D. DEBTS

This is referring to any debts that you might have outside the mortgage (car loan, credit cards, student loans, etc.). If we were going to write you a check to pay off all debts (excluding your mortgage) how much would that check be for?

Total Debt: $

I. Income Replacement

After paying off your debt, if we could bring your family a check every month to cover normal living expenses - how much would that monthly check need to be? And, for how many years?

Monthly Amount: $ For How Many Years: = $

M. Mortgage Protection

What is your current balance that you owe the bank for your mortgage?

Mortgage: $

E. Education

What do you feel would be an adequate amount to set aside for your children's education? $50,000? $100,000? What is the approximate amount that you have already established in a college savings?

Adequate Education: $ - Amount Saved: = $

E. Expenses - Final

On average, we allocate around $10,000-15,000 to cover final expenses.

Final Expenses: $

ESTIMATED TOTAL INSURANCE NEED: $