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Search for:
Home
One-Stop Platform
Our Mission
Event Portfolio
Solutions
Financial Planning
Insurance Services
Education Planning
Retirement Planning
Estate Planning
Family Office
Harvest Financial Literacy Foundation
Opportunity
News
Quotation
Life Insurance
Health Insurance
Auto Insurance
Homeowners Insurance
Commercial Insurance
Contact
Language
中文
English
Agent Login
Login
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个⼈财富问卷
Harvest Financial
2024-09-16T08:23:39+00:00
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个⼈财富问卷
-
Step
1
of 3
个⼈信息
客⼾姓名
First
Last
出⽣⽇期
是否为美国公民︖
是
否
地址
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
电话
电⼦邮件
职业和头衔
婚姻状况
单身
已婚
离婚
丧偶
伴侣
是否有子女
*
是
否
共同客⼾姓名
First
Last
出⽣⽇期
是否为美国公民︖
是
否
职业和头衔
地址 ( 如果不同于上⾯所填 )
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
电话
电⼦邮件
家庭信息
请根据每位家庭成员的情感和财务成熟度进⾏评估,评分范围为1到5( 1 = 最低,5 = 最⾼ )
⼦女姓名1
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
⼦女姓名2
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
⼦女姓名3
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
⼦女姓名4
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
孙辈姓名1
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
总负债 如果不同于上⾯所填
居住状态
情感成熟度 *
财务成熟度*
孙辈姓名2
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
孙辈姓名3
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
孙辈姓名4
First
Last
出⽣⽇期
是否为受抚养⼈︖
是
否
居住状态
情感成熟度 *
财务成熟度*
下一页
财务⽬标
退休
住房
长期护理
教育
旅行度假
年收入
个⼈收入
配偶收入
房租收入
年度⽀出
贷款/房租
房产税
汽车租赁
保险
家庭⽀出
旅⾏度假
总⽀出
下一页
资产
银⾏
股票/债券
⼈寿险现⾦价值
年⾦
房地产
总资产
负债
抵押贷款
汽⻋贷款
个⼈贷款
其他债务
总负债
客戶
债务
收入
房屋贷款
教育
保险需求
配偶
债务
收入
房屋贷款
教育
保险需求
回上一页
提交
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Personal Information
-
Step
1
of 3
Personal Information
Client Name
First
Last
Date of Birth
U.S. Citizen?
*
Yes
No
Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
Email
Occupation and Title
Life Status
Single
Married
Divorced
Widowed
Significant Other
Do you have children?
*
Yes
No
3 Expenses of
Co-Client Name
First
Last
Date of Birth
U.S. Citizen?
Yes
No
Occupation and Title
Address ( if different from above )
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
Email
Family Information
*Please evaluate the emotional and financial maturity of each family member on a scale of 1 to 5 (1 = lowest, 5 = highest).
Names of Children 1
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Children 2
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Children 3
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Children 4
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Grandchildren 1
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Grandchildren 2
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Grandchildren 3
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Names of Grandchildren 4
First
Last
Date of Birth
Dependent
Yes
No
State of Residence
Emotional Maturity*
Financial Maturity*
Next
Financial Goals
Retirement
Home
LTC (Long-Term Care)
Education
Vacation
Annual Income
Personal Income
Spouse Income
Households
Annual Expenses
Mortgage / Rent
Property Tax
Car Finance / Lease
Insurance
Household Expenses
Travel Vacation
Total Expenses
Next
Assets
Bank
Stock / Bonds
Cash Value Life Insurance
Annuities
Real Estate
Total Assets
Liabilities
Mortgages
Loans on Car
Personal Loan
Other Debts
Total Liabilities
Client
Debt
Income
Mortgage
Education
Insurable Need
Spouse
Debt
Income
Mortgage
Education
Insurable Need
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