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Client Application

Welcome! Bienvenue 

No obligation whatsoever, we always do our best to guide you. 

This form is essential so we can advise you and your situation.

We only save your information if you decide to move forward.  

Otherwise it will be deleted.

Please review our privacy policy below.

Birthday
Year
Month
Day
When would you like to Retire? (Years)
0-5
6-10
11-20
20+
How much do you have saved for retirement in total?
Under $50,000
$50 - $150,000
$150,000 plus
Do you have a Spouse or Partner?
YES
NO
Do you have personal life insurance coverage?
YES
NO
UNSURE

©2025 by Planification Levesque Wealth with Rob Levesque, Owner

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