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FREE Retirement Plan Analysis

Complete the form below!

Any personally identifiable information gathered by Padlock Retirement will be used for internal purposes only. We will not disclose or divulge such data outside of Padlock Retirement Consultants. Please allow our team 48 hours to create your custom report before a short review appointment with your Federal Benefit Consultant.

Free Retirement Plan Questionnaire

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Date of Birth (MM/DD/YYYY) *

Spouse's Age *

Are You Married? (Joint Tax Filing) *

Yes No Yes - but keep separate finances

Annual Salary? *

Spouse Annual Salary *

Estimated Age or Date of Retirement *

Estimated Expenses (Cost Per Month) *

Do You Own Property? *

Yes - Home No Yes - Multiple Properties

401k/403b Savings:

Current Traditional 401k/403b *

Contribution % Per Paycheck *

Current Roth 401k/403b Value *

Contribution % Per Paycheck *

Additional Assets:

Dollar Amount: *

Tax Status: *

Asset Type: *

Dollar Amount: *

Tax Status *

Asset Type *

Biggest Retirement Goal/Additional Comments *

Upload of Statements (recommended but not required) *

Max file size: 20MB

Upload of Statements (recommended but not required) *

Max file size: 20MB

Upload of Statements (recommended but not required) *

Max file size: 20MB

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Free Retirement Plan Questionnaire

401k/403b Savings:

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