Guiding you through life.
FACT FINDER
NEEDS ANALYSIS
Advanced Markets
Basic Needs Analysis
Planning For Your Loved Ones
Client Information (Client A)
Client Information (Client B)
First Name:
First Name:
Last Name:
Last Name:
Gender:
DOB/Age:
Gender:
DOB/Age:
Underwriting Risk Class* (Legend on back page):
Underwriting Risk Class* (Legend on back page):
Retirement Age:
Retirement Age:
Inflation Rate (used to index income streams):
%
Income Replacement
Inflation Rate (used to index income streams):
%
Income Replacement
After-Tax Insurance Investment Rate
(for present value calculation):
%
After-Tax Insurance Investment Rate
(for present value calculation):
%
Tax Bracket :
%
Tax Bracket:
%
Salary to Replace: $
Salary to Replace: $
Years to Replace Salary:
Years to Replace Salary:
Index for Inflation:
Yes
No
Index for Inflation:
Yes
Estate Administration
Estate Administration
Funeral/Burial Needs: $
Funeral/Burial Needs: $
Probate: $
Probate: $
Other Expenses: $
Other Expenses: $
Existing Life Insurance: $
Existing Life Insurance: $
Existing Assets Set Aside for Needs at Death: $
Existing Assets Set Aside for Needs at Death: $
No
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NEEDS ANALYSIS
Other Needs at Death (Client A)
Other Needs at Death (Client B)
Child Care:
Child Care:
❙ Amount Per Year: $
❙ Amount Per Year: $
❙ Years to Replace:
❙ Years to Replace:
Short-Term Debt
(loans, credit cards): $
Short-Term Debt
(loans, credit cards): $
Other Debt
(mortgage, home loans): $
Other Debt
(mortgage, home loans): $
Other Expenses
(emergency funds, gifts): $
Other Expenses
(emergency funds, gifts): $
College Fund Amount:
College Fund Amount:
Lump Sum: $
(OR)
Schedule: $
Lump Sum
(OR)
Schedule
% to Cover:
Product:
Advanced Markets
%
UL
VUL
Specify
% to Cover:
Product:
%
UL
VUL
Specify
Other Comments:
Advisor Contact Information
First Name:
Last Name:
Company:
Address:
City, State and Zip Code:
Phone:
Fax:
Email:
* Underwriting Legend:
Super Preferred Non Smoker
Preferred Non Smoker
Standard Plus Non Smoker
Standard Non Smoker
Preferred Smoker
Standard Smoker
Uninsurable
© 2012 John Hancock. All rights reserved.
Insurance products are issued by: John Hancock Life Insurance Company (U.S.A.), Boston, MA 02116 (not licensed in New York) and John Hancock Life Insurance Company of New
York, Valhalla, NY 10595.
IM7022 MLINY03041318242 03/13
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