Financial Needs Analysis

1

About you

The basics, so the analysis is built around your household.

Full name

Date of birth

Age

Occupation / employer

Phone

Email

Marital status

Single Married Partnered Divorced / widowed

Spouse / partner name & occupation (if any)

Dependents — names / ages

Who makes the financial decisions?

I decide on my own Jointly with my partner Other

2

Your goals & dreams

Tick everything that sounds like you. This becomes the goals page of your finished analysis.

Short-term goals — next 1–2 years

Medium-term goals — 3–7 years

Retire — still work enjoyably Buy / invest in property Airbnb / rental income Grow savings & investments Increase income Estate plan in place Children's education Grow a business

Long-term goals

Relaxed retirement Beach / travel lifestyle Work from home / part-time Leave a legacy for family No money worries Help children / grandchildren

Financial independence means…

Not worrying about bills A cushion of savings Working by choice Freedom to travel

Your immediate priorities — tick your top 2–3

Retirement

Age you would like to retire

Retirement income you want — per month

Ideal amount, if different — per month

Amount you would be happy with — per month

3

Income & monthly budget

Monthly, after tax (take-home). Exact figures where you can — estimates are fine.

Income — per month

SourceYouSpouse / other

Job / self-employment

Business / side income

Pension / Social Security / benefits

Other

Total monthly income$0

Annual income (calculated)

How are you paid?

Weekly Biweekly Monthly

Monthly expenses — by category

Housing — rent / mortgage

Utilities, cell phone, internet

Groceries & household

Transportation — car, gas, Uber / transit

Insurance premiums (all)

Personal care, clothing, subscriptions

Business expenses

Children / family support, giving

Debt payments (minimums — detail in the next section)

Total monthly expenses$0

Your budget at a glance

Calculated from the figures above.

Money left over each month (income − expenses)—

Debt-to-income ratio (debt payments ÷ income)—

Housing as a share of income—

Anything worth noting about your spending? (optional)

4

Debts, assets & tax buckets

What you owe, what you have, and how your savings are taxed.

Debts

DebtBalance owedMonthly payment

Mortgage

Auto loan

Student loans

Credit cards

Personal / other loans

Total debt$0 owed · $0/mo

Assets

Checking / savings (liquid)

Retirement accounts — 401(k) / 403(b) / IRA

Investments / brokerage

Property / other assets

Total assets$0

Where your savings sit — by tax treatment

Rough amounts are fine. This shows how much of your money is taxed now, taxed later, or tax-advantaged.

Tax now — taxable accounts

Tax later — 401(k) / IRA (deferred)

Tax advantage — Roth

5

Existing coverage & estate planning

What protection you already have in place — and what is still missing.

Life insurance you have now — tick all that apply

Your policies, if you know them

Policy 1 — type / company

Coverage amount

Premium / month

Policy 2 — type / company

Coverage amount

Premium / month

Total current coverage$0

Does your coverage include living benefits?

Yes No Not sure

Past policies — what happened? (optional)

Estate planning — what do you have in place?

Will Revocable living trust Financial power of attorney Healthcare power of attorney Advance directive None yet

Who must be protected if something happens to you? (beneficiaries)

6

The three calculations

These update live from your answers above. Add the two figures below, and your protection need, emergency fund, and retirement outlook calculate themselves. They are estimates — your finished analysis will confirm them.

Education / children's future costs you want covered

Final expenses / other need you want covered

What you currently save toward retirement — per month

Social Security / pension you expect — per month

A — Life insurance & protection need (DIME method)

Debts + Income replacement + Mortgage + Education + Final expenses — the standard way to size coverage. (Your mortgage is counted once, in its own line.)

D — Debts other than the mortgage (from section 4)—

I — Income replacement (annual income × 10)—

M — Mortgage balance to cover—

E — Education / children's future costs—

Final expenses / other need—

Total protection need—

Minus coverage you already have—

Protection gap—

B — Emergency fund

Six months of expenses, compared with the liquid savings you have today.

Recommended emergency fund (monthly expenses × 6)—

Liquid savings available today (checking / savings)—

Emergency fund shortfall—

C — Retirement projection

Uses the retirement age and monthly income you entered in section 2, and the retirement savings in section 4.

Years until retirement—

Fund needed by retirement age—

On track for — at 4% a year—

On track for — at 6% a year—

Extra per month that closes the gap (at 6%)—

How the fund needed is estimated: the yearly income you want in retirement, after the Social Security / pension you expect, multiplied by 25 — a common rule of thumb, so the fund could provide roughly 4% a year. Projections grow your current retirement savings plus your current monthly saving, compounded monthly. Hypothetical and illustrative only — returns are not guaranteed and investments can lose value.

7

Set-aside, concerns & next steps

The most important number of all — what you can comfortably put toward your future each month.

How much can you comfortably set aside each month for the future?

Amount — per month

Would splitting the payment help? (e.g. half at the start of the month, half later)

Yes No

Best dates for payments (optional)

Concerns — tick anything that is on your mind

Cost / timing is tight Numbers feel hard to reach Past policy did not work out Health concerns I need time to think I want family involved Skeptical about retirement I have coverage already

Health notes — only what you want to share (optional)

What you would like your plan to cover — tick all that apply

Term life insurance for the protection gap Long-term savings plan with a life insurance component & living benefits Build emergency fund Stay debt-free / a plan for my debt Establish a will and trust

Next steps

Book a follow-up to review my plan Prepare my plan at the set-aside amount above Send me my finished analysis Start will / trust homework Confirm split payment Review again in 6 months

Preferred follow-up date & time

Who else should be there?

Important disclosures

Information and estimates: This analysis is based on the information you provided and the assumptions shown. Confirm accuracy and completeness with your financial professional before acting. Estimates may change. This is not a comprehensive financial plan.

Hypothetical calculations: Assumed returns do not predict investment performance or guarantee results. Outcomes may be lower, and investments can lose value. Fees, taxes and inflation affect outcomes.

Insurance: Needs estimates are not quotes or guarantees of eligibility, pricing or benefits. Coverage depends on underwriting, policy terms, exclusions and availability. Guarantees depend on the insurer's claims-paying ability. Review carrier documents.

Tax, legal and ongoing review: This analysis does not provide tax, legal or accounting advice. Consult qualified professionals. Review the analysis when your situation changes.

Your name — typed here, this confirms the information above is yours

Date

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