About your spouse
First name: Last name:
Sex:
Male Female
Date of birth (mm/dd/yy): ________ / ________ / ________
What life expectancy are you planning for? ______ years _______months
Use average (Men=86 years, Women=89 years)*
Have you already started Social Security benefits? Yes No If yes, at what age? _____ Filing date:____ /____ /____
If so, how much is the monthly benefit you’re currently receiving? $___________
Government or Nonprofit Employees/Former Employees
Do you have a pension from employment in which you did NOT pay Social Security taxes?
Yes No
If yes, Page 3 of your SS benefit statement, “Your earnings statement,” should be included with this fact finder to ensure a more accurate report.
What is the name of the pension/employer? ______________________ What is the monthly pension amount?
$
_______
When does this pension start?
___________ What is the projected cost-of-living adjustment for this pension? $_______ %
Your spouse’s earnings
For this section, please refer to a current Social Security benefit statement.
Statement date: ______ / ______ / ______ Your estimated monthly benefits at full retirement age: $___________
At what age do you plan to stop working?
__________________
If you’re planning to work after 62, what is your anticipated annual employment income? $_________________
If you’re widowed
If eligible for survivor benefits, you will need proof of marriage and death to retrieve benefits for a deceased spouse when you visit your local SSA oce.
Deceased spouse’s date of birth (mm/dd/yy): _____ / _____ / _____
How long were you married? _______ years _______ months
What monthly benefit amount would you receive if you elect widow’s benefits at your full retirement age? $_______________
What is the monthly primary insurance amount (PIA) of your deceased spouse? $_________________
If you’re divorced
You may be eligible for benefits based on an ex-spouse’s record, if you were married for at least 10 years. You will need proof of marriage and divorce to
retrieve information and benefits for an ex-spouse when you visit your local SSA oce.
Ex-spouse’s date of birth (mm/dd/yy): _____ / _____ / _____
What is your ex-spouse’s anticipated life expectancy? _______ years _______ months
Deceased
How long were you married? _______ years _______ months
At what age does your ex-spouse plan to claim benefits? _______ years _______ months
What monthly benefit amount would you receive if you elect spousal benefits at your full
retirement age (or soonest available if you are more than 6 years older than your ex-spouse)? $_________________
TheinformationcollectedonthisfactfinderwillbekeptconfidentialandusedtoprovideanestimateofyourSocialSecuritybenefitsinretirementFormore
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Investorsshouldworkwiththeirfinancialprofessionaltodiscusstheirspecificsituation
Thisisbeingprovidedforinformationalpurposesonlyandshouldnotbeconstruedasinvestmenttaxorlegaladvice
Theinformationprovidedisbasedoncurrentlawswhicharesubjecttochangeatanytimeandhasnotbeenendorsedbyanygovernmentagency
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