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Retirement Analysis Questionnaire
Now let's gather some basic information to create your own customized and comprehensive retirement plan. We keep it simple, with just a few questions now, then we customize during our next meeting to fit your situation regardless of how simple or complex your life is. If you prefer a detailed form to download and complete, (click here).

    Please take a few minutes to complete our Retirement Analysis Questionnaire

    Contact Information
    2. SALARIES & RETIREMENT DATE: CHOOSE WHETHER YOU’RE RETIRED OR WORKING, THEN IF WORKING, YOUR GROSS MONTHLY SALARY AND THE DATE YOU’D LIKE TO RETIRE
    3. SOCIAL SECURITY: ADD THE AGE YOU’D LIKE TO START AND THE PROJECTED MONTHLY AMOUNTS OF YOUR SOCIAL SECURITY BENEFITS. (You can go to SSA.GOV to get your exact Social Security Numbers) 
    4. PENSIONS: Add the age you’d like to start and the projected monthly amounts of your pension benefits
    5. RETIREMENT ACCOUNTS: Enter the combined totals and we will separate out accounts during our next meeting
    WORK PLANS
    TRADITIONAL IRA's
    ROTH IRA's
    INVESTMENT ACCOUNTS
    BANK / Credit Union Accounts
    6. NON-RETIREMENT ACCOUNTS: List items that are part of your net worth but not intended for use for retirement
    7. MONTHLY EXPENSES: Enter the total amount of your current estimated monthly expenses.
    8. RETIREMENT GOALS:  What is most important part of your retirement future?
    9. RETIREMENT CONCERNS: What is the top three largest concerns during your retirement life?
    Thank You for the details. We will now start creating your retirement plan!
    This information will be kept confidential and used for the purpose of helping you create a retirement plan analysis.
We are experts on Retirement and Tax Planning Strategies.

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Birdseye Financial Services
​136 Hillside Drive E
Burleson, TX 76028

​Client Resources
Main # 360-722-7889
Texas # 817-717-1487
Fax #425-412-6865

​[email protected]
birdseyefinancial.com
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The information contained herein: (1) is proprietary to Birdseye Financial Group and/or its content providers; (2) may not be copied or distributed; and (3) is not warranted to be accurate, complete, or timely. Any information herein about providers, speakers, and services does not constitute a recommendation or endorsement. This material is not to be distributed without the express written consent of Birdseye Financial. Regarding your financial situation, you should consult with a financial professional before acting on specific actions or suggestions given. For legal or tax advice, you should contact your qualified attorney or CPA. Insurance and tax planning services are offered through Birdseye Financial. Investing involves risk, including the potential loss of principal. No market investment strategy can guarantee a profit or protect against loss during declining values. ​Fiduciary Investment Advisory Services are offered through Simplicity Asset Management, an SEC-Registered Investment Advisor. Registration does not denote any level of skill or qualification.

MEDICARE MANDATORY DISCLAIMER
“We may not offer every plan available in your area. ​Please get in touch with Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.” All calls regarding Medicare may be recorded by phone or online and a SCOPE of appointment required by Medicare will be obtained 48 hours before any sales meeting to discuss plan details. (NOTE - The organizations and plans can vary by state and county, we can validate these numbers upon request.)

State Licenses
LICENSES: AZ #7101306, CA #4140429, FL #W825259, GA #3621424, ID #863617, KS #7101306, MA #2176921, NV#3879853, NC #7101306, OK #3001663224, OR #7101306, TX #2695866, WA #190780. Note that in California, our DBA is Birdseye Financial and Insurance Services. The current license status may increase or decrease without being updated on this site. ​If you have any questions, please don't hesitate to ask.

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