Fact Finding

Azura Wealth Advisers Fact Find

Name

Date of Birth

Resident state

Occupation

Employer name

Annual income

Are you Married?

Yes

No

Spouse name

Date of Birth

Occupation

Employer name

Annual income

Do you currently have:

Estate plan

Trust

Life insurance

Do you anticipate any major purchases?

Yes

No

Please List

Net Worth

Cash $:

Insurance cash value $:

Brokerage accounts $:

Retirement accounts $:

Real estate $:

Total liabilities $:

Current saving ability $:

Current saving rate

Ready to bring your plan into focus?