Family Information – Heckman Financial & Insurance Services Inc.

Are You Paying Too Much In Taxes In Retirement? Get Your Free Report Get Your Advisor Check

Is your life insurance policy up to date?

taxes Needs evolve — so should your life insurance. Review this quick guide to see if you should schedule a policy review. This guide includes:

Steps you can take to help protect the ones you love
Questions to ask when reviewing your policy
Guidance on what your financial professional needs to know

First Name*
Email Address*
Phone
CAPTCHA
- Opt into our weekly e-newsletter!
Name
This field is for validation purposes and should be left unchanged.

Guarantees and protections provided by insurance products are backed by the financial strength and claims-paying ability of the issuing insurance carrier.

Call 408-297-9800
Text 408-539-5735

Download Checklist Challenge

What's My Risk Number?

Get Your Free Report

Get Your Advisor Check

Download Our Checklist Challenge
Employee Education
What’s Your Risk Number?
Client Upload
Client Login

Download Our Checklist Challenge
Employee Education
What’s Your Risk Number?
Client Upload
Client Login

Our Services
About Us
In the Media
Careers
Events and Webinars
- Events and Webinars
- Client Events
Refer
Schedule a Visit

Our Services
About Us
In the Media
Careers
Events and Webinars
- Events and Webinars
- Client Events
Refer
Schedule a Visit

Our Services
About Us
In the Media
Careers
Attend a Webinar
Schedule a Visit
Employee Education
Client Upload
Client Login

Our Services
About Us
In the Media
Careers
Attend a Webinar
Schedule a Visit
Employee Education
Client Upload
Client Login

Download you Checklist Challenge now!

Enter your information below to instantly download the guide.

First Name*
Email Address*
Phone*
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Family Information Sheet

Step 1 of 9

11%

Person 1
Full Name*
Nickname
Date of Birth
MM slash DD slash YYYY
Age*
Phone*
Cell Phone
Work Phone
Email*
Employer
Add person 2?*
Person 2
Full Name
Nickname
Date of Birth
MM slash DD slash YYYY
Age
Phone
Cell Phone
Work Phone
Email
Employer
Hidden
Section Break
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Please list your children
How many children do you have?
Name
Age
Helps with financial decisions?
- Yes
- No
Name
Age
Helps with financial decisions?
- Yes
- No
Name
Age
Helps with financial decisions?
- Yes
- No
Name
Age
Helps with financial decisions?
- Yes
- No
Name
Age
Helps with financial decisions?
- Yes
- No

Are you working with a Financial Professional?*
- Yes
- No
If yes, who?
Do you have a living trust?*
- Yes
- No
Do you have a will?*
- Yes
- No
Do you have a Power of Attorney?*
- Yes
- No
Do you have a Power of Health Care?*
- Yes
- No
Do you have income from real estate?*
- Yes
- No
Do you have an attorney?*
- Yes
- No
Do you have an accountant?*
- Yes
- No
Do you expect to care for a child or parent?*
- Yes
- No
Do you expect an inheritance?*
- Yes
- No
Any problems with stockbrokers-advisors?*
- Yes
- No

Is your current cash flow sufficient and comfortable?*
- Yes
- No
Do you take any withdrawals from your retirement savings to meet your budget needs?*
- Yes
- No
Do you anticipate any significant changes in your cash flow?*
- Yes
- No
Do you foresee any large purchases greater than $5,000 in the next 3 years?*
- Yes
- No
Are you planning any major lifestyle changes?*
- Yes
- No
Do you contribute more than $10,000 a year to charity?*
- Yes
- No
How did you acquire your wealth?*
Who else do you rely on for your financial decisions?*
If something were to happen to you tomorrow, who do you want taken care of?*

What do you think is a reasonable rate of return over 10 years?*
How much short-term "rainy day" cash do you need available?*
Person 1: What percentage of your money are you comfortable with the risk of loss of principal? (circle one)
- 0%
- 10%
- 25%
- 50%
- 90%
Person 2: What percentage of your money are you comfortable with the risk of loss of principal? (circle one)
- 0%
- 10%
- 25%
- 50%
- 90%

Person 1
On a scale of 1-10, with 1 being ‘Ultra Conservative’ and 10 being ‘Very Aggressive’ your risk tolerance is:
Person 1*
What is your main concern with your money?*
Knowing what you know now, what would you have done differently with your money?*

Person 2
On a scale of 1-10, with 1 being ‘Ultra Conservative’ and 10 being ‘Very Aggressive’ your risk tolerance is:
Person 2
What is your main concern with your money?
Knowing what you know now, what would you have done differently with your money?

Person 1
Rank in order of importance-1 being the highest, 3 being the lowest
Safety
Liquidity
Growth
Person 2
Rank in order of importance-1 being the highest, 3 being the lowest
Safety
Liquidity
Growth

How would you describe your financial knowledge?
What are your financial objectives?
- Develop an Income plan
- Protect assets from market loss
- Minimize taxes now & future
- Pass assets to beneficiaries
- Earn more interest than currently
- Protect funds from medical costs
- Develop a more conservative portfolio
Comments
This field is for validation purposes and should be left unchanged.

Contact Us

Call: 408-297-9800
Text: 408-539-5735
Email: EricHeckman@WealthCreator.com
CA Insurance License #0A95364

Our Location

333 W. Santa Clara St., Suite 604
San Jose, CA 95113
Get Directions

Connect

Facebook
Linkedin
Google My Business
Twitter
Instagram
YouTube

Investment advisory services offered through Heckman Financial and Insurance Services, Inc. a Registered Investment Advisor.

Investing involves risk, including the potential loss of principal. None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy a security or any insurance product.

No investment strategy can guarantee a profit or protect against loss in periods of declining values. Any comments on this website regarding safety and guaranteed income streams refer only to fixed insurance products. They do not refer, in any way, to securities or investment advisory products. Insurance and annuity product guarantees are subject to the claims-paying ability of the issuing company.

The information and opinions contained in any of the material requested from this website are provided by third parties and have been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. They are given for informational purposes only and are not a solicitation to buy or sell any of the products mentioned. The information is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the particular needs of an individual’s situation.

Neither the firm nor its agents or representatives may give tax or legal advice. Individuals should consult with a qualified professional for guidance before making any purchasing decisions.

Is your life insurance policy up to date?

Download you Checklist Challenge now!

Family Information Sheet

Step 1 of 9

Person 1

Person 2

Section Break

Please list your children

Person 1

Person 2

Person 1

Person 2

Contact Us

Our Location

Connect