Life Insurance Needs Assessment

At Galveston Insurance Associates, we try to anticipate your needs.  We provide insurance to protect your auto, home and other tangible assets.  We also offer a variety of products and services to insure your future.

Print and complete this form in order to help you determine what your life insurance needs may be.

1. Income

   • 50% to 70% of annual take-home pay times the number of years until you retire ___________

2. Mortgage or Rent

   • Remaining mortgage or rental until you retire __________________

3. Outstanding Debt

   • Loans, credit cards and other debts ___________________

4. Education

   • College or private school per year times number of children _________________

5. Funeral Cost

   • $8,000 - $10,000 approximately ____________________

6. Probate and Administrative Fees

   • Approximately 5% of net worth ___________________

7. Emergency Fund

   • 1/4 to 1/2 of your annual income ___________________

8. TOTAL CASH NEEDED:

   Add #1 - #7 ______________________

9. Available Assets

   • Include cash, savings, checking, retirement funds, life insurance, investments, value of home, business, other real estate ____________________________

10. POTENTIAL LIFE INSURANCE NEED:

#8 MINUS #9 _________________________