RISK PROFILE QUESTIONNAIRE

RISK PROFILE QUESTIONNAIRE
Client Name/s:*
Email*
example@example.com
Please select ONE answer to each of the following questions.
SECTION 1: FINANCIALS
1. What is your approximate net worth (excluding your principal residence)?*

Under $100K$100K - $300K$300K - $500K$500K - $750K$750K - $1.0M$1.0M - $3.0MOver $3.0M
If greater than $3M enter amount:
2. What is your liquid net worth? (assets that can be readily converted to cash)*

Under $25K$25K - $50K$50K - $100K$100K - $250K$250K - $500KOver $500K
If greater than $500K enter amount:
3. What is your current household income?*

Under $50K$50K - $100K$100K - $150K$150K - $250K$250K - $500KOver $500K
4. What is your federal income tax bracket?*

10%12%22%24%32%35%37%
5. If you needed immediate funds equal to 1/4 the value of your investment accounts, where would you obtain the money?*

All from this portfolio (0)At least 75% from this portfolio and the remainder from other savings and investments (1)50% from this portfolio and the remainder from other savings and investments (2)Less than 25% from this portfolio and the remainder from other savings and investments (3)All from other savings and investments (4)
Section 1 TOTAL
SECTION 2: GOALS
1. What is your investment objective?*

Preserve Principal (0)Income (3)Income and Growth (6)Growth (9)Aggressive Growth (12)
2. When do you expect to begin withdrawals on a regular basis from your investment accounts?*

Less than 1 year (0)1-3 years (3)4-6 years (6)7-10 years (9)More than 10 years (12)
3. Today, how much do you rely on income from your investment accounts?*

Heavily (0)Moderately (1)Slightly (2)Not at all (4)
Section 2 TOTAL
SECTION 3: RISK TOLERANCE
1. What is your investment experience?*

NoneLimitedModerateExtensive
2. Indicate the response that you feel best describes your risk tolerance.*

Conservative (0)Moderately Conservative (2)Moderate (4)Moderately Aggressive (6)Aggressive (8)
3. Based on the picture above, which hypothetical portfolio are you most comfortable with, considering the possible range of returns, for $100,000 invested, over a 1-YEAR period?*

A (0)B (1)C (2)D (3)E (4)
4. Generally, investments with the highest potential for gains carry the greatest risk of loss. Based on the picture above, which hypothetical portfolio are you most comfortable with, considering the possible outcomes of $100,000 invested for 5 YEARS:*

A (0)B (3)C (6)D (9)E (12)
5. Historically, markets have experienced sharp, short-term downturns. If your investment portfolio lost 25% of its value over TWO DAYS, how would you react?*

I would immediately move all my holdings to cash (0)I would immediately change to strategies that are more conservative (3)I would wait at least 3 months before deciding to make any changes (6)I would immediately change to strategies that are more aggressive (9)I would immediately add to my investment portfolio and buy more equities to take advantage of the lower prices (12)
6. Historically, markets have experienced prolonged periods of declines. If your investment portfolio lost 33% of its value over the last 3 MONTHS, how would you react?*

I would immediately move all my holdings to cash (0)I would immediately change to strategies that are more conservative (3)I would wait at least 3 months before deciding to make any changes (6)I would immediately change to strategies that are more aggressive (9)I would immediately add to my investment portfolio and buy more equities to take advantage of the lower prices (12)
Section 3 TOTAL
YOUR SCORE TOTAL FROM ALL SECTIONS:
I understand that the above-referenced Risk Profile Questionnaire acts as a guide only to building an overall financial solution. I recognize that there are other factors to consider besides my score on this questionnaire when making portfolio decisions. I understand that my responses to the Risk Profile Questionnaire provided by my investment advisor representative indicates that my risk tolerance is:*
If you disagree with your risk tolerance as calculated, check this box

I disagree
I disagree with the above assessment and would like to indicate my risk tolerance as:
My reasoning for disagreeing with this assessment is:
Signature

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Signature - Client #2 (if applicable)

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RISK PROFILE QUESTIONNAIRE

SECTION 1: FINANCIALS

SECTION 2: GOALS

SECTION 3: RISK TOLERANCE