Financial Situation Questionnaire
Help us prepare a precise plan for you
First Name
*
Last Name
*
Email
*
Phone
*
I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.
If you were to pass away today, what would happen to your business and loved ones?
My family depends on my income – major impact
The business would struggle or have to shut down
Both
No major impact
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Do you have any dependent children?
Yes
No
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Number of dependent children
Their ages
Do you have any other dependents?
Yes
No
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Number of other dependants
In case of illness or injury preventing you from working, could you maintain your financial obligations?
Yes
No
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for how long could you maintain your financial obligations?
1 month
3 month
6 month
12 month +
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Alternative sources of income
If you were diagnosed with a critical illness (3+ months without being able to work), would you have a safety net?
Yes
No
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If yes, for how long?
1 month
3 months
6 months
12 months +
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Alternative source of income
Do you own your primary residence?
Yes
No
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Solde hypothécaire
$
Estimated value
$
Number of properties
Mortgage balance
$
What types of accounts do you currently have?
TFSA (Tax-Free Savings Account)
RRSP (Registered Retirement Savings Plan)
FHSA (First Home Savings Account)
RESP (Registered Education Savings Plan)
Corporate / Business Account
Other
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How much personal income tax did you pay last year?
$
Would you like to optimize your taxes?
Yes
No
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Do you have personal or business debts to restructure?
Yes
No
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Do you know your financial independence number?
Yes
No
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Estimated amount of your financial independence
$
Are you interested in a FREE financial plan?
Yes
No
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Would you be interested in learning more about an additional income opportunity in the financial field?
Yes
No
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