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CURRENT LIFE INSURANCE	 Client _____________________________	 Type: _____________	 Carrier: _____________
	Spouse ____________________________	 Type: _____________	 Carrier: _____________
When we get back together, if I can offer recommendations that, in your opinion, are better for you and your family in every way, is there any reason
we couldn’t do business?
Would you be kind enough to refer our services to 8-10 other people like you?
Date of our next meeting: Time: BPM
World Financial Group, Inc. (WFG) is a financial services marketing company whose affiliates offer a broad array of financial products and services.
Insurance products offered through World Financial Group Insurance Agency, Inc., World Financial Group Insurance Agency of Hawaii, Inc., World Financial Group Insurance Agency
of Massachusetts, Inc., World Financial Group Insurance Agency of Wyoming, Inc., World Financial Insurance Agency, Inc. and/or WFG Insurance Agency of Puerto Rico, Inc. -
collectively WFGIA.
WFG and WFGIA are affiliated companies.
World Financial Group and the WFG logo are registered trademarks of World Financial Group, Inc.
Headquarters: 11315 Johns Creek Parkway, Johns Creek, GA 30097-1517. Phone: 770.453.9300. WorldFinancialGroup.com
©2014 World Financial Group, Inc. 		 					 0900/5.16
	 Total	 Monthly
Debts	 Student Loans	 $ ___________	 $ ___________
	 Car Loans	 $ ___________	 $ ___________
	 Credit Cards	 $ ___________	 $ ___________
Income	If you or your spouse could not work again, how much income would
	 you need to sustain your current lifestyle? $ ___________/month
Mortgage	 What do you think your house is worth? $ _____________
	 What is your current balance on your home mortgage?
	 1. $ ___________ 2. $ ___________
	 Monthly payment: $ ___________
	 Type of Loan: ____ Fixed ____ Adjustable
	 Number of Years: _____________
	 Interest Rate: ________________%
Education	 Would you like to provide for your children’s education? _______
	 ____ ALL or ____ PART
	 Approximate Cost for Education: $ ___________
	 Amount Saved: $ ___________
WFG’s Mission
To help families achieve financial independence
Notes
Current Life Insurance
Financial
Checkup
A Transamerica Company
Client:Date://Associate:Code#:
Spouse:Co-Associate:Code#:
Personal Statistics
Taxable Tax Deferred Tax Advantaged
CF = College Funding Ret = Retirement Pass = Pass on to Heirs
Check Up What do you intend to do with these assets?
Please note the following about these products:
*Variable Life Insurance: Both principal and yield of investment securities will fluctuate with changes in the market
conditions, and may be worth more or less than the original investment. If tax-free loans are taken from a variable life insurance
policy and the policy lapses, a taxable event may occur. Loans and withdrawals from the life insurance policies that are classified
endowment contracts may be subject to tax at the time the loan or withdrawal is made. Early withdrawal may be subject to
surrender charges, and if taken prior to age 59 1/2 a 10% IRS penalty may apply. Withdrawals and loans have the effect of
reducing the death benefit and cash surrender value of a policy.
Variable life insurance is sold by prospectus, which contains complete information on
charges, expenses and tax consequences in relation to the policy. The prospectus should be
read carefully before investing or sending money.
**This product is offered through securities registered representatives. An investor should consider the investment objectives, risk,
and charges and expenses associated with municipal fund securities before investing. More Information about municipal fund
securities is available in the issuer’s official statement
	Total	 CF	 Ret	Pass
Savings	$ 	 	 	
Checking	$ 	 	 	
CDs	$ 	 	 	
Mutual funds	 $ 	 	 	
Stocks	$ 	 	 	
Bonds	$ 	 	 	
Treasuries	$ 	 	 	
Other	$ 	 	 	
Total	$
	 Total	 CF	 Ret	Pass
IRAs	$ 	 	 	
401(k), 403(b)s and	 $ 	 	 	
other pension plan assets
Variable Annuities	 $ 	 	 	
Fixed Annuities	 $ 	 	 	
Savings Bonds	 $ 	 	 	
Other	$ 	 	 	
Total	$
	 Total	 CF	 Ret	Pass
Roth IRAs	 $ 	 	 	
Single Premium	 $ 	 	 	
Variable Life Insurance* Cash Value
529 Plan** College	 $ 	 	 	
Savings Programs
Single Premium	 $ 	 	 	
Whole Life Insurance Cash Value
Annual Pay VUL Cash Value	 $ 	 	 	
Annual Pay	 $ 	 	 	
Whole Life Insurance and/or
Universal Insurance Cash Value
Total	 $
Tax Advantaged assets are positioned for the future since they receive
preferential tax treatment during accumulation and at distribution.
NOTE: Certain events and distributions may be subject to taxation and individuals would be responsible for the appropriate liability.
This piece provides general information regarding the Internal Revenue Code and does not take into consideration specific state
laws. World Financial Group, Inc. and its associates do not provide tax advice and strongly recommend that clients consult a compe-
tent tax advisor concerning any tax issues relating to their investments.
Tax Deferred assets are earmarked for long-term needs, such as college
funding and retirement. These assets are invested into less-liquid investments
where any growth or interest is ultimately taxable at distribution.
Taxable assets are generally positioned for current or short-term needs that
can be best served with highly liquid investment instruments.
Last Name First DOB
Spouse Name DOB Home Phone Work Phone
Address City State Zip
Employer (C) Yrs. Annual Gross Income $
Employer (S) Yrs. Annual Gross Income $
Other Income Sources
Children/Age 1. / 2. / 3. / 4. /
At what age do you plan to retire?
In today’s dollars, how much income on a monthly basis would you like during retirement?
And for how many years?

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Financial Checkup (Please email to drsimpsonwfg@gmail.com for appoinment)

  • 1. CURRENT LIFE INSURANCE Client _____________________________ Type: _____________ Carrier: _____________ Spouse ____________________________ Type: _____________ Carrier: _____________ When we get back together, if I can offer recommendations that, in your opinion, are better for you and your family in every way, is there any reason we couldn’t do business? Would you be kind enough to refer our services to 8-10 other people like you? Date of our next meeting: Time: BPM World Financial Group, Inc. (WFG) is a financial services marketing company whose affiliates offer a broad array of financial products and services. Insurance products offered through World Financial Group Insurance Agency, Inc., World Financial Group Insurance Agency of Hawaii, Inc., World Financial Group Insurance Agency of Massachusetts, Inc., World Financial Group Insurance Agency of Wyoming, Inc., World Financial Insurance Agency, Inc. and/or WFG Insurance Agency of Puerto Rico, Inc. - collectively WFGIA. WFG and WFGIA are affiliated companies. World Financial Group and the WFG logo are registered trademarks of World Financial Group, Inc. Headquarters: 11315 Johns Creek Parkway, Johns Creek, GA 30097-1517. Phone: 770.453.9300. WorldFinancialGroup.com ©2014 World Financial Group, Inc. 0900/5.16 Total Monthly Debts Student Loans $ ___________ $ ___________ Car Loans $ ___________ $ ___________ Credit Cards $ ___________ $ ___________ Income If you or your spouse could not work again, how much income would you need to sustain your current lifestyle? $ ___________/month Mortgage What do you think your house is worth? $ _____________ What is your current balance on your home mortgage? 1. $ ___________ 2. $ ___________ Monthly payment: $ ___________ Type of Loan: ____ Fixed ____ Adjustable Number of Years: _____________ Interest Rate: ________________% Education Would you like to provide for your children’s education? _______ ____ ALL or ____ PART Approximate Cost for Education: $ ___________ Amount Saved: $ ___________ WFG’s Mission To help families achieve financial independence Notes Current Life Insurance Financial Checkup A Transamerica Company
  • 2. Client:Date://Associate:Code#: Spouse:Co-Associate:Code#: Personal Statistics Taxable Tax Deferred Tax Advantaged CF = College Funding Ret = Retirement Pass = Pass on to Heirs Check Up What do you intend to do with these assets? Please note the following about these products: *Variable Life Insurance: Both principal and yield of investment securities will fluctuate with changes in the market conditions, and may be worth more or less than the original investment. If tax-free loans are taken from a variable life insurance policy and the policy lapses, a taxable event may occur. Loans and withdrawals from the life insurance policies that are classified endowment contracts may be subject to tax at the time the loan or withdrawal is made. Early withdrawal may be subject to surrender charges, and if taken prior to age 59 1/2 a 10% IRS penalty may apply. Withdrawals and loans have the effect of reducing the death benefit and cash surrender value of a policy. Variable life insurance is sold by prospectus, which contains complete information on charges, expenses and tax consequences in relation to the policy. The prospectus should be read carefully before investing or sending money. **This product is offered through securities registered representatives. An investor should consider the investment objectives, risk, and charges and expenses associated with municipal fund securities before investing. More Information about municipal fund securities is available in the issuer’s official statement Total CF Ret Pass Savings $ Checking $ CDs $ Mutual funds $ Stocks $ Bonds $ Treasuries $ Other $ Total $ Total CF Ret Pass IRAs $ 401(k), 403(b)s and $ other pension plan assets Variable Annuities $ Fixed Annuities $ Savings Bonds $ Other $ Total $ Total CF Ret Pass Roth IRAs $ Single Premium $ Variable Life Insurance* Cash Value 529 Plan** College $ Savings Programs Single Premium $ Whole Life Insurance Cash Value Annual Pay VUL Cash Value $ Annual Pay $ Whole Life Insurance and/or Universal Insurance Cash Value Total $ Tax Advantaged assets are positioned for the future since they receive preferential tax treatment during accumulation and at distribution. NOTE: Certain events and distributions may be subject to taxation and individuals would be responsible for the appropriate liability. This piece provides general information regarding the Internal Revenue Code and does not take into consideration specific state laws. World Financial Group, Inc. and its associates do not provide tax advice and strongly recommend that clients consult a compe- tent tax advisor concerning any tax issues relating to their investments. Tax Deferred assets are earmarked for long-term needs, such as college funding and retirement. These assets are invested into less-liquid investments where any growth or interest is ultimately taxable at distribution. Taxable assets are generally positioned for current or short-term needs that can be best served with highly liquid investment instruments. Last Name First DOB Spouse Name DOB Home Phone Work Phone Address City State Zip Employer (C) Yrs. Annual Gross Income $ Employer (S) Yrs. Annual Gross Income $ Other Income Sources Children/Age 1. / 2. / 3. / 4. / At what age do you plan to retire? In today’s dollars, how much income on a monthly basis would you like during retirement? And for how many years?