Please answer all the questions below (see red alerts).

Part 1: Cash Flow Issues

1. Do you use a monthly budget?

   Yes No

2. Do you use an annual budget

   Yes No

3. Does your budget include regular monthly expenses?

   Yes No

4. Does your budget include regular non-monthly expenses?

   Yes No

5. Does your budget include future capital expenditures?

   Yes No

6. Does your budget include special marketing expenses?

   Yes No

7. Does your budget include estimated quarterly Federal and State income taxes?

   Yes No

8. Does your budget include your retirement plan contributions?

   Yes No

9. Does your budget include staff retirement plan contributions?

   Yes No

10. Does your budget include regular emergency fund contributions?

    Yes No

11. Do you break down income and expenses by specific sources of income?

    Yes No

Part 2: Planning Issues

12. Do you generate a monthly profit and loss statement?

    Yes No

13. Has your personal and business life insurance program been reviewed in the last 12 months?

    Yes No

14. Has your disability insurance program been reviewed in the last 12 months?

    Yes No

15. Has your long-term care insurance program been reviewed in the last 12 months?

    Yes No

16. Has your retirement plan been reviewed in the last 12 months?

    Yes No

17. Do you have Errors & Omissions (E&O) coverage?

    Yes No

18. Has your property and casualty program been reviewed in the last 12 months?

    Yes No

19. Do you have an up-to-date will?

    Yes No

20. Are you satisfied with the guardian and executor of your will?

    Yes No

21. Do you generate a balance sheet at least twice a year?

    Yes No

22. Are all of your records easily accessible in the event of your death or disability?

    Yes No

Please answer the questions marked in red