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["[Company name]"]
["Retirement Checklist"]
["Client Name: ___________________________"]
["<Date>"]
[]
["Address:",null,"Medicare Number:"]
["Phone:",null,"Primary Physician:"]
["Marital Status:",null,"Primary Insurance:"]
["Spouse Contact Information:"]
[]
["LIFESTYLE"]
["Key Consideration","Question","Answer","Notes"]
["Preferred style of living","Where do you plan to live after retirement?","Portland, OR","My wife and I plan to move to Portland when I am age 55 (3 years from now)."]
["Preferred style of living","Do you plan to finish life at home or in assisted living?","Retirement community","We'd like to move into an over-55 community that provides assisted living and nursing home support as required."]
["HEALTH "]
["Key Consideration","Question","Answer","Notes"]
["Health insurance","What level of benefits will be required in a worst-case scenario?","$9,000/month","If one of us gets a debilitating illness, our current health insurance covers up to $1,000 of costs per month. We need to explore obtaining additional coverage."]
["Medical","Have you compiled a list of your medical history, physicians, and current medication prescriptions?","Yes","A list is located in our bank safe. The list was last updated on 1/1/2005."]
["Long-term care","Does your family have a history of debilitating illness and/or long life expectancy?","No","We'd like to explore long-term care insurance, but only as a supplement to existing life insurance policies."]
["FINANCES"]
["Key Consideration","Question","Answer","Notes"]
["Asset listing","Have you compiled a list of all the assets you or your spouse (if applicable) own? Do you update this list monthly?","Yes","A list is located in our bank safe. It was last updated on 1/1/2005. We update this list monthly."]
["Asset protection","Based on a conservative investment strategy, will returns be enough to support your desired style of living?","No","Based on current and projected income/asset mix, higher returns will be required over the next 3 years. Otherwise, I'll need to work until age 60."]
["Tax minimization","At what tax rate will you be taxed during your later years?",0.25,"We'd like to consider new investments to lower the effective tax rate during our retirement years."]
["Life insurance","How do you plan to protect your beneficiaries?","$1.5M in coverage","A $1.5M death benefit will cover the surviving spouse. A sizable estate will pass to our two children."]
["Estate planning","How do you want to pass your assets on to the next generation?","100% distribution","We'd like to create a trust to ensure that all of our assets pass directly to our children without requiring probate."]
["LEGAL"]
["Key Consideration"," Question","Answer","Notes"]
["Friends and family","Have you compiled a list of contact information for your closest family and trusted friends?","Yes","A list is located in our bank safe. The list was last updated on 1/1/2005."]
["Wills","Do you have an updated will and living will prepared?","Yes","Both documents are located in our bank safe. Our lawyer reviews them every year."]
["Power of attorney (POA)","Who will handle your will or living will?","Paula Nartker","Paula is designated as our POA if the surviving spouse is declared incompetent because of medical reasons."]