First Name                          MI         Last Name                                  Gender                Birthday  mm/dd/yyyy

            M    F          

 

Spouse

First Name                          MI         Last Name                                  Gender                Birthday  mm/dd/yyyy

            M    F          

 

Street Address                                                      City                                                  State               Zip

           

Target Retirement Age(s)        You    Spouse

Approximate Financial Information:	You	Spouse
Employer Plans, Profit Sharing, 401(k), etc
Personal IRA's, Tax-deferred Annuities, Etc
Other Investments, Mutual Funds, Stocks, CD's
Other personal assets, homes, cars, etc.
Approximate Current Annual Income
Monthly Retirement Income Needed
Approximate monthly Pensions and starting age	$   at age	$  at age
Where do you work?
(Employer information is optional and confidential.  But, since we are familiar with many employers' Plans, it helps us serve you better to know what plan you are currently enrolled in.)

What percentages do you want used for inflation and growth ?

All information disclosed above is confidential.  If by choice you would prefer not to disclose any of this information on the internet, just print this page and mail it to:

CFS Free Retirement Planning Analysis
PO Box 646
Farmington MO 63640

Thank You.  Your Analysis should arrive in 14 Business days from the time it arrives in our office for processing.