Retirement Income Planning Intake Form

Retirement Income Planning Intake Form — Form Fields

This finance template includes 12 fields. Collect client information for retirement income planning with asset, income, and goal details. Free to customize and use on ZenBuild.

• Client Full Name (text, required)
• Email Address (email, required)
• Phone Number (text, required)
• Date of Birth (text, required)
• Marital Status (dropdown selection, required) — options: Single, Married/Partnered, Divorced, Widowed
• Current Age (number, required)
• Planned Retirement Age (number, required)
• Current Retirement Savings Total ($) (number, required)
• Annual Household Income ($) (number, required)
• Primary Retirement Account (dropdown selection, required) — options: 401(k), IRA (Traditional), Roth IRA, Pension, 403(b), Self-Employed Plan, None
• Other Income Sources in Retirement (checkboxes, optional) — options: Social Security, Rental Income, Part-Time Work, Annuity, Inheritance
• Retirement goals and lifestyle expectations (long text, required)