D & N Financial Services - A Simple Personal Financial Plan
An easy way to take stock of your personal financial state. Print these pages and fill
them out to get the most from speaking with your financial advisor.

I Personal Data
Name Date
Address Spouses Name
Telephone Work Address
Occupation Work Telephone
Date of Birth Children's names and ages
.
.
.

II Cash Liquidity Available Now
1. Savings - bank accounts, term deposits, etc. $
2. Investments - stocks, bonds, etc. $
3. Present Life Insurance $
4. Group Life Insurance $
5. Income Producing Assets - mortgages, pension, etc. $
Total
$

III Cash Required Immediately
1. Estate Expenses - legal fees, funeral costs, etc. $
2. Taxes - capital gains, estate taxes, deferred income $
3. Mortgage $
4. Loans $
5. Current Bills $
6. Other Debts - credit cards, leases, etc. $
Total
$

Total cash remaining to provide income $
Add any negative amount to capital needs $
Annual income from total remaining cash $
Annual income from Social Security $
How much more annual income needed? $
How much more capital is needed to provide this income? $
Total*
$
*This is the amount of life insurance needed.