Instructions Client Review Checklist for All Financial Representatives

CLIENT REVIEW CHECKLIST

NAME /

DATE

HOME PHONE

/

BUSINESS PHONE

FAX NUMBER

/ EMAIL ADDRESS
( ) Changed my residence. New address: / ( ) Changed my business. New address:
( ) Changed my home phone to: / ( ) Changed my business phone to:
( ) Added to my family (including grandchildren) / ( ) Changed job status/been promoted
( ) Change marital status / ( ) Started a new business
( ) Change beneficiary / ( ) Review business life or disability insurance
( ) Review personal life or disability insurance / ( ) Incorporated my business
( ) Changed my will/trust / ( ) Added/Dropped an associate
( ) Purchased real estate for investment / ( ) Drawn up/changed my buy-sell agreement
( ) Purchased real estate for business use
I would like to discuss:
( ) Life insurance / ( ) Retirement funding
( ) Converting term insurance / ( ) Business planning
( ) Disability income insurance (individual/group) / ( ) Charitable giving
( ) Long-term care insurance / ( ) Health insurance
( ) Estate planning / ( ) Investment Planning
( ) Employee/Employer/Executive benefits

( ) Please call me. I have questions or would like to schedule a review.

( ) Nothing has changed since my last review.

( ) Referral: Please contact ______who might be interested in your services.

Comments:

You can submit this form three ways:

Email:
1.  Save the completed document to your computer
2.  Send it as an email attachment to / 3.  / Mail:
Northwestern Mutual
Penntower Bldg
3100 Broadway St Ste 711
Kansas City, MO 64111
Attn: Jeri Evans / Fax:
Fax: 816-412-1525