Orchestrate Retirement Harmony Lloyd Advisory Group Step 1 of 7 14% Client Name(Required) Full Name Age(Required)Nickname First Date of Birth(Required) MM slash DD slash YYYY Date Retired/Planned(Required) MM slash DD slash YYYY Occupation Email Address(Required) Favorite Hobby Spouse's Name Full Name AgeNickname First Date of Birth MM slash DD slash YYYY Date Retired/Planned MM slash DD slash YYYY Occupation Email Address Favorite Hobby Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone (Home)(Required)(Cell)Wedding Anniversary MM slash DD slash YYYY Any Pets? Yes No How Did You Hear About Us?(Required) Children's Name and AgesGrandchildren's Name and Ages Personal QuestionsDo you have a financial advisor? Yes No Who is your current financial advisor? Do you have an attorney? Yes No Do you have an accountant? Yes No Do you have a living trust? Yes No Do you have a will? Yes No Do you have income from real estate? Yes No Do you expect to care for a child or a parent? Yes No Do you expect an inheritance? Yes No Please answer the following questions:What do you think a reasonable rate of return is?Please enter a number from 0 to 100.Your spouse?Please enter a number from 0 to 100.What percentage of your money would you be OK with losing?Please enter a number from 0 to 100.Your spouse?Please enter a number from 0 to 100.How much short-term, immediate cash do you want available?Please enter a number greater than or equal to 0.Your spouse?Please enter a number greater than or equal to 0.Please rank the following items from 1-3 based on what is most important to you (1=most important, 3=least important)Protection from LossReturnLiquidity Add RemoveWhat do you want your retirement assets to accomplish? What are the goals for your assets?What does your spouse want their retirement assets to accomplish? Please answer the following questions:What is the main concern with your assets and retirement nest egg?What is your spouse's main concern with their assets and retirement nest egg?Knowing what you know now, what would you have done differently with your money?There are four things you can do with your nest egg. Which two are the most important to you and your spouse?Spend itPass it on to family though inheritance or giftingPurchase financial products with risk of loss to principalPurchase financial products, including insurance products with risk of loss to principalWhat my spouse and I REALLY want from my financial coach is:How would you want to be remembered?Your spouse?Who is the most important in your life? Your spouse? We are an independent financial services firm helping individuals create retirement strategies using a variety of investment and insurance products to custom suit their needs and objectives. We do not provide tax or legal advice and encourage all individuals to seek professional guidance regarding decisions about their personal situation. Advisory services offered through Lloyd Advisory Services, LLC. The Lloyd Group, Inc. and Lloyd Advisory Services, LLC. are affiliated. The Lloyd Group, Inc. is an independent licensed insurance agency.CommentsThis field is for validation purposes and should be left unchanged. Δ Contact Us Phone: 770-932-0387Toll Free: 800-731-5572Email: heidi@lloydadvisorygroup.com