New Client Intake Form – Lake Road Advisors

This field is for validation purposes and should be left unchanged.

Client Name*

Email*

Drivers License #*

Drivers License State*

Child's First Name

Child's Last Name

Additional Child's First Name

Additional Child's Last Name

Additional Child's First Name

Additional Child's Last Name

Employer

Significant Other First Name*

Significant Other Last Name*

Significant Other Occupation*

Significant Other Phone Number*

Significant Other Drivers License #*

Significant Other Drivers License State*

State Estate Plan Completed In

Why Did You Choose To Work WIth LRA Over Other Providers?

Documentation Collection

Please upload any of the following documents you may have (don't worry if you don't have all of these now, you can upload them at a future date): Firm Benefit Info - Disability, Health, 401k plan, Life Insurance, HSA, Stock/Option/Incentive Plans; Life Insurance Policies; Home & Auto Policies (Declaration Pages); Latest Tax Return; Recent Pay Stub;

Drop files here or

Max. file size: 256 MB.

Please upload any of the following documents you may have (don't worry if you don't have all of these now, you can upload them at a future date):

Firm Benefit Info - Disability, Health, 401k plan, Life Insurance, HSA, Stock/Option/Incentive Plans
Life Insurance Policies
Home & Auto Policies (Declaration Pages)
Latest Tax Return
Recent Pay Stub

Upload your files to RightCapital here.