Life Stages and Event Inventory

This inventory can help you take stock of your life and determine if there are any recent or upcoming life events or life stage changes that require you to reevaluate your current insurance protection. Whether you complete this form and return it to us, or simply use it as a self-evaluation tool, we think you’ll find it helpful in focusing your attention on potential needs you have that may otherwise be overlooked.

Any of the following life events could mean a change in your financial needs.

Let us know which of these events you’ve experienced in the past year.

  • New child or grandchild
  • New job or promotion
  • Received an inheritance
  • Experienced an investment gain or loss
  • Health concerns
  • Married or divorced
  • Changed your estate plan
  • Bought or sold a home
  • Started or purchased a business
  • Sold or acquired assets
  • Kids off to college
  • Financial windfall
  • Death of a family member
  • New investments or insurance
  • Retired
  • Gained or lost a business partner
  • Other

What is your current life stage?

  • Student
  • Starting out
  • Established professional
  • Domestic partnership
  • Married
  • Suddenly single
  • Empty nesters
  • Caring for aging parents
  • Retired

What are your financial planning objectives? Check all that apply.

  • Retirement planning
  • Estate planning
  • Major asset purchase or lease
  • Business and executive benefits
  • Personal property or liability insurance
  • Education funding
  • Income tax planning
  • Planning for elderly parents
  • Business continuation
  • Disability income
  • Investment review
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Name
Date Of Birth
Address
Do you have group life insurance through work?
Payment Method*
American Express
Discover
MasterCard
Visa
Maestro
Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro
 
Credit Card
American Express
Discover
MasterCard
Visa
JCB
Maestro
Supported Credit Cards: American Express, Discover, MasterCard, Visa, JCB, Maestro
Expiration Date
 

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