Risk Tolerance Questionnaire

Name *

First Name Last Name

Account (if desired)

Email *

example@example.com

Phone Number

Area Code Phone Number

What best describes your current situation? (Select One) *

A. Income and expenses are expected to rise and investable assets are accumulating (e.g., Early Career) B. Income and expenses are relatively steady and savings are growing modestly (e.g., Mid/Late Career) C. Income and expenses are relatively steady and savings are growing significantly (e.g., Mid/Late Career) D. Income and expenses are declining and/or savings are being used to maintain desired lifestyle (e.g., Retirement)

What is your greatest concern? (Select One) *

A. Not growing my assets significantly over time; I am willing to assume higher risk for higher return potential B. Losing money in a market downturn along the way C. Losing more than a certain amount of money within a given timeframe (e.g., retirement) D. Not having more confidence about achieving my wealth goal in the remaining time

Each year, the value of your portfolio fluctuates as markets change. If you invested $500,000, which of the above portfolios would you choose? (Select One) *

A. Portfolio 1 B. Portfolio 2 C. Portfolio 3

In addition to the information already provided with respect to your preferences for certain investment types, which of the following describes you best? (Select One) *

A. I am a long-term investor focused on growing my assets B. I want to plan long-term but have a hard time shrugging off moderate to severe losses C. I need stable cash flows to meet my living expenses D. I am focused on preserving capital; I don’t mind if this approach sacrifices return potential

If I look at my account statement and there is moderate loss, my primary reaction is _________ (Select One): *

A. Do nothing. I lost money and am unhappy but willing to stick with it until a recovery B. Sell all of the investment; I don’t like losses C. Buy more; I am okay with temporary losses, because they present opportunities D. Sell half; I can’t lose all my money

If your portfolio experienced a market correction, declining 10%, how would you feel? (Select One) *

A. Anxious B. Concerned, but understand that the market does fluctuate over time C. Indifferent; I am focused on long-term growth D. Fine; short-term fluctuations do not concern me in the least

From what source was this proposed account obtained? (Select Best) *

A. Investment activities, personally taking market risks B. Entrepreneurial activities, personally taking business risks C. Inheritance or other large, one-time payment D. Accumulated savings over a long period of secure employment

If this proposed account suffered a temporary decline, could you cover your immediate cash-flow (i.e. expenses) needs from other sources of assets? (Select One) *

A. No. There are no other assets that I could use to cover my immediate cash-flow needs B. Yes. I have other assets that I could use to cover my immediate cash-flow needs, but it would be difficult to access them C. Yes. I have other assets that I could use to cover my immediate cash-flow needs D. This proposed account is not expected to fund any spending

Select your time horizon. (Select Best) *

A. Less than 3 years B. 3-8 years C. 9-15 years D. 16-20 years E. Greater than 20 years

How important is it for you to achieve the investment object for these assets? (Select one) *

A. Highly important; this is a number-one priority B. Medium importance; I would like to do this, but can live without it C. Less important; this is not necessary

Risk Tolerance Score

Risk Level	Risk Score
Low	0 - 31.99
Medium	32 - 68.99
High	69 - 100

CA Insurance Lic. #0G80589.

Securities offered through Securities America, Inc., member FINRA/SIPC. Advisory services offered through NY&A, LLC DBA Align Wealth Advisors. NY&A, LLC and Securities America are separate entities.