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Client Worksheet

Financial planning intake.

This is the information behind an accurate net worth picture. Fill in what you know, leave the rest blank, and AnchorLine will work through the gaps with you.

Printable PDF

Prefer paper? Download the same worksheet and bring it to a first meeting.

Please do not enter account numbers, Social Security numbers, or passwords. Round numbers are fine; they are refined together.

01Household and contact

Client full name

Date of birth

Spouse or partner full name

Date of birth

Mobile phone

Mailing address

Client employer and occupation

Target retirement age

Spouse employer and occupation

Target retirement age

Marital status

Dependents

Dependents
Name	Relationship	Date of birth	Lives at home	Support ends

02Assets: cash and taxable investments

Owner: Client, Spouse, Joint, or Trust. Use the value from your most recent statement.

Worksheet entries
Account description	Type	Institution	Owner	Current value	Annual additions

03Assets: retirement and tax advantaged

Employer plans, IRAs, Roth accounts, HSAs, and pension lump sum values.

Worksheet entries
Account description	Plan type	Institution	Owner	Current value	Annual contribution

Employer match formula (client)

Employer match formula (spouse)

Outstanding loans against any plan

Pension: monthly benefit and start age

04Assets: education and custodial

Worksheet entries
Beneficiary	Account type (529, UTMA, Coverdell)	Institution	Current value	Monthly savings

05Assets: real estate, business, and other

Real estate

Real estate
Property	Use (primary, second, rental, land)	Owner	Purchase price	Estimated value

Business interests

Business interests
Business interest	Entity type	Ownership %	Estimated value	Annual distributions

Other assets

Annuities, cash value life insurance, notes receivable, collectibles, crypto, vehicles.

Other assets
Asset	Owner	Current value

06Liabilities

Mortgages, home equity lines, auto loans, student loans, credit cards, business debt, and personal loans.

Worksheet entries
Debt description	Lender	Owner	Balance	Rate %	Monthly payment	Payoff date

07Income and cash flow

Worksheet entries
Income source	Whose	Amount	Frequency	Expected change or end date

Estimated monthly living expenses

Estimated annual taxes paid

Monthly amount saved outside of payroll

Cash reserve you want to keep on hand

Any large expense expected in the next 24 months

Social Security

Estimate obtained from ssa.govAlready claimingNot yet reviewed

08Insurance and protection

Current policies

Policy types: term life, permanent life, disability, long term care, umbrella liability, health, property.

Current policies
Policy type	Carrier	Insured	Coverage amount	Annual premium	Beneficiary

Coverage you would like reviewed

09Estate and beneficiaries

Documents to list: will, revocable trust, irrevocable trust, financial power of attorney, healthcare directive, guardianship designation.

Worksheet entries
Document	In place	Date signed	Attorney or source	Location of original

Accounts where beneficiaries may be out of date, or beneficiaries you want to change0/2000 characters

10Goals and priorities

Common goals: retirement income, education funding, home purchase or remodel, travel, business exit, care for a family member, charitable giving, legacy.

Worksheet entries
Goal	Target date or age	Amount needed	Priority (1 to 5)

In your own words, what would make the next five years feel successful?0/2000 charactersWhat worries you most about money right now?0/2000 characters

11Other professionals

Roles: CPA or tax preparer, attorney, insurance agent, prior advisor, banker, business partner.

Worksheet entries
Role	Name	Firm	Phone or email	May we coordinate?

Anything else we should know0/2000 characters

12Helpful documents

Sending a statement is faster than typing numbers. Tell us what you can provide and we will follow up with a secure link.

AnchorLine Financial Planning is a marketing name. Advisory services are offered through Clear Creek Financial Management LLC, a Registered Investment Advisor. This form gathers information for planning purposes only and is not an offer, solicitation, or recommendation to buy or sell any security. Nothing here is tax or legal advice. Please do not enter account numbers, Social Security numbers, or passwords.