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Dhanayoga - Client Pre-Consultation Questionnaire
Thank you for your interest in allowing us to assist you in your financial planning. Please complete the following questionnaire so that we can better understand your financial status, expectations and concerns prior to our initial consultation
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* Indicates required question
Email
*
Your email
Your Full Name
*
Your answer
Your Date of Birth
*
MM
/
DD
/
YYYY
Your Mobile Number with Country Code
*
Your answer
Number of dependents (exclude yourself)
*
Your answer
What Financial concerns cause you to seek financial planning assistance? (mention maximum THREE concerns)
*
Your answer
7. When do you want to retire? (mention either the "Year" or timeline from now (for e.g, in the next 5 years)
*
Your answer
8. What are your major financial goals? (Please mention no more than SIX goals - for e.g., have regular income post retirement, children's college education, daughter's marriage, pay off EMIs etc etc.,)
*
Your answer
9. Do you have any special circumstances which worry you? (for e.g., health issues, disability, job stability etc.)? If so, please mention
*
Your answer
10. Estate Planning - Do you have any of the following? (tick those ones you have)
*
A Current Will?
Power of Attorney (PoA)?
Medical Power of Attorney?
Trust Fund or Estate Fund?
None of the above
Required
11. Tick the risk protection you currently have?
*
Life Insurance (Employer funded)
Life Insurance (Self Funded)
Health Insurance (Employer funded)
Health Insurance (Self funded)
Home Insurance
Disability Insurance
Accidental Death Insurance
Health Insurance (for Critical Illness)
Required
12. What is your Annual Household Income (in INR Lakhs)?
*
0 to 5L
> 5L and <= 10L
>10L and <= 25L
>25L and <= 50L
> 50L and <= 100L
>100L
What is your Annual Household Savings (in INR Lakhs)?
*
0 to 1.5L
> 1.5L and <= 3.0L
> 3.0L and <= 7.5L
> 7.5L and <=15L
> 15L and <= 30L
> 30L
13. Value of Liquid Assets (Savings & Liquid cash) (Current value in INR)
*
Your answer
14. Value of Mutual Funds and Stocks (Shares) (Current value in INR)
Your answer
15. Fixed Income Deposits / Bonds / Debentures (Current value in INR)
*
Your answer
16. Retirement / Social Security Contribution Account (Provident Fund / Employer Gratuity / Superannuation etc) (Current value INR)
*
Your answer
17. Property / Real Estate (current value in INR)
*
Your answer
18. Other assets (if any - give description and current value in INR)
*
Your answer
19. Residence or Home Loan (current outstanding INR and EMI value INR) (if not, type NA or Zero)
Your answer
20. Car or Vehicle Loan (current outstanding value in INR)
*
Your answer
21. Credit Cards / Other Cards (current outstanding value in INR)
*
Your answer
22. Other Loans (if any - Loan Name and current outstanding value in INR)
Your answer
23. How did you come to know about us (Dhanayoga)?
Your answer
24. Are you eligible for pension? (if yes, how much per month)
Your answer
25. Form Submission Date (select today's date)
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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