Legacy Wealth Survey

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All information shared is confidential and only shared with Legacy Wealth program owners.

What's High On Your Priority List?(Required)

Get Out of Debt

Stop Treading Water (Living paycheck to paycheck)

Get out of the Pay Day Loan Cycle

Save for retirement

Build a legacy of wealth

Stop working

Build a business

Grow my business

Check all that apply, we can help.

Relationship Status(Required)

Single

Engaged

Married

Separated

Divorced

Widowed

Is there someone you trust that can be an accountability partner on this journey?(Required)

Yes

No

It's okay if you don't have someone in your life that you trust in this manner right now.

How are money conversations between you and your spouse?(Required)

We make all major money decisions together

Talking about money sparks arguments

Most of the time we agree and discuss money when necessary

We pay major bills together

We manage our money separately

Any children under 18 living at home?

None

1

2

3

4

5

6+

Generally speaking, how do you feel about money?(Required)

Anxious

Don't know

Confident

Frustrated

How would you say you handle money?(Required)

I plan every dime I spend before I get the money

I have an idea of how much I owe before I get paid and I spend money based on that

I usually spend more than I make

I cannot pay my current bills

Employment Status(Required)

Full-time

Part-time

Self-employed

Stay at home

Retired

Unemployed

Could you pay for $1,000 emergency in cash today?(Required)

Yes

No

Do you have 3 or more months of expenses in savings?(Required)

Yes

No

How much do you save each month for retirement?(Required)

Under 10%

10%

More than 10%

Nothing

Not sure

Include a percentage of gross monthly income. Include savings accounts, stocks, bonds, 401Ks, 403Bs, IRAs, etc.

Living situation(Required)

Have a mortgage

We rent

Home is paid off

I live rent free with someone

Planning to purchase a home in the next 12 months?(Required)

Yes

No

Select each type of non-mortgage debt you have(Required)

Credit cards

Car loan(s)

Student loan(s)

Personal loan(s)

Medical debt

Other

I'm out of debt

Four Windows of a Financial House

Monthly Income(Required)

Please enter a number greater than or equal to 0.

Please include all sources. Paychecks, dividends, fixed income sources, etc.

Monthly Expenses(Required)

Please enter a number greater than or equal to 0.

Please include all expenses paid each month. Including subscription services, household expenses, loans, etc.

Retirement Assets(Required)

Please enter a number greater than or equal to 0.

Include all sources like 401K, IRAs, pensions, etc. Do not include

Liquid Assets(Required)

Please enter a number greater than or equal to 0.

These are assets that are easily converted into cash when needed. Including cash, savings accounts, brokerage accounts, etc.

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20015 S LaGrange Rd
#1403
Frankfort, IL 60423

(+1) 800-570-6185

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