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WMM Formadmin2021-05-01T19:38:53+00:00

The Wealth Maximization Method

Step 1 of 14

7%

Personal Information
Client Name*
First
Date of Birth*
DD slash MM slash YYYY
Social Sec #.*
Marital Status*
- Single
- Married
- Windowed
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Alt. Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Occupation
Home Phone
Business Phone
US Citizenship?
- Yes
- No
Have a Will?
- Yes
- No
Last Update?
Life Insurance?
- Yes
- No
Owned by Trust?
- Yes
- No
Benefit Amount
LTC?
- Yes
- No
Planned Retirement Age?

Spouse Name*
First
Date of Birth
MM slash DD slash YYYY
Social Sec #.*
US Citizenship?
- Yes
- No
Planned Retirement Age?

Financial Data
Assets
Owned by Clients
Bank accounts
Mutual Funds
Stocks
Bonds
Retirement Accounts
Fixed or Variable Annuities
Life Insurance
Primary Residence
Other Property
Total

Liabilities
Owned by Clients
Mortgage Residence
Other Properties
Other Liabilities
Total
Net Worth
Owned by Client

Financial Data
Assets
Owned by Spouse
Bank accounts
Mutual Funds
Stocks
Bonds
Retirement Accounts
Fixed or Variable Annuities
Life Insurance
Primary Residence
Other Property
Total

Liabilities
Owned by Spouse
Mortgage Residence
Other Properties
Other Liabilities
Total
Net Worth
Owned by Spouse

Financial Data
Assets
Owned Jointly
Bank accounts
Mutual Funds
Stocks
Bonds
Retirement Accounts
Fixed or Variable Annuities
Life Insurance
Primary Residence
Other Property
Total

Liabilities
Owned Jointly
Mortgage Residence
Other Properties
Other Liabilities
Total
Net Worth
Owned Jointly

Financial Data
Assets
Owned by Trust
Bank accounts
Mutual Funds
Stocks
Bonds
Retirement Accounts
Fixed or Variable Annuities
Life Insurance
Primary Residence
Other Property
Total

Liabilities
Owned by Trust
Mortgage Residence
Other Properties
Other Liabilities
Total
Net Worth
Owned by Trust

Expense Components
Fixed Expenses
Mortgage Payment Primary Residence
Monthly
Annually
Annually
Mortgage Payment Secondary Residence
Monthly
Annually
Annually
Mortgage Vacation Home
Monthly
Annually
Annually
Rent
Monthly
Annually
Annually
Taxes
Monthly
Annually
Annually
Common Charges
Monthly
Annually
Annually
Car Payments
Monthly
Annually
Annually
Auto Insurance Premiums
Monthly
Annually
Annually
Life Insurance Premiums
Monthly
Annually
Annually
Health Insurance Premiums
Monthly
Annually
Annually
Long Term Care Insurance Premiums
Monthly
Annually
Annually
Annual Dues or Memberships
Monthly
Annually
Annually
Others
Monthly
Annually
Annually
Total Fixed Expenses
Monthly
Annually
Annually

Checklist
Please check the appropriate box to upload your documents.
Checklist
- Copy of Your Latest Tax Return
- Completed Wealth Maximization Questionnaire
Copy of Your Latest Tax Return
Max. file size: 100 MB.
Completed Wealth Maximization Questionnaire
Max. file size: 100 MB.
Please note: You do not have to be concerned about providing exact figures. Estimates are sufficient at this stage of the process.
Copies of the Following Financial Statements
- a. Bank Account Statements ( First Page showing balances only )
- b. Itemized List of all Savings Bonds and Certificates of Deposits
- c. Brokerage Account Statements
- d. Mutual Fund Account Statements
- e. List of all Stocks Held in Certificate Form
- f. Annuity Statements
- g. IRA Statements
- h. Qualified Plan Account Statements (403(b), 401(k), 457, Pension Statements, Defined Benefit Plans)
- i. Life Insurance Policy Statements
- j. Long Term Care Policy Statements
Please check the appropriate box to upload your documents.
Bank Account Statements (first page showing balances only)
Max. file size: 100 MB.
Itemized List of all Savings Bonds and Certificates of Deposits
Max. file size: 100 MB.
Brokerage Account Statements
Max. file size: 100 MB.
Mutual Fund Account Statements
Max. file size: 100 MB.
List of all Stocks Held in Certificate Form
Max. file size: 100 MB.
Annuity Statements
Max. file size: 100 MB.
IRA Statements
Max. file size: 100 MB.
Qualified Plan Account Statements
Max. file size: 100 MB.
Life Insurance Policy Statements
Max. file size: 100 MB.
Long Term Care Policy Statements
Max. file size: 100 MB.
Copies of Estate Planning Documents
- a. Wills
- b. Trusts
- c. Health Proxy
- d. Living Will
- e. Power of Attorney
Please check the appropriate box to upload your documents.
Wills
Max. file size: 100 MB.
Trusts
Max. file size: 100 MB.
Health Proxy
Max. file size: 100 MB.
Living Will
Max. file size: 100 MB.
Power of Attorney
Max. file size: 100 MB.
Securities traded through Liberty Partners Financial Services, LLC; Office of Supervisory Jurisdiction (OSJ), 5060 California Ave, Suite 600, Bakersfield, CA 93309; Phone 800-440- 0442; Member FINRA/SIPC. Fee based advisory services processed through and supervised by Liberty Partners Capital Management, LLC (LPCM) – a SEC registered investment advisory firm. Liberty Partners Financial Services, LLC is a separate entity from Davenport and Associates
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Securities traded through Liberty Partners Financial Services, LLC; Office of Supervisory Jurisdiction (OSJ), 119 Simmons St, Mt. Pleasant, SC 29464; phone 800-440-0442; Member FINRA/SIPC. Fee-based advisory services processed through and supervised by Modern Capital Advisors, LLC (MCA), a SEC-registered investment advisory firm. from Davenport and Associates.

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