“My knowledge and experience enables me to provide INDEPENDENT Risk Management Options to individuals, families and small businesses in Michigan”

William E. Taylor III MA CLTC     bill@riskomo.com         810-360-0507

Before I meet with clients I encourage them to take a few minutes with their spouse and answer the Questionnaire or Questionnaires that apply.

Risk Management Life Questionnaire (Non Business owners)

1)Are you married or have a significant other?______

2)Do you have children?_______grandchildren? _________

3)Is it important to you that a Life Insurance policy be in place when you die? ______

4)Is it important to you to buy the most Life Insurance for your $s invested?_______

5)What is your Annual Income?_______

6)How many more years do you plan on working?________

7)What are your financial assets? $401K Q assets _________ N/Q assets________

Roth IRA assets ________ Total assets________

8)Are your Parents healthy?________

9)Is leaving a financial legacy important to you?________

10)How much Life Insurance do you have in place at work _________ own _______

Risk Management Disability Questionnaire (Non Business owners)

1) Have you reviewed your workplace Disability Policy in the last 12 months? ________

2) Does your workplace Disability Ins. Policy require that you accept any job? _______

3) Do you have the option to increase benefits with the workplace DI Policy?________

4) Are your monthly household expenses greater than 50% of you paycheck?________

5) Could you scale back on your expenses if you were disabled?________

6) If you are married could your spouse make up the difference in lost income? _______

7) In case of a disability could you still contribute to your retirement?________

8) In case of a disability could you still contribute to the children’s education? _________

9) Is your home in jeopardy of foreclosure with an extended disability?_________

10) Do you participate in sports such as jogging, skiing, and biking?­­­________

Risk Management Long Term Care Questionnaire (Non Business owners)

1) Are your financial assets less than $50,000 excluding your residence?________

2) Are your financial assets greater than $1M excluding your residence?________

3) Have you or your spouse reached your 50th birthday?________

4) Do you have children? _______Girls ______Boys______

5) Does either side of the family have a history of long life expectancy?_________

6) Does either side of the family have a history of nursing home care?__________

7) Will your home be paid off in retirement?_______ When?__________

8) Has any person promised to care for you when you need help?_________

9) Do you have a desire to help fund the grandchildren’s education?_________

10) Is leaving a financial legacy important to you?_________

Do you own a Personal Umbrella Policy (with a Homeowners Insurance Policy)_________

William E. Taylor III MA CLTC       bill@riskomo.com        810-360-0507