spouse to get the maximum amount possible.
I want to protect my non-spouse beneficiaries (children, grandchildren, others) from creditors, predators and divorcing spouses.
I want my beneficiaries to withdraw the balance of my IRA over as many years as possible.
I am charitably inclined.
I want my primary beneficiary and contingent beneficiaries to share the benefit of my retirement accounts.
I am open to purchasing life insurance with my lifetime IRA distributions to provide my beneficiaries tax free inheritance.
I am open to purchasing a long-term care policy with my lifetime IRA distributions to assist with long-term care costs.
I am open to pay current income tax to convert my traditional IRA into Roth IRA.
I am interested in reducing my IRA by taking distributions to pay for a long term care policy for me and/or my spouse.
How Many Retirement Accounts?
*
Retirement Account 1 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 2 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 3 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 4 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 5 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 6 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
Retirement Account 7 Institution
*
List each account. For “type” use the following abbreviations: Traditional IRA “IRA”; Roth IRA “RIRA”; 401(k)s “401(k)”; Roth 401(k)s “R401(k)”; Other Qualified Accounts “OTHER”.
Type
*
Owner
*
Balance
*
Beneficiaries
*
Please list all beneficiaries. Click the arrow to the side to add additional parties.
Name
Relationship
Age
State of Residence
Marginal Income Tax Rate
Distribution Percentage
Primary or Contingent?
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