Social Security Analysis (RSSA®)

1

Your contact information

So we know where to send the completed analysis.

First name

Please enter your first name.

Last name

Please enter your last name.

Phone

Please enter a phone number.

Email

Please enter a valid email address.

Street address

City

State

ZIP code

Best way to reach you

Phone call Text Email Video meeting

Please choose one.

2

Dates of birth

Your date of birth sets your full retirement age and every credit or reduction around it. Include your spouse — couples get one combined strategy, not two separate ones.

Your date of birth

Please enter your date of birth.

Spouse's date of birth — if applicable

Your gender

Spouse's gender — if applicable

3

Marital history

This is the section people skip, and it's often where the money is. Spousal, divorced-spouse, and survivor benefits each have their own rules.

Current marital status

Married Divorced Widowed Never married

Please choose one.

Spouse's first name

Year you married

Has your spouse worked and paid into Social Security?

Yes No Some years, not many

Year that marriage began

Year it ended

Ex-spouse's date of birth — month/year is fine

Is your ex-spouse living?

Have you remarried?

Yes No

Year your spouse passed away

Their age at that time

Were they receiving Social Security when they passed?

Yes No Not sure

Their monthly benefit, if you know it — approximate is fine

Every marriage, divorce, and death — with dates List them all, including any we haven't covered above. Month and year is enough. Example: “Married 6/1979, divorced 3/1994. Married 8/1998, spouse died 11/2021.” A divorced-spouse benefit may be available if the marriage lasted at least 10 years, you're currently unmarried, and you're at least 62. That's why every date matters.

Do you have eligible children? Children under 19 and still in high school, or permanently disabled before age 22, may qualify for a benefit on your record.

Yes No

List each child's name and date of birth

4

Work and earnings

Your benefit comes from your highest 35 years of earnings. Years still ahead of you can replace low or zero years and raise the number.

Are you working now?

Yes, full time Yes, part time Self-employed Not working

Please choose one.

Approximate annual earnings

When do you plan to stop working? — or "undecided"

Do you plan to keep working after you file for benefits?

Yes No Undecided

Earnings before full retirement age can temporarily withhold part of a benefit. We'll show you how that plays out in your case.

Do you have 35 years of earnings, or are there gaps?

35 or more Fewer than 35 Not sure

Earnings detail The last year you expect to have earnings, and what you expect to earn this year. These two figures drive the projection.

You

Last age (or year) of earnings

Current year annual earnings

Spouse

Last age (or year) of earnings

Current year annual earnings

Pension from work that did not pay into Social Security Public school, some municipal or federal service, railroad, or a foreign employer. Also called a non-covered pension.

You

Yes No Not sure

Spouse

Yes No Not sure

If either of you has one, describe it — employer, monthly amount, when it starts

At tax time, do you typically get a refund or owe? Helps flag whether withholding on Social Security or other income may need adjusting.

Usually get a refund Usually owe About even Not sure

Roughly how much, most years? (optional)

5

Your Social Security statement

The most accurate analysis comes from your own earnings record. If you don't have your statement yet, the steps below will get you one — and we can start with estimates in the meantime.

Do you have your Social Security statement?

Yes — I have it in hand I have an ssa.gov account but haven't downloaded it No — I don't have an account yet I'm not sure what that is

Please choose one.

How to get your statement — about 10 minutes

Go to ssa.gov/myaccount and choose Create an Account.
You'll sign in through Login.gov or ID.me. Have your Social Security number, a photo ID, and your phone nearby — they send a code to confirm it's you.
Once you're in, open Your Social Security Statement. Look for the option to Download XML — that's the one we want. If you only see Download PDF, take that instead; it still works.
Send us the file using either option below.

Why XML? The XML file lets us import your year-by-year earnings record exactly as Social Security has it, with no retyping and no transcription errors. The PDF works too — XML is just faster and more accurate.

Prefer paper? Call Social Security at 1-800-772-1213 and ask them to mail your statement. It takes a few weeks, so start that now and we'll begin with estimates.

Stuck on identity verification? It trips up a lot of people, and this account has to be created by you, in your own name. Say so in the last section and James will walk you through it on the phone.

Send it over using either option below and we'll build the analysis from your actual earnings record rather than an estimate.

Upload your statement — XML preferred, PDF or a photo also fine A clear phone photo of a paper statement works too.

Which format are you sending?

XML from ssa.gov PDF Photo / paper copy Not sending one yet

Spouse's statement — if you have it A couple's strategy needs both earnings records to be accurate.

Or email it to us instead

Send to jrbinsurancehelp@gmail.com with your name in the subject line and we'll match it to this request.

I'll email my statement separately

Your estimated monthly benefit at full retirement age — if you have it

Spouse's estimated benefit at full retirement age

6

Benefits you're already receiving

If a claim is already in place there may still be options — suspending, switching, or coordinating with a spouse.

Are you currently collecting Social Security benefits?

You

Yes No

Spouse

Yes No N/A

Your start date

Your current monthly amount

Whose earnings record is your benefit based on?

My own record My spouse's record Not sure

Spouse's start date

Spouse's current monthly amount

Whose earnings record is your spouse's benefit based on?

Their own record My record Not sure

If you're not collecting yet — when do you plan to file? Your best guess is fine. This is the assumption we test against every other option.

You

Age you plan to file

Spouse

Age they plan to file

Other claiming ages you want compared Tell us any specific ages you're weighing and we'll model those alongside the optimal one.

Are either of you receiving any of these?

Social Security disability (SSDI) A spousal benefit A survivor (widow/widower) benefit Supplemental Security Income (SSI) A child is receiving a benefit on our record None of these

Are you enrolled in Medicare?

Yes, Part A and B Part A only Not yet

Part B premiums come out of your Social Security check, so the two decisions are connected. Sign-up guide →

7

The rest of your retirement picture

Social Security rarely stands alone. Knowing what else is coming in tells us whether you can afford to let a benefit grow.

Other income you expect in retirement

Do you have any retirement savings accounts?

Yes No

Do you own any real estate?

Yes No

Do you have any significant debt other than what you've already told us about?

Yes No

Age you'd like to retire

Anticipated monthly expenses once you (both) stop working — approximate, combine with a spouse if applicable

If you delayed Social Security a few years, could your other income cover the gap?

Yes, comfortably Maybe, it would be tight No, I need the income now That's what I want to find out

Are you concerned about your income in retirement?

Yes No

Do you have a will, trust, or any estate planning documents in place?

Yes No

Do you have life insurance or long-term care insurance coverage?

Yes No

Are you currently providing care or financial support to a spouse, parent, or other family member?

Yes No

Is there anything else you'd like to share about your retirement goals, family situation, or concerns related to Social Security?

8

Health and family history

Nobody knows their own timeline. But the claiming math is sensitive to it, so we run the comparison across a range rather than a single guess.

How would you describe your general health?

And your spouse's?

Projected maximum age of life The whole comparison turns on how long the money has to last. Rather than guess, take the free calculator at livingto100.com — about 10 minutes — and put the result here. Leave it blank if you'd rather we use standard tables.

You

Projected age

Spouse

Projected age

Have your parents or grandparents generally lived into their late 80s or beyond?

Yes No Mixed

9

What matters most to you

There's no single best filing age — only the one that fits what you're trying to protect. Choose as many as apply.

The largest total over our lifetimes Income starting as soon as possible Protecting the survivor income for whoever outlives the other Keeping taxes on my benefits down Coordinating with Medicare premiums Leaving more to my children or heirs Honestly, I just want to understand my options

Questions you want answered

When would you like to review the analysis together?

Anything else you'd like information about? Optional, and checking a box doesn't commit you to anything — it just tells James what to bring up when you talk. He'll send you the right form for whatever you pick.

Medicare Individual/family health (ACA) Dental, vision & hearing Annuities / retirement income Life insurance Long-term care Nothing else right now

10

Two ways to get your analysis

Same report either way. The only question is who pays for it.

On its own

$1,199

Invoiced after we review the report together — nothing due up front.

How most clients get it

Included with coverage

$0

Place an annuity, Medicare, or health plan through our office and ~~$1,199~~ comes off entirely. Your premium is the same either way — rates are set by the carrier and regulated by law.

Which describes you?

I'm already a client of yours I'm looking at an annuity, health plan, or Medicare coverage with you Neither — I just want the analysis Not sure yet — let's talk about it

Please choose one.

Request your Social Security analysis

Your contact information

Dates of birth

Marital history

Work and earnings

Your Social Security statement

How to get your statement — about 10 minutes

Benefits you're already receiving

The rest of your retirement picture

Health and family history

What matters most to you

Two ways to get your analysis

On its own

Included with coverage

You get one shot at this decision. Let's get it right.