Asset Inventory Worksheet  
 ALTHOFF LAW - LLC
713 Sandpiper Point
Fort Collins, Colorado 80525
970/223-5913
margaret @ althoff-law.com
       [remove spaces]
Download Form
  -
right click and save as
  - 20 Kb pdf file
 

 

Ā General Information

Name

Social Security No.

Date of Birth

Citizenship

Spouseís Name

Social Security No.

Date of Birth

Citizenship

Home Address

City

State

Zip Code

Telephone Number

Business Address

City

State

Zip Code

Telephone Number

E-Mail

 
           

 Should correspondence be sent to home or business?

CHildren/Grandchildren

Date of Birth

Handicapped/Incapacitated?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

? Assets and Liabilities

 

Fair Market Value and Ownership

assets

Single

Husband

Wife

Joint[1]

Residence

$

$

$

$

Non-Income Real Estate

$

$

$

$

Income Real Estate

$

$

$

$

Other Real Estate

$

$

$

$

Cash and Savings

$

$

$

$

Money Market/CDs

$

$

$

$

Taxable Bonds

$

$

$

$

Tax-Exempt Bonds

$

$

$

$

Equities

$

$

$

$

Mutual Funds

$

$

$

$

Annuities

$

$

$

$

Options

$

$

$

$

Futures, Commodities

$

$

$

$

Personal Property (Art, Antiques, Etc.)

$

$

$

$

Retirement Plans

$

$

$

$

Business Interests

$

$

$

$

Life Insurance (Face)

$

$

$

$

Spouseís  Life Insurance (Face)

$

$

$

$

Other

$

$

$

$

Total Assets

$

$

$

$

[1] If owned with a person other than spouse, state with whom title is held 

 

Liabilities

Single

Husband

Wife

Joint

Loans

$

$

$

$

Mortgages

$

$

$

$

Margin Debt

$

$

$

$

Other

$

$

$

$

Total Liabilities

$

$

$

$

  

 

Single

Husband

Wife

Joint

Total net Worth (total assets  - total liabilities)

$

$

$

$

 


 

? Income and Retirement Plans

Annual Salary ($)

Spouseís Annual Salary ($)

Other Income ($)

Spouseís Other Income ($)

 When do you plan to retire (age and year?)________________________________

 How much after-tax spendable income do you expect to need at retirement?_______________

 How much annual income would your family need in the event of your death?________________

 

Employee Benefits

Estimated Value

Name of Participant

Pre-Retirement Death  Beneficiary

Amount of Life Insurance Included

Pension/Defined Benefit Plan/ Money Purchase

$

 

 

 

Profit Sharing Plan [401(k)]

$

 

 

 

Stock Purchase Plan

$

 

 

 

Stock Options (unexercised)

$

 

 

 

IRA

$

 

 

 

Keogh

$

 

 

 

Other

$

 

 

 

Total Value

$

 

 

 

 

? Estate  Planning Information & Objectives

 

Have you drafted a will?________________ If so, when (year)?__________ Where (state)?___________

Has your spouse drafted a will?__________ If so, when (year)?___________ Where (state)?__________

Do you and/or your spouse have any living trusts?_______ If so, when were they drafted (years)?______

What property is in the trust?_____________________________________________________________

Do you have a power of attorney?___________ If so, date of document.__________________________

Do you have a medical power of attorney?______________ If so, date of document._________________

Have you ever lived in one of the following states: Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and/or Wisconsin?

 

NOTE: If you indicated above that you and/or your spouse have a will and/or a living trust(s), please attach copies.

 

What are your financial goals?  (Please check which objective is most applicable. If more than one applies, please number in order of importance - (l) being most important and (5) being least important.

 

______ To have adequate funds to cover both living expenses and future needs.

______ To reduce taxes by taking advantage of current tax laws.

______ To provide for retirement.

______ To provide income/assets for survivors in the event of death.

______ To provide for educational costs for children/grandchildren.


 

PRIVACY NOTICE

Notices concerning a companyís privacy policies and practices are mandated by the Gramm-Leach-Bliley Act, Pub. Law 106-102 November 12, 1999 and the correlative FTC regulation, 16 CFR Part 313 (May 24, 2000). The FTC has taken the position that lawyers and law firms that undertake certain types of representation, such as estate planning and tax planning, are also required to comply with the notice provisions of the regulation. Therefore, I am providing you with the firm's policies regarding privacy of client information. 

In the course of providing you with income tax, estate tax, and gift tax advice, the firm receives significant personal financial information from you, the client. If you are a client of Margaret A. Althoff, LLC, you should know that all information that you provide to the firm is held in confidence, and is not released to people outside the firm, except as agreed to by you, or as required under an applicable law. 

The firm retains records relating to professional services that it provides so that it is better able to assist you with your professional needs and in, some cases, to comply with professional guidelines.  In order to guard your nonpublic personal information, the firm maintains physical, electronic, and procedural safeguards that comply with its professional standards.

As you are probably aware, attorneys, are bound by professional standards of confidentiality that are even more stringent than those required by this new law.  Therefore, the firm will protect your right to privacy.           

              If you have any questions regarding the firm's policies regarding privacy of client information, please do not hesitate to call me, Margaret Althoff -- 970-223-5913.


 
 

  Home   About   Services   Tutorial   Contact   Map   Testimonial   Press   Partners   Website Terms of Use


. .