How do you rate your overall financial position right now?

Please rate yourself from 1( very poor / not confident) to 10 (excellent / very confident).

How confident are you that you are on track for a long comfortable stress free retirement?

Please rate yourself from 1( very poor / not confident) to 10 (excellent / very confident).

How confident are you that your family would be financially provided for in the event of your death or disability?

Please rate yourself from 1( very poor / not confident) to 10 (excellent / very confident).

In the event of your death, how confident are you that your estate proceeds would be distributed in line with your wishes?

Please rate yourself from 1( very poor / not confident) to 10 (excellent / very confident).

How confident are you that you can successfully clear all debts before retirement?

Please rate yourself from 1( very poor / not confident) to 10 (excellent / very confident).

Please complete this snapshot client data form

Indicate Dependent's Ages

Client 1

Client 2

Assets

Liabilities

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