Client Info

Before you begin, please take a moment to gather your electronic financial documents and statements and have them handy to upload.

Step 1 of 28

Name

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Personal Information

Are you single or married?

Single

Married

Are your finances separate or combined?

If you selected separate, please complete this form two times, one for each spouse.

Separate

Combined

Full Legal Name

First Middle Last

Date of Birth

State in Which You Were Born

Phone Number

Email Address

Home Address

Street Address Address Line 2 City State ZIP Code

Employer Name

Job Title

Annual Income (W-2, 1099)

Projected Annual Increase

Please upload your 2–3 most recent pay stubs

Drop files here or

Max. file size: 256 MB.

Credit Score

Projected Retirement Age

Please upload a picture of your drivers license

Drop files here or

Max. file size: 256 MB.

Risk Assessment

1. In general, how would your best friend describe you as a risk taker?

A real gambler

Willing to take risks after completing adequate research

Cautious

A real risk avoider

2. You are on a TV game show and can choose one of the following. Which would you take?

$1,000 in cash

A 50% chance at winning $5,000

A 25% chance at winning $10,000

A 5% chance at winning $100,000

3. You have just finished saving for a "once-in-a-lifetime" vacation. Three weeks before you plan to leave, you lose your job. You would:

Cancel the vacation

Take a much more modest vacation

Go as scheduled, reasoning that you need the time to prepare for a job search

Extend your vacation, because this might be your last chance to go first-class

4. If you unexpectedly received $20,000 to invest, what would you do?

Deposit it in a bank account, money market account, or an insured CD

Invest it in safe high quality bonds or bond mutual funds

Invest it in stocks or stock mutual funds

5. In terms of experience, how comfortable are you investing in stocks or stock mutual funds?

Not at all comfortable

Somewhat comfortable

Very comfortable

6. When you think of the word "risk" which of the following words comes to mind first?

Loss

Uncertainty

Opportunity

Thrill

7. Some experts are predicting prices of assets such as gold, jewels, collectibles, and real estate (hard assets) to increase in value; bond prices may fall, however, experts tend to agree that government bonds are relatively safe. Most of your investment assets are now in high interest government bonds. What would you do?

Hold the bonds

Sell the bonds, put half the proceeds into money market accounts, and the other half into hard assets

Sell the bonds and put the total proceeds into hard assets

Sell the bonds, put all the money into hard assets, and borrow additional money to buy more

8. Given the best and worst case returns of the four investment choices below, which would you prefer?

$200 gain best case; $0 gain/loss worst case

$800 gain best case; $200 loss worst case

$2,600 gain best case; $800 loss worst case

$4,800 gain best case; $2,400 loss worst case

9. In addition to whatever you own, you have been given $1,000. You are now asked to choose between:

A sure gain of $500

A 50% chance to gain $1,000 and a 50% chance to gain nothing

10. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:

A sure loss of $500

A 50% chance to lose $1,000 and a 50% chance to lose nothing

11. Suppose a relative left you an inheritance of $100,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?

A savings account or money market mutual fund

A mutual fund that owns stocks and bonds

A portfolio of 15 common stocks

Commodities like gold, silver, and oil

12. If you had to invest $20,000, which of the following investment choices would you find most appealing?

60% in low-risk investments 30% in medium-risk investments 10% in high-risk investments

30% in low-risk investments 40% in medium-risk investments 30% in high-risk investments

10% in low-risk investments 40% in medium-risk investments 50% in high-risk investments

13. Your trusted friend and neighbor, an experienced geologist, is putting together a group of investors to fund an exploratory gold mining venture. The venture could pay back 50 to 100 times the investment if successful. If the mine is a bust, the entire investment is worthless. Your friend estimates the chances of success is only 20%. If you had the money, how much would you invest?"

Nothing

One month's salary

Three month's salary

Six month's salary

14. If you had $1,000,000 how much would you be willing to lose in the market in retirement?

10% ($100,000)

15% ($150,000)

20% ($200,000)

25% ($250,000)

30% ($300,000)

Full Legal Name

First Middle Last

Date of Birth

State in Which You Were Born

Wedding Date

Phone Number

Email Address

Home Address

Street Address Address Line 2 City State ZIP Code

Employer Name

Job Title

Annual Income (W-2, 1099)

Projected Annual Increase

Please upload your 2–3 most recent pay stubs

Drop files here or

Max. file size: 256 MB.

Credit Score

Projected Retirement Age

Please upload a picture of your drivers license

Drop files here or

Max. file size: 256 MB.

Risk Assessment

1. In general, how would your best friend describe you as a risk taker?

A real gambler

Willing to take risks after completing adequate research

Cautious

A real risk avoider

2. You are on a TV game show and can choose one of the following. Which would you take?

$1,000 in cash

A 50% chance at winning $5,000

A 25% chance at winning $10,000

A 5% chance at winning $100,000

3. You have just finished saving for a "once-in-a-lifetime" vacation. Three weeks before you plan to leave, you lose your job. You would:

Cancel the vacation

Take a much more modest vacation

Go as scheduled, reasoning that you need the time to prepare for a job search

Extend your vacation, because this might be your last chance to go first-class

4. If you unexpectedly received $20,000 to invest, what would you do?

Deposit it in a bank account, money market account, or an insured CD

Invest it in safe high quality bonds or bond mutual funds

Invest it in stocks or stock mutual funds

5. In terms of experience, how comfortable are you investing in stocks or stock mutual funds?

Not at all comfortable

Somewhat comfortable

Very comfortable

6. When you think of the word "risk" which of the following words comes to mind first?

Loss

Uncertainty

Opportunity

Thrill

Hold the bonds

Sell the bonds, put half the proceeds into money market accounts, and the other half into hard assets

Sell the bonds and put the total proceeds into hard assets

Sell the bonds, put all the money into hard assets, and borrow additional money to buy more

8. Given the best and worst case returns of the four investment choices below, which would you prefer?

$200 gain best case; $0 gain/loss worst case

$800 gain best case; $200 loss worst case

$2,600 gain best case; $800 loss worst case

$4,800 gain best case; $2,400 loss worst case

9. In addition to whatever you own, you have been given $1,000. You are now asked to choose between:

A sure gain of $500

A 50% chance to gain $1,000 and a 50% chance to gain nothing

10. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:

A sure loss of $500

A 50% chance to lose $1,000 and a 50% chance to lose nothing

11. Suppose a relative left you an inheritance of $100,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?

A savings account or money market mutual fund

A mutual fund that owns stocks and bonds

A portfolio of 15 common stocks

Commodities like gold, silver, and oil

12. If you had to invest $20,000, which of the following investment choices would you find most appealing?

60% in low-risk investments 30% in medium-risk investments 10% in high-risk investments

30% in low-risk investments 40% in medium-risk investments 30% in high-risk investments

10% in low-risk investments 40% in medium-risk investments 50% in high-risk investments

Nothing

One month's salary

Three month's salary

Six month's salary

14. If you had $1,000,000 how much would you be willing to lose in the market in retirement?

10% ($100,000)

15% ($150,000)

20% ($200,000)

25% ($250,000)

30% ($300,000)

Home Address

Street Address Address Line 2 City State ZIP Code

Spouse 1

Full Legal Name

First Middle Last

Date of Birth

State in Which You Were Born

Wedding Date

Phone Number

Email Address

Employer Name

Job Title

Annual Income (W-2, 1099)

Projected Annual Increase

Please upload your 2–3 most recent pay stubs

Drop files here or

Max. file size: 256 MB.

Credit Score

Projected Retirement Age

Please upload a picture of your drivers license

Drop files here or

Max. file size: 256 MB.

Spouse 2

Full Legal Name

First Middle Last

Date of Birth

State in Which You Were Born

Phone Number

Email Address

Employer Name

Job Title

Annual Income (W-2, 1099)

Projected Annual Increase

Please upload your 2–3 most recent pay stubs

Drop files here or

Max. file size: 256 MB.

Credit Score

Projected Retirement Age

Please upload a picture of your drivers license

Drop files here or

Max. file size: 256 MB.

Risk Assessment | Spouse 1

Spouse 1 | First Name

1. In general, how would your best friend describe you as a risk taker?

A real gambler

Willing to take risks after completing adequate research

Cautious

A real risk avoider

2. You are on a TV game show and can choose one of the following. Which would you take?

$1,000 in cash

A 50% chance at winning $5,000

A 25% chance at winning $10,000

A 5% chance at winning $100,000

3. You have just finished saving for a "once-in-a-lifetime" vacation. Three weeks before you plan to leave, you lose your job. You would:

Cancel the vacation

Take a much more modest vacation

Go as scheduled, reasoning that you need the time to prepare for a job search

Extend your vacation, because this might be your last chance to go first-class

4. If you unexpectedly received $20,000 to invest, what would you do?

Deposit it in a bank account, money market account, or an insured CD

Invest it in safe high quality bonds or bond mutual funds

Invest it in stocks or stock mutual funds

5. In terms of experience, how comfortable are you investing in stocks or stock mutual funds?

Not at all comfortable

Somewhat comfortable

Very comfortable

6. When you think of the word "risk" which of the following words comes to mind first?

Loss

Uncertainty

Opportunity

Thrill

Hold the bonds

Sell the bonds, put half the proceeds into money market accounts, and the other half into hard assets

Sell the bonds and put the total proceeds into hard assets

Sell the bonds, put all the money into hard assets, and borrow additional money to buy more

8. Given the best and worst case returns of the four investment choices below, which would you prefer?

$200 gain best case; $0 gain/loss worst case

$800 gain best case; $200 loss worst case

$2,600 gain best case; $800 loss worst case

$4,800 gain best case; $2,400 loss worst case

9. In addition to whatever you own, you have been given $1,000. You are now asked to choose between:

A sure gain of $500

A 50% chance to gain $1,000 and a 50% chance to gain nothing

10. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:

A sure loss of $500

A 50% chance to lose $1,000 and a 50% chance to lose nothing

11. Suppose a relative left you an inheritance of $100,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?

A savings account or money market mutual fund

A mutual fund that owns stocks and bonds

A portfolio of 15 common stocks

Commodities like gold, silver, and oil

12. If you had to invest $20,000, which of the following investment choices would you find most appealing?

60% in low-risk investments 30% in medium-risk investments 10% in high-risk investments

30% in low-risk investments 40% in medium-risk investments 30% in high-risk investments

10% in low-risk investments 40% in medium-risk investments 50% in high-risk investments

Nothing

One month's salary

Three month's salary

Six month's salary

14. If you had $1,000,000 how much would you be willing to lose in the market in retirement?

10% ($100,000)

15% ($150,000)

20% ($200,000)

25% ($250,000)

30% ($300,000)

Risk Assessment | Spouse 2

Spouse 2 | First Name

1. In general, how would your best friend describe you as a risk taker?

A real gambler

Willing to take risks after completing adequate research

Cautious

A real risk avoider

2. You are on a TV game show and can choose one of the following. Which would you take?

$1,000 in cash

A 50% chance at winning $5,000

A 25% chance at winning $10,000

A 5% chance at winning $100,000

3. You have just finished saving for a "once-in-a-lifetime" vacation. Three weeks before you plan to leave, you lose your job. You would:

Cancel the vacation

Take a much more modest vacation

Go as scheduled, reasoning that you need the time to prepare for a job search

Extend your vacation, because this might be your last chance to go first-class

4. If you unexpectedly received $20,000 to invest, what would you do?

Deposit it in a bank account, money market account, or an insured CD

Invest it in safe high quality bonds or bond mutual funds

Invest it in stocks or stock mutual funds

5. In terms of experience, how comfortable are you investing in stocks or stock mutual funds?

Not at all comfortable

Somewhat comfortable

Very comfortable

6. When you think of the word "risk" which of the following words comes to mind first?

Loss

Uncertainty

Opportunity

Thrill

Hold the bonds

Sell the bonds, put half the proceeds into money market accounts, and the other half into hard assets

Sell the bonds and put the total proceeds into hard assets

Sell the bonds, put all the money into hard assets, and borrow additional money to buy more

8. Given the best and worst case returns of the four investment choices below, which would you prefer?

$200 gain best case; $0 gain/loss worst case

$800 gain best case; $200 loss worst case

$2,600 gain best case; $800 loss worst case

$4,800 gain best case; $2,400 loss worst case

9. In addition to whatever you own, you have been given $1,000. You are now asked to choose between:

A sure gain of $500

A 50% chance to gain $1,000 and a 50% chance to gain nothing

10. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:

A sure loss of $500

A 50% chance to lose $1,000 and a 50% chance to lose nothing

11. Suppose a relative left you an inheritance of $100,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?

A savings account or money market mutual fund

A mutual fund that owns stocks and bonds

A portfolio of 15 common stocks

Commodities like gold, silver, and oil

12. If you had to invest $20,000, which of the following investment choices would you find most appealing?

60% in low-risk investments 30% in medium-risk investments 10% in high-risk investments

30% in low-risk investments 40% in medium-risk investments 30% in high-risk investments

10% in low-risk investments 40% in medium-risk investments 50% in high-risk investments

Nothing

One month's salary

Three month's salary

Six month's salary

14. If you had $1,000,000 how much would you be willing to lose in the market in retirement?

10% ($100,000)

15% ($150,000)

20% ($200,000)

25% ($250,000)

30% ($300,000)

Children

Do you have children?

Yes

Children Info

Please add a new line for each child

Full Legal Name

Date of Birth

Address

Dependent? Yes or No

Current Concerns

Taxes

Yes

Market Volatility

Yes

Investment Fees

Yes

Debt Elimination

Yes

Retirement Income

Yes

Asset Protection

Yes

Early Death of a Loved One

Yes

Chronic or Terminal Illness

Yes

Financial Legacy

Yes

Estate Planning

Yes

Primary Residence

Do you rent or own your primary residence?

Rent

Own

What is your monthly rent payment?

Is your primary residence paid off or do you carry a mortgage?

Paid Off

Mortgage

What type of mortgage do you have?

What is the term length of your mortgage?

Please upload your mortgage statement here.

Drop files here or

Max. file size: 256 MB.

Other Real Estate

Do you own other real estate?

Yes

Other Real Estate Information

Please add a new line for each property

Property Address

Paid Off or Mortgage (term & length)?

Monthly Rental Income

Monthly Property Expenses

Please upload mortgage statements for all other properties here.

Drop files here or

Max. file size: 256 MB.

Savings & Investments

Bank Accounts (Checking, Savings, CDs, Money Market, etc.)

Please add a new line for each account

Owner Name

Type

Institution

Balance

How much money are you comfortable keeping liquid in an emergency fund at all times?

Employer Sponsored Plans

Retirement Accounts (401k, 403b, 401a, 409a, 457, Roth 401k, Roth 403b, Roth 457, Pension, ESOP, KEOGH, TSP, Roth TSP, Profit Sharing, SARSEP, etc.)

Please add a new line for each account

Owner Name

Type

Company

Your Monthly Contribution

Employer Monthly Contribution

Balance

Beneficiary(ies)

Health Savings Account (HSA)

Please add a new line for each account

Owner Name

Company

Your Monthly Contribution

Employer Monthly Contribution

Balance

Beneficiary(ies)

Please upload statements and summary plan description(s) for all employer sponsored plans listed above

Drop files here or

Max. file size: 256 MB.

Personal Retirement Plans

Taxable Retirement Accounts (Traditional IRA, Rollover IRA, Inherited IRA, SEP IRA, Simple IRA, Solo 401k, etc.)

Please add a new line for each account

Owner Name

Type

Company

Monthly Contribution

Balance

Beneficiary(ies)

Non-Taxable Retirement Accounts (Roth IRA, Inherited Roth IRA, etc.)

Please add a new line for each account

Owner Name

Type

Company

Monthly Contribution

Balance

Beneficiary(ies)

Please upload statements for all personal retirement plans listed above

Drop files here or

Max. file size: 256 MB.

After Tax Investments

Investments (Stocks, Bonds, Mutual Funds, Municipal Bonds, Fixed Annuities, Indexed Annuities, Variable Annuities, ETFs, REIT, UIT, Cryptocurrency, Precious Metals, Coins, Stamps, Classic Cars, Precious Gems, Fine Art, Fine Wine, Antiques, Rare Rugs, Other Collectables, etc.)

Please add a new line for each investment

Owner Name

Type

Company

Monthly Contribution (if applicable)

Balance

Beneficiary(ies)

Investments for Children (529, Coverdell, UGMA/UTMA, etc.)

Please add a new line for each account

Owner Name

Type

Company

Monthly Contribution

Balance

Child's Name

Beneficiary(ies)

Please upload statements for all after tax investments listed above

Drop files here or

Max. file size: 256 MB.

Business

Do you own a business?

Yes

Business

Please add a new line for each business

Owner Name

Business Name

Current Value

Equity

Stock

Exit Strategy

Projected Exit Price

Please provide the following information for each business.

Structure (C-Corp, S-Corp, etc.), annual revenue, number of employees, key people in the business, employee benefits offered, 401k plan?

Social Security

Download statement at www.ssa.gov

Upload Current Statement(s)

Drop files here or

Max. file size: 256 MB.

Cars

Car 1

Year

Make

Model

Current Value

How long do you plan on keeping this car?

Finance Arrangement

Paid Off

Loan

Lease

Loan Balance

What will you replace it with?

Approximate cost. Will you pay cash, lease, or loan?

Do you have another car?

Yes

Car 2

Year

Make

Model

Current Value

How long do you plan on keeping this car?

Finance Arrangement

Paid Off

Loan

Lease

Loan Balance

What will you replace it with?

Approximate cost. Will you pay cash, lease, or loan?

Do you have another car?

Yes

Vehicle 3

Year

Make

Model

Current Value

How long do you plan on keeping this car?

Finance Arrangement

Paid Off

Loan

Lease

Loan Balance

What will you replace it with?

Approximate cost. Will you pay cash, lease, or loan?

Protection - Life

Life Insurance (Term, IUL, UL, VUL, Whole Life)

Please add a new line for each policy

Owner Name

Type

Death Benefit

Company

Insured

Beneficiary(ies)

Disability Insurance (Short Term, Long Term, etc.)

Please add a new line for each policy

Owner Name

Type

Company

Long-Term Care Insurance

Please add a new line for each policy

Owner Name

Type

Company

Insured

Beneficiary(ies)

Please upload statements for all policies listed above

Drop files here or

Max. file size: 256 MB.

Protection - Assets

Do you have an umbrella policy?

Yes

Date Last Reviewed Umbrella Policy

Umbrella Policy Annual Premium

Date Last Reviewed Homeowners Policy

Homeowners Policy Annual Premium

Date Last Reviewed Renters Policy

Renters Policy Annual Premium

Date Last Reviewed Auto Policy(ies)

Auto Policy Annual Premium(s)

Protection - Estate

Do you have a will?

Yes

Date of Will

Date Last Reviewed

Do you have a trust?

Yes

Date of Trust

Date Last Reviewed

Please upload a copy of your Certificate of Trust

Drop files here or

Max. file size: 256 MB.

Do you have a CPA / Tax Preparer?

Yes

Debt / Loans

Debt / Loans (Auto, Student, Personal, SBA, Life Insurance, HELOC, Credit Card, 401k, etc.)

Please add a new line for each debt / loan

Owner Name

Type

Balance

Interest Rate

Minimum Payment

Actual Payment

Future Expenses / Income

Expenses (College, Wedding, Vehicle, Down Payment, etc.)

Please add a new line for each expense

Type

Projected Cost

Projected Date

Income (Inheritance, Home Sale, Business Sale, Stock Sale, Other Liquidity Event, etc.)

Please add a new line for each income

Type

Projected Amount

Projected Date

Other Monthly Income

Dividends

Interest

Social Security

RMDs

Maintenance

Child Support

Other

Tax Return

Please upload your prior year's tax return

Drop files here or

Max. file size: 256 MB.

Goals

What would you say is your most important financial goal?

What would you say is your most important personal goal?

What would you say could potentially get in the way of achieving your financial goals?

What personal concerns (non-financial) do you have?

Plans for Retirement

How do you plan to fill your days 6-months after you retire?

What are your travel plans?

What are your plans for where you are going to live?

Sell primary residence, move somewhere else, etc.

Will you continue working in some capacity?

Yes

Please describe

Start a business, invest in real estate, invest in a start-up, etc.

Is leaving an inheritance important to you?

Yes

Is there anything else about your current and future financial plan or retirement that would be helpful information for us to know?

Please use the box below

Enter your email Address

Client Info

Personal Information

Risk Assessment

Risk Assessment

Spouse 1

Spouse 2

Risk Assessment | Spouse 1

Risk Assessment | Spouse 2

Children

Current Concerns

Primary Residence

Other Real Estate

Savings & Investments

Employer Sponsored Plans

Personal Retirement Plans

After Tax Investments

Business

Social Security

Cars

Car 1

Car 2

Vehicle 3

Protection - Life

Protection - Assets

Protection - Estate

Debt / Loans

Future Expenses / Income

Other Monthly Income

Tax Return

Goals

Plans for Retirement

Contact Us

*By appointment only

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Monthly Financial Wins

✨ A heartfelt THANK YOU to our community! ✨

We’re so honored (and still a little stunned!) to share that for the second year in a row, Judy Carlson Financial Group has been named Best of the Best Financial Planner in both Castle Pines and Lone Tree by Colorado Community Media.