Client Profile

Client Profile

Please provide us with your information below. The more we know, the better advice we may offer. Thank you.
Name*

First NameMiddle NameLast Name
Preferred Name or Greeting
Your preferred name or greeting, example, Robert may be prefer to be called Bob
Email*
someone@example.com
Date of Birth*

MonthDayYear
The requested items below are for identification purposes.

If you prefer not to share these items via this form, please contact our Client Service Team at 1-877-566-9468. Thank you!
Social Security Number
Mother's Maiden Name
Maiden Name (If applicable)
Birthplace (City, State)
Address and Contact Information
Street Address (Required)*
Mailing Address if different than Street Address
City*
State*

Street Address

Street Address Line 2

CityState

Zip Code
Zip*
Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Type of Phone*

MobileHomeWork
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Type of Phone

MobileHomeWork
Marital Status*

MarriedSingleDivorcedWidowedCivil UnionDomestic Partnership
Spouse's Name

First NameLast Name
Spouse's Preferred Name or Greeting
Your preferred name or greeting, example, Robert may be prefer to be called Bob
Marital Anniversary

MonthDayYear
Marriage Location, City & State
Income and Employment Information
Employment Status*

EmployedSelf-EmployedRetiredUnemployedHomemakerStudent
Occupation
Employer Name
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If not employed, source of income is: (select all that apply)

AlimonyUnemploymentSocial SecurityDisabilityRetirement IncomeInvestmentsOther
U.S. Citizen*

U.S. CitizenOther
Gross Annual Income (from all sources)*

None$175,001 - 250,000Under $35,000$250,001 - 400,000$35,000 - 75,000$400,001 - 700,000$75,001 - 125,000$700,001 - 1,000,000$125,001 - 175,000Over $1,000,000
Estimated Net Worth (excluding primary residence)*

Under $50,000$700,001 - 1,000,000$50,000 - 100,000$1,000,001 - 2,000,000$100,001 - 200,000$2,000,001 - $4,000,000$200,001 - 400,000Over $4,000,000$400,001 - 700,000
Marginal Tax Bracket*

0-15%15.1-32%32.1-50%50.1%+
Investment Experience
Annuities Fixed*

NoneLimitedModerateExtensive
Annuities Variable*

NoneLimitedModerateExtensive
Equities / Stocks*

NoneLimitedModerateExtensive
Exchange Traded Funds*

NoneLimitedModerateExtensive
Fixed Income*

NoneLimitedModerateExtensive
Insurance*

NoneLimitedModerateExtensive
Mutual Funds*

NoneLimitedModerateExtensive
Options*

NoneLimitedModerateExtensive
Real Estate*

NoneLimitedModerateExtensive
United Investment Trusts*

NoneLimitedModerateExtensive
Other Investments*

I have no outside investment holdings.I have outside investment holdings, but do not wish to disclose them. I understand my financial advisor will be unable to consider this information when making recommendations.I have outside investment holdings I will share with the financial professional.
If you wish for us to consider your other investments, please upload statement(s) below, or provide to your Advisor.

Cancelof
Affiliations
Are you an associated person with Lincoln Investment?*

YesNo
Does an associated person with Lincoln Investment have a beneficial financial interest in, control trading in or have authority to make investment decisions as they relate to this account?*

YesNo
Are you related* to an associated person with Lincoln Investment?*

YesNo
Are you an associated person with, or related* to an associated person of another B/D?*

YesNo
Does an employee of FINRA, a Stock Exchange, or a state or federal securities regulatory organization have a beneficial financial interest in, control trading in or have authority to make investment decisions as they relate to this account?*

YesNo
Name of Associated Person
Relationship to Associated Person (if applicable)
Name of Broker/Dealer
Address of Broker/Dealer
*Related Person—is defined as the 1) spouse, 2) child and child’s spouse (if residing in the same household as, or is financially dependent on the associated person), 3) any related individual over whose account the associated person has control, or 4) any individual over whose account the associated person has control or contributes material financial support.
Important Note: If you are an "Associated Person" please submit a letter authorizing the opening of this account from your broker/dealer or employer with submission of this paperwork.
Are you, or anyone with an interest in this account, a Politically Exposed Person? For purposes of this question, this includes current or former: (1) senior military, governmental, or political officials; (2) his/her immediate family members; (3) his/her close associates.*

YesNo
If yes, indicate country type.

U.S.Non-U.S.
Name of the Official
Position Held
Country (if non-U.S.)
Should be Empty: