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Planning Questionnaire

This questionnaire is a tool we use to better understand your life circumstances and goals. Please complete all fields and click Submit to send electronically. You can submit your information with confidence because Robinswood Financial's Web site is certified by Verisign. Click the Verisign logo at the right to verify our SSL Certificate.

If you prefer to mail or fax the questionnaire click Print Form at the bottom of this page when you have completed the form. Our fax number is (425) 296-1612. The fax machine is located in a private, locked office so your confidential information remains secure. Our mailing address is 3425 Carillon Point - Building 3000, 4th Floor - Kirkland, WA 98033. You can expect to hear from us within a few days.

Fields in orange are required information

Tell us about yourself

Full Name:
Daytime Phone:
Evening Phone:
Best time to call:
Year Born:
Years until retirement:

Tell us about your spouse or domestic partner

Full Name:
Daytime Phone:
Evening Phone:
Year Born:
Years until retirement:

Tell us about your dependents

Do you have children?
Are any of them financially dependent on you?
Please enter the names and ages of your children, whether he or she is financially dependent on you, and if so, for how many more years
Do you currently have any other dependents?
Could you be providing support to someone in the future?
If yes, how much per year?
For how many years?
Starting when?

Tell us about your financial situation

Do you have a financial plan?
What are your financial priorities?
Do you own your home?
If yes, what is the current market value?
Do you have a mortgage?
If yes, how much do you owe on your mortgage?
What is the interest rate?
When will it be paid off?
Will you spend retirement in your current home?

Tell us about your household income and expenses

Earned income per year:
Pension per year:
Social security per year:
Other income per year:
What changes to your income do you anticipate? When do you expect these changes to take place?
Other than a mortgage, do you have other liabilities (for example, auto loan, credit cards, etc.)? If so, what is the approximate amount owed, and when do you expect to have them paid off?
What is your total annual cost of living (consider your regular expenses, lifestyle, income tax, etc.)?
Do you expect your current cost of living to change? If so, how and when?

Tell us about your investible assets

Total value of your qualified retirement accounts (401k, 403b, IRA, Roth, etc.):

Total value of your non-qualified accounts (brokerage, savings, CDs, etc.):

Total value of other assets (investment property, partnerships, etc.):

Tell us about your investment experience and risk tolerance

On a scale of 1-5, how would you characterize yourself as an investor?
Conservative Moderate Aggressive
How would you describe your investment goal?
I want to beat the market
I want to achieve the highest return I can within my risk tolerance
I want to achieve the return that will meet my long-term financial needs
What amount of loss could you tolerate in a single year?
A little, but over time the total value of the investment should not decline
Swings in the market are expected; consistency of total return is more important
One or two years of negative returns is the price you must pay when looking at the total picture
It's unimportant to me
How important is it for you to beat the stock market over any given two-to-three-year period?
Of no importance at all
A minor concern
Fairly important
Highly critical
Absolutely essential
How would you describe your knowledge of investing?
I am a knowledgeable investor who's able to explain concepts such as standard deviation and risk measurements
I understand how mutual funds work and feel confident discussing the best funds in different categories
I understand investment basics and the major markets such as stocks, bonds, and money markets
I have only a vague idea about financial terminology
I never get into financial discussions because I don't understand any of the concepts
In which one of the following investment types do you consider yourself to have experience?
No investment experience
Money market accounts or mutual funds
Government/corporate/municipal bonds or mutual funds
High-yield bonds or mutual funds
Small company stocks or mutual funds
Large company stocks or mutual funds
International stocks or mutual funds
What are your expectations in terms of market performance and market risk?
How well do you think your portfolio protects you from financial disaster?
What positive investment experiences have you had?
What negative investment experiences have you had?
What are your long-term goals regarding income, retirement, lifestyle, and legacy planning?
What is your vision of retirement? Please consider hobbies, travel, volunteer work, coaching, part-time employment, relocation, multiple homes, and so on.
What should we ask that we haven't asked?
Please tell us what else we should know about your situation:
What would be your expectations in terms of our performance and service?
How did you hear about us?


(425) 296-1611   •   3425 Carillon Point - Building 3000, 4th Floor - Kirkland, WA 98033   •
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