First Name *

Last Name *

Phone *

Email Address *

What are your investment objectives? *
Receive current incomeInvest for future retirementGrowth and incomeFinance and educationWealth accumulationOther

What is your current household income?
—Please choose an option—Under $25,000$25.000-$49,999$50,000-$99,999$100,000-$249,999$250,000-$499,999$500,000+

What is your approximate net worth? (excluding your primary residence)
—Please choose an option—Less than $50K$50K-$100K$100K-$250K$250K-$500K$500K-$750K$750K-$1M$1M-$1.5M$1.5-$2M$2M-$3M$3M-$5MGreater than 5M

What is your federal income tax bracket?
—Please choose an option—10%15%25%28%33%35%

What is your investment experience?
—Please choose an option—NoneLimited investment experienceModerate investment experienceExtensive investment experience

Time Horizon

When do you expect to begin withdrawing money from your investment account?
—Please choose an option—Less than a year1-3 years4-6 years7-10 yearsMore than 10 years

For how many years will you be making the withdrawals?
—Please choose an option—I plan to take a lump sum distribution1-3 years4-6 years7-10 yearsMore than 10 years

How much do you rely on income from this investment?
—Please choose an option—Not at allSomewhatHeavily

Risk Tolerance

Investment decisions involve a trade-off between risk and return. Risk is any possibility of loss to your portfolio value. Return is the amount earned or profit on an investment. Generally, investments with the highest potential for gains carry the greatest risk of loss.

Indicate the response that you feel best describes your risk tolerance:
—Please choose an option—ConservativeModerately ConservativeModerateModerately AggressiveAggressive

What is your annual investment return expectation relative to inflation?
—Please choose an option—Satisfied with investments keeping pace with inflationLike investments to moderately outpace inflation and am willing to accept some long term risk to achieve this goalPrefer investments to significantly outpace inflation and am willing to accept moderate long-term risks to achieve this goalDesire investments to achieve highest performance possible and am willing to accept substantial long term risk to achieve this goal

How strongly do you agree or disagree with the following statement: “I am willing to lose larger sums of money in the short term if I can enjoy potentially higher returns in the long term.”
—Please choose an option—Strongly AgreeAgreeDisagreeStrongly Disagree

Which hypothetical portfolio are you most comfortable with, considering the possible outcomes of $100,000 invested for 5 years:
—Please choose an option—Worst Case: $50,000 - Best Case: $300,000Worst Case: $75,000 - Best Case: $250,000Worst Case: $100,000 - Best Case: $200,000Worst Case: $110,000 - Best Case: $150,000

What is your investment priority?
—Please choose an option—Increasing returnsPrimarily increasing returns while also reducing riskPrimarily reducing risk while also increasing returnsReducing risk

Historically, markets have experienced downturns, both short-term and prolonged, followed by market recoveries. Suppose you owned a well-diversified portfolio that fell by 20% (i.e. $100,000 initial investment would now be worth $80,000) over a short period, consistent with the overall market.

From the above scenario, assuming you still have 10 years until you begin withdrawals, how would you react?
—Please choose an option—I would not change my portfolioI would wait at least 1 year before changing to options that are more conservativeI would wait at least 3 months before changing to options that are more conservativeI would immediately change to options that are more conservative

Which of the following statements best describes your attitude towards long-term investing?
—Please choose an option—I am willing to accept the lower returns associated with conservative investments that have minimal chance for loss of principalIn order to pursue moderate returns, I am willing to accept moderate fluctuations in the value of my investmentsIn order to pursue moderately high returns, I am willing to accept significant fluctuations in the value of my investmentsIn seeking maximum returns, I am willing to accept large fluctuations in the value of my investments and substantial risk of loss to principal

If a unique circumstance were to require an amount of capital equal to at least one-fourth the value of this portfolio, where would you obtain the money?
—Please choose an option—I cannot envision a circumstance that would require that much capitalAll from this portfolioThe majority from this portfolioFrom other savings/investmentsLess than half for this portfolio, and the remainder from other savings and investments

Investments generate returns in different ways. Which of the following more closely describes your view?
—Please choose an option—Dividend yields and interest is better suited for meeting living expenseOverall return is my primary concern; it doesn’t matter where it comes from or how it is employed to meet any cash flow needs I may have

Describe the kind of risk which with you are comfortable:
—Please choose an option—I could handle being down over a three-year period, but not longer.I could handle a one-year loss, but do not want to pursue a strategy that could result in longer periods of loss.I could handle losses over one or two quarters, but would not be comfortable subjecting myself to longer down periods.I don’t want to lose any money ever. I could handle only a very small loss over a few months at most. I could accept being down over longer than three years if my long-term return potential was above average.