GMW Client Profile

Client Profile
  Taxpayer name   ______________________________ Change in phone #'s / Address (circle)
  Spouse      ______________________________        
  E-mail address   ______________________________        
  Children's names and ages ______________________________ ______________________________
        ______________________________ ______________________________
  How were you originally referred to our office? ______________________________      
  Are you expecting your tax return to change before we file?    Yes /  No        
    (a minimum fee of $25 will apply for any changes)          
  Would you like your tax return e-mailed to you?                    Yes  /  No        
  Next year, would you like your tax organizer e-mailed to you or accessible via the Web?  E-mail  /  Web  
  Attorney's name/phone # ______________________________        
  Insurance Agent's name/phone # ______________________________        
  Investment Advisor's name/phone # ______________________________        
  Do you have a will or trust in place?                  Yes  /  No   Referral needed?    Yes  /  No    
  Do you have any insurance issues to discuss?  Yes  /  No   Referral needed?    Yes  /  No    
  Do you need any investment advisory services? Yes  /  No   Referral needed?    Yes  /  No    
  Current mortgage rate   ___________   Any high-interest debt?           Yes  /  No    
  Are you currently estate planning with your parents and children?   Yes  /  No        
    *** One Free Hour Consultation for Parents or Children (Includes free tax return review for past 3 years) ***
  Are you planning to buy or sell principal residence, vacation property, or other real estate?       Yes  /  No  
  Do you have any issues regarding retirement goals, education planning, insurance, or estate?  Yes  /  No  
  Are you expecting any future inheritance or change in lifestyle?        Yes  /  No  
  In order to help determine tax/investment strategies, please provide estimates of the following
                    (USE BACK IF NEEDED)  
  Real Estate Holdings, Value, and Debt:              
  Investments (Stocks, Mutual Funds, Bonds, etc.):            
  Retirement Accounts (Roth IRA, 401K, Traditional IRA, etc.):          
  Life/Disability Insurance - term or variable: