Financial Planning Inventory



Fill this form out the best you can. There are no right or wrong answers.? This is only so I can better help you. Where you are at today with your money is not nearly as important as where you want to be. We will work together to get there. Which 3 of these would you most like to work on?Work and get off cash benefits Have more money for things I want to buyManage my money betterPay my bills on timePay off my debtsImprove my creditSave for the futureGet insurance (health, life, etc.)Get taxes done Buy a homeStart my own businessGo to college/vocational trainingKeep my house or apartmentWork and keep my cash benefitsOther___________________________________________________________Do you understand what will happen to your benefits (Social Security, MA, Housing, SNAP, etc.) when you work?YesA littleNoNot a concernHave you ever heard of work incentives (e.g., earned income disregard, trial work period, impairment related work expense, etc.)?YesNoHave you ever had a personal or family budget?Yes, and I use it regularlyYes, use it only a littleNo, but would like oneNo, not interestedDo you get help with your money?Yes, I have a representative payee who gets my money and manages it for meYes, someone other than a representative payee helps meNo, but would like helpNo, help not neededIf you needed $1000 for an unexpected emergency, where would you get it?My savingsSell or cash out an asset, like a carBorrow from family/friendCredit card, payday loan, or other debtGo to the countyI don’t knowOther___________________________________________________________Check all that you have/use:Checking accountSavings accountCredit cardDebit/ATM CardElectronic banking/bill payingCheck cashing/pay day lender, pawn shop, refund anticipation loanStocks/bondsMutual fundMoney market accountCertificate of deposit (CD)Who does your taxes?Free tax servicesPaid tax preparerMyselfI don’t do my taxesDo you qualify for an Earned Income Tax Credit?YesNo, I don’t qualifyI don’t know Have you ever gotten the Earned Income Tax Credit?YesNoDon’t know Describe your credit:Good, I pay all bills on timeFair, I pay most of my bills on timePoor, I have bills I haven’t paidI don’t know When is the last time you checked your credit score?Past 12 months2 years or moreNever Do you have any loans (car, home, student, personal)?Yes, working on paying it offYes, in default or unable to payYes, but discharged due to disabilityNo Which of these do you have or have you used?Assistive technology loan programIndividual Development Account (IDA)Lifelong learning accountDirect Express EBT CardFamily Self-Sufficiency ProgramPlan for Achieving Self Support (PASS)College savings plan (529)Special Needs TrustFederal Home Loan BanksABLE AccountNone of the above Is there anything else you would like me to know about your situation? NoYes ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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