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Basic Client Information Summary

This form can be used as a quick reference to essential client information. The planner should complete a basic client information
summary form for each client and file them in a readily accessible location. This form is particularly helpful when handling day-today client matters.

Clients Last Name:


Office Telephone:
Home Telephone:
Other Telephone:

Location

Number

Clients Full Name:____________________________


Date of Birth:___________ SS#: _____-____-______
Spouses Full Name:___________________________
Date of Birth:___________ SS#: _____-____-______

Home Address:
_______________________________

Employment Information:

Employment Information:

CLIENT
Occupation:
Title:
Employer:
Address:

SPOUSE:
Occupation:
Title:
Employer:
Address:

_______________________________
_______________________________
_______________________________
_______________________________

Correspondence Sent To: ________ Home


________ Clients Office
________ Spouses Office
Childrens Name:

Advisors:
Attorney
Accountant

Approximate Gross Income:


$______________(for year ended_______)
Approximate Net Worth:
$______________(as of__________)

DOB

SS#

Phone

Name:
_______________

Telephone:
__________

Firm Name:
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________

_______________

__________

Insurance Agent

_______________

__________

Banker

_______________

__________

Investment Advisor

_______________

__________

Stockbroker

_______________

__________

Other____________

_______________

__________

_______________________________
_______________________________
_______________________________
_______________________________

Residence

Address:
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

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