New Client Form - Wealth Realized

Please fill in the form below. Once complete please also include: Most recent copies of RRSP, Pension plan and/or DPSP. Most recent copies of Non-registered investment and corporate investment statements. Most recent copies of RESP in trust or other savings intended for education. A copy of your life, disability, long-term care and critical illness insurance. Most recent tax returns, corporate year-end documents. For Estate planning we require Wills & Power of Attorney. These additional documents can be sent to us direct to our drobox using the portal found on our contact page.

Primary Client Information

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Date of Birth

Employer

Occupation

Are you a Canadian citizen?

Yes
No
Other

Co-Client Information

Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Date

Employer

Occupation

Text Box

Are you a Canadian citizen?

Yes
No
Other

Children Information

Life Assumptions

Asset Information - Registered Investments

Non-Registered Investments

Corporate Investments

Education Savings

House Value:

Rental Properties

Debt Information

Income Information

Life Insurance

Disability

Long-term Care

Critical Insurance

Tell me a bit about your short, medium, and long-term financial goals. What sort of things do you hope to accomplish in the next 1 to 5 years? For example, are you planning to buy a new car? Want to pay off a debt? Rank them in order of importance, from most to least, and attach specific deadlines when possible.

What about over the next 5 to 10 years? Put a child through school? Save for a major home renovation? Rank them in order of importance, from most to least, and attach specific deadlines when possible.

And what about things you hope to accomplish 10 years and beyond? When do you hope to retire? Rank them in order of importance, from most to least, and attach specific deadlines when possible.

Let's review the three categories above. Do you think the goals you've listed above are realistic, or should wording be changed or expectations altered to make sure that the goal is attainable?

If I asked you to name the financial situations that keep you awake at night worrying, what would they be? Are you concerned about debt? Paying for a future or current expense? Once again, rank these in order of importance for me.

Where are the flames highest? Could you list the top five financial goals you feel that you'd most like to get accomplished, and give me a date for when you like to get them accomplished by? Can you rank them in terms of priority, from most to least?

What do you want out of life? Be realistic, but describe the type of lifestyle you'd like to start working towards. The more know about what your personal goals are and the sort of life you want to live, the better I'll be able to help you reach them.

Primary Client Information

Co-Client Information

Submit Your Documents To Our DropBox