Confidential Client Questionnaire

Prepared for:

Prepared by:

Date:
Fact Finder

1 Client
Information
This financial analysis is based primarily on the age of ‘Client’. For this reason, we
recommend that the primary wage earner’s information be entered as ‘Client’.

Client Spouse/Partner

DOB DOB

Male Female Male Female

Retired: Yes No Retired: Yes No

Marital Status: Married Common-Law Single Widowed Separated Divorced

Address

City Province Postal Code

2 Contact
Information
Please enter your contact information and preferred method of contact.

Client Spouse/Partner

Mobile Phone Mobile Phone

Home Phone Home Phone

Work Phone Work Phone

Email Email

Alt. Email Alt. Email

Preferred Preferred
Contact Contact

3 Employment If you are not currently retired, please enter the earned income that you anticipate
reporting on your tax return for the current taxation year. Do not include investment
Income income such as interest, dividends or capital gains in this amount.

Client Spouse/Partner

Annual Income $ Annual Income $

Occupation Occupation

Employer Employer

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4
In addition to the earned income on which you pay tax, you may also be responsible for
Other Income generating other income, such as corporate earnings, that is not paid to you directly
(Prior to Retirement) but does benefit you financially. Please enter any additional taxable income sources.

Client Spouse/Partner

Annual Amount $ Annual Amount $

To Age To Age

5 Retirement Please enter your expected retirement age and after-tax retirement income goals
in today’s dollars. A second stage of retirement is also available if you expect your
Income Needs income goal to increase or decrease at some point in the future.

Client Spouse/Partner

Retirement Retirement
Lifestyle 1 Age Lifestyle 1 Age

Monthly Income $

Retirement
Lifestyle 2 Age

Monthly Income $

6 Goals and Please summarize the other goals and objectives that you have for your family. You
may want to include things that you would like to accomplish before you retire,
Objectives during your retirement and on the distribution of your estate.

Goal 1

Goal 2

Goal 3

Goal 4

Goal 5

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Many employers offer pension plans to provide a monthly income in retirement

7 Pension Income
based on the employee’s years of service and age. Please enter the monthly
pension income that you expect to earn in retirement from your current and/or past
Canadian employers, and any survivor benefits provided.

Client Spouse/Partner

Monthly Monthly
Amount $ Amount $

Indexed: Full Partial % Indexed: Full Partial %

Starting Age Starting Age

Survivor % Survivor %

8 Canadian Pension Canada Pension Plan (CPP/QPP) provides a monthly pension to contributors upon
retirement. Please enter the monthly amount of CPP/QPP that you are currently
Plan (CPP/QPP) receiving or the % of maximum CPP/QPP that you expect to receive.

Client Spouse/Partner

Current Current
Monthly Monthly
Benefits $ Benefits $

Or, Expected % Or, Expected % of

of Maximum % Maximum %

Starting Age Starting Age

The Old Age Security program provides you with a modest pension starting age

9 Old Age Security

65-67 (depending on date of birth) if you have lived in Canada for at least 10 years.
Please enter the % of maximum OAS that you are currently receiving or expect
to receive.

Client Spouse/Partner

Expected % of Expected % of
Maximum % Maximum %

Starting Age Starting Age

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10 Working in Many people plan to transition into retirement by continuing to work for a number
of years doing something they enjoy. Please enter the income that you expect to
Retirement earn and the length of time, during which, you anticipate receiving it.

Client Spouse/Partner

Monthly Monthly
Amount $ Amount $

Indexed: Full Partial % Indexed: Full Partial %

Starting Age Starting Age

Ending Age Ending Age

Other
11
In addition to the retirement income discussed previously, you may receive income
Retirement in retirement from other sources, such as a rental property or an annuity. Please
enter the monthly amount that you expect to receive in today’s dollars.
Income

Client Spouse/Partner

Source Source

Monthly Monthly
Amount $ Amount $

Indexed: Full Partial % Indexed: Full Partial %

Percentage Percentage
Taxable % Taxable %

Starting Age Starting Age

Ending Age Ending Age

Survivor % Survivor %

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Retirement Investments are designed to help you save for your retirement.

12 Registered
Investments
Contributions are tax deductible and grow tax-free until withdrawn. Please enter the
current asset value of all Registered Investments (RRSP/RRIF and Spousal RRSP/
RRIF) and any contributions that you plan to make in the future.

Client Spouse/Partner

Personal Value $ Personal Value $

Contribution Contribution
Limit $ Limit $

Pension Pension
Adjustment $ Adjustment $

RRSP RRSP
Contribution $ Contribution $

Contribution Contribution
Frequency: Annual Monthly Frequency: Annual Monthly

Indexed RRIF Age Indexed RRIF Age

Locked-In Plans/Defined Contribution Plans are typically set up by an employer

13 Locked-In Plans
and could include LIFs, LIRAs or LRIFs. Please enter the total value of your
Locked-In plans and any contributions that you and your employer plan to make
in the future.

Client Spouse/Partner

Total Value $ Total Value $

Contributions $ Contributions $

Contribution Contribution
Frequency: Annual Monthly Frequency: Annual Monthly

Indexed Province Indexed Province

Income Income
Start Age Start Age

Income Income
Amount: Minimum Maximum Amount: Minimum Maximum

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Non-Registered investments include any other investment accounts outside of

14 Non-Registered
Investments
RRSP/RRIFs and Pensions. This can include Savings Accounts and Cash Investments.
Please enter the total value of your Non-Registered investments and any amounts
you plan to save in the future.

Client Spouse/Partner

Total Value $ Total Value $

Cost Base $ Cost Base $

Savings $ Savings $

Savings Savings
Frequency: Annual Monthly Frequency: Annual Monthly

Indexed Indexed

Joint

Total Value $

Cost Base $

Savings $

Savings
Frequency: Annual Monthly

Indexed

15 Tax Free Savings Tax Free Savings Accounts (TFSA) allow you to earn tax free investment income.
Please enter the total value of your TFSA investments and any amounts you plan
Accounts (TFSA) to save in the future.

Client Spouse/Partner

Total Value $ Total Value $

Savings $ Savings $

Savings Savings
Frequency: Annual Monthly Frequency: Annual Monthly

Indexed Indexed

Contribution Contribution
Room $ Room $

Auto Allocate Auto Allocate

to TFSA to TFSA

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For many people, their home represents the largest investment that they will ever

16 Real Estate
Holdings
make. In addition to your home, you may also own recreational and/or investment
properties. Please enter the value of all your personal real estate holdings and any
associated mortgage balance.

Principal Residence

Current Value $ 0.00%

Mortgage $ Interest Rate % Monthly Payment $

Recreational Properties

Current Value $ Cost Base $

Mortgage $ Interest Rate % Monthly Payment $

Investment/ Rental Properties

Current Value $ Cost Base $

Mortgage $ Interest Rate % Monthly Payment $

17 Lump-Sum You may be expecting to receive future lump-sum cash amounts from inheritance
or other sources. If so, please enter the amount and age that these amounts are
Amounts expected.

Client Spouse/Partner

Amount $ Amount $

Age Age

Amount $ Amount $

Age Age

18 Other Assets Please enter the value and cost base of any other assets that you own personally.

Assets that will increase in value at a rate equal to inflation.

Current Value $ Cost Base $

Assets that will increase in value at your investment rate of return.

Current Value $ Cost Base $

Assets that you do not anticipate will increase in value.

Current Value $ Cost Base $

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19 Additional
Notes

Please provide your drivers license number and exp date:

Where do you do your banking and mortgage loans:

Are you part of a private bank, if so which one:

Name and firm of accountant:

Name and firm of investment advisor:

Name and firm of lawyer:

Name and firm of notary:

Name and firm of realtor:

Corporations of which you are controlling shareholder:

Corporate/trust structure and main activities:

Any other information you feel may be relevant:

If you do not own any corporate assets, no further data is required.

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Corporate If you are a major shareholder of a private corporation, you will want to include

20 Investments and
Securities
the value of any assets owned by the corporation in your financial planning.
Please enter the total value of all corporate investment accounts as well as any
future deposits.

Current Value $ Cost Base $

Savings $ Savings Frequency: Annual Monthly

Indexed

21 Corporate
Real Estate
Please enter the value of all corporate real estate holdings and any associated
mortgage balances.

Current Value $ Cost Base $

Mortgage $ Interest Rate % Monthly Payment $

In addition to investments and real estate, your business may also have considerable

22 Goodwill and
Operations
value in the ‘goodwill’ of the day to day operations. The total value of your business
includes all assets, investments, real estate and goodwill. Please enter the value of
business operations and goodwill.

Current Value $

The Fair Market Value (FMV) of the shares you own is calculated as ‘Total Corporate

23
Assets’ less ‘Total Corporate Liabilities’. The FMV of your shares less the Cost Base of
Share Value your shares represent the capital gains that will be taxable on death.

Please enter the Ownership percentage and Cost Base of your shares.

Client Spouse/Partner

Ownership % Ownership %

Cost Base $ Cost Base $

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24 Additional
Notes

©2017 Razor Logic Systems Inc. | Version 1.9 | Nov, 2017

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