美国养老 & 税务规划问卷（新移民 / 准移民）【≥55岁】 U.S. Retirement & Tax Planning Questionnaire (≥ Age 55)

本问卷用于初步了解您家庭在美国养老、税务、医疗及现金流安全方面的整体状况，以便后续规划更稳妥、更有针对性。  
This questionnaire is designed to help us preliminarily understand your household’s retirement security, tax exposure, healthcare planning, and cash-flow stability in the U.S., so that future planning can be more prudent and targeted.
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1.
电子邮件地址
第一部分｜身份 & 税务阶段 Section 1 | Residency & Tax Status
2.
当前身份 / 税务阶段（请选择最符合的一项） Current residency / tax status (please select the one that best applies)
已是美国税务居民（≤1 年）U.S. tax resident (≤ 1 year)
已是美国税务居民（1–5 年）U.S. tax resident (1–5 years)
已是美国税务居民（6–10 年）U.S. tax resident (6–10 years)
尚未成为税务居民，预计 1 年内成为美国税务居民Not yet a U.S. tax resident; expect to become one within 1 year
尚未成为税务居民，预计 3 年内成为美国税务居民Not yet a U.S. tax resident; expect to become one within 3 years
第二部分｜现金流与收入稳定性 Section 2 | Cash Flow & Income Stability  
您家庭目前的主要收入来源有：（可多选） Your household’s current main sources of income (select all that apply)
3.
美国境内收入 | U.S.-sourced income  【多选题】
美国 W-2 工资收入U.S. W-2 employment income
美国 1099 / 自雇收入U.S. 1099 / self-employment income
美国自有公司 / 企业经营收入（分红 / 股息）Income from U.S. owned businesses (dividends / distributions)
美国房租 / 不动产收入U.S. rental / real estate income
美国投资收入（股票 / 基金 / 债券）U.S. investment income (stocks / funds / bonds)
美国存款利息收入U.S. bank interest income
4.
美国境外收入 | Non-U.S. (foreign) income  【多选题】
美国境外工资收入Foreign employment income
美国境外自有公司 / 企业经营收入（分红 / 股息）Income from foreign businesses (dividends / distributions)
美国境外房租 / 不动产收入Foreign rental / real estate income
美国境外投资收入（股票 / 基金 / 债券）Foreign investment income (stocks / funds / bonds)
美国境外存款利息或理财收入Foreign bank interest or financial products
美国境外年金收入Foreign annuity income
美国境外分红型 / 储蓄型保险收入（含带现金价值）Foreign dividend-type or savings-type insurance income (with cash value)
5.
  其他 | Other  【多选题】
子女或父母支持Financial support from children or parents
已基本退休，主要依靠存量资产Largely retired, relying mainly on accumulated assets
目前无稳定收入No stable income at present
其他
说明 / Note:
收入类型仅用于初步判断税务与养老规划方向，如不确定可按大致情况选择。
Income categories are for preliminary planning purposes only. If unsure, please select the closest option.  
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6.
 您更担心以下哪种情况？（可多选） Which of the following concerns you most? (Select all that apply)【多选题】
退休后现金流不足或不稳定Unstable retirement cash flow
投资市场波动影响生活Market volatility affecting daily living
资产在账面上，但变现不方便Assets exist but are difficult to liquidate
收入来源过于单一Income sources are too concentrated
未来身体不好，需要请人照顾，但消费高，又不想给子女造成负担If my health deteriorates in the future and I need someone to take care of me, but the expenses are high, and I don't want to burden my children.
目前不太担心Not particularly concerned at this time
其他
第三部分｜资产结构 & 流动性 Section 3 | Asset Structure & Liquidity
您家庭目前拥有以下哪些资产？（可多选） Which of the following assets does your household currently own? (Select all that apply)
7.
不动产 | Real Estate  【多选题】
自住房（美国） / Primary residence (U.S.)
投资房（美国） / Investment property (U.S.)
海外房产 / Foreign real estate
8.
  金融资产（美国） | Financial Assets (U.S.)  【多选题】
现金 / 银行储蓄账户 / Cash ＆ bank accounts
投资账户（股票 / ETF / 基金 / 债券） / Investment accounts
退休账户（401(k) / IRA / Roth IRA 等） / Retirement accounts
年金 / 寿险账户 / Annuity or life insurance accounts
9.
  金融资产（美国境外） | Financial Assets (Non-U.S.)  【多选题】
海外股票 / 基金 / 债券 / 保险（带现金价值） Foreign stocks, funds, bonds, or insurance with cash value
海外养老金 / Foreign pension plans
海外公司股权 / 合伙企业 / Foreign business ownership
10.
  资产分布判断 | Asset Location  
主要资产在美国境内 / Assets mainly in the U.S.
主要资产仍在美国境外 / Assets mainly outside the U.S.
11.
  资产结构感受 | Asset Structure (55+ focus)  【多选题】
资产以增长为主，波动较大Growth-oriented, higher volatility
资产以不动产为主，现金流偏紧Real-estate heavy, limited cash flow
资产分散但结构不清晰Diversified but unclear structure
资产结构相对稳健Relatively stable asset structure
12.
您家庭目前是否有以下负债？（可多选）   Does your household currently have any of the following liabilities?【多选题】
自住房房贷 / Primary mortgage
投资房贷款 / Investment property loans
其他长期负债 / Other long-term liabilities
其他短期负债 / Other short-term liabilities
基本无负债 / No significant liabilities
第四部分｜养老“安全线”与账户结构 Section 4 | Retirement Safety Net & Account Structure
您家庭是否在美国已建立以下基础？（可多选） Which of the following foundations has your household established? (Select all that apply)  
13.
  养老账户 / 收入基础 | Retirement Accounts / Income Base  【多选题】
正在或已经积累美国社安税点Actively earning or already earned Social Security credits
401(k) / 403(b) / Traditional IRA / SEP IRA 等（税前）Pre-tax retirement accounts
Roth IRA 等（税后）After-tax retirement accounts
已配置年金（用于退休现金流）Annuities for retirement income
尚未系统配置任何美国养老工具No U.S. retirement tools systematically established
14.
  保障与风险管理 | Protection & Risk Management  【多选题】
人寿保险（Term / IUL / WL / VL）Life insurance
长期护理相关保障（LTC / 混合型）Long-term care coverage
医疗保险Health insurance
尚未系统配置任何保障工具No protection tools in place
15.
您家庭是否清楚目前的社安税点？ Are you aware of your current Social Security credits?
税点已满或接近 40Credits met or close to 40
税点明显不足Significantly insufficient credits
完全没有积累也不准备积累I have absolutely no accumulation, nor do I intend to accumulate any.
不清楚 / Not sure
第五部分｜医疗 & 长寿风险 Section 5 | Healthcare & Longevity Risk
16.
您家庭是否已经规划或正在关注以下问题？（可多选） Have you planned for or are you considering any of the following?【多选题】
Medicare 资格与衔接Medicare eligibility and transition
65 岁前后的医疗保险安排Health insurance before and after age 65
长期护理（失能 / 失智）费用风险Long-term care cost risk
医疗支出对退休现金流的影响Impact of healthcare costs on retirement cash flow
家庭成员是否需要承担照护或经济压力Potential caregiving or financial burden on family
尚未系统考虑过Not yet systematically considered
第六部分｜税务 & 通胀侵蚀 Section 6 | Taxes & Inflation Risk  
17.
您家庭是否担心以下问题？（可多选） Are you concerned about any of the following? (Select all that apply)【多选题】
退休后美国或海外退休金不足Insufficient U.S. or foreign retirement income
退休后取用资产时税率过高High taxes on retirement withdrawals
资产集中在单一税务类型账户Assets concentrated in one tax category
海外资产在美国的合规与申报风险U.S. compliance risk for foreign assets
通胀长期侵蚀养老资金Long-term inflation erosion
社安金或境外养老金税务不确定Tax uncertainty on Social Security or foreign pensions
未来政策变化带来的不确定性Policy and regulatory uncertainty
对整体税务影响不清楚Unclear overall tax impact
其他
第七部分｜养老目标 & 主要担忧 Section 7 | Retirement Goals & Concerns  
18.
对您来说，理想的退休状态更接近哪几项？（最多选 3 项）【多选题】
每月有稳定、可预期的现金流Stable, predictable monthly income
医疗和长期护理有明确安排Clear healthcare and LTC planning
市场波动不影响基本生活Market volatility does not affect daily life
不给子女增加经济或照护负担Not burdening children financially or emotionally
资产结构清晰、心里有底Clear asset structure and peace of mind
能留一部分资产给家人Leaving assets for family
其他
第八部分｜服务需求 & 规划节奏 Section 8 | Service Needs & Planning Pace 
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19.
您家庭目前更希望获得哪类帮助？ What type of assistance are you seeking?
退休安全与现金流结构评估Retirement safety and cash-flow assessment
税务 + 养老 + 医疗一体化规划 planning of taxation, retirement, and healthcare
都不需要
都需要
20.
 在不影响当前生活质量的前提下，您更倾向的规划节奏是： Preferred planning pace (without affecting current lifestyle):
以安全为先，逐步调整结构Safety-first, gradual restructuring
在 1–3 年内完成关键配置Complete key planning within 1–3 years
先解决最紧迫问题，再逐步完善Address urgent issues first, then refine
暂不清楚，需要专业建议 / Not sure; need guidance
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21.
 是否考虑与配偶一起规划养老？   Do you plan to include your spouse in retirement planning?
是 / Yes
否 / No
基本信息（用于规划参考） Basic information (for planning reference)  
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22.
  您的年龄 / Your age  
23.
  配偶年龄（如适用） / Spouse’s age (if applicable)  
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24.
期望退休的年份（如2030年）The year you expect to retire (e.g., 2030)
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25.
你的微信号
26.
您更倾向于在哪里养老？ Where do you plan to retire?
美国境内 / In the U.S.
美国境外 / Outside the U.S.
美国境内与境外相结合 / Combination of both
还没想好I haven't decided yet.
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