Personal Financial Planning Questionnaire（个人财务规划的调查问卷）.pdf

Personal Financial Planning Questionnaire Part I: Personal and Family Information 1. Your General Information Your Full Name Your Date of Birth Your Place of Birth Your State of Residency Spouse’s Full Name Spouse’s Date of Birth Spouse’s Place of Birth Spouse’s State of Residency Mailing Address Permanent Address 2. Do you have any children? Yes No If yes, please complete the table below: Name Birthdate Dependent Yes No 3. Do you have any grandchildren? Yes No If yes, please complete the table below: Name Birthdate Dependent Yes No 1 Personal Financial Planning Questionnaire 4. Does anyone other than your children depend financially on you or your spouse? Yes No If yes, please complete the table below: Name Birthdate Relationship 5. Do any members of your family or any dependents have significant health problems? Yes No If yes, please explain: 6. Advisors Phone Name E-Mail Number Attorney Banker/Banking Institution Insurance agent Stockbroker Trust Officer Other