Premier Vision Document

1

When Will You Retire?

1-4 Years

5-9 Years

10-19 Years

20-29 Years

30+ Years

Already Retired

2

How Are You Currently Managing Your Finances?

I Manage My Own Investments

I Utilize My Workplace Retirement Plan

I Work With A Financial Advisor

Other

3

Are You Married?

YESNO

4

Do You Own Your Home?

YESNO

5

When Investing Are You:

Most Concerned About Protecting Principal

Equally Concerned About Maintaining Principal & Growth

Most Concerned About Growth

6

Do You Have a 401(k)

YESNO

7

Approximate 401(k) Balance

8

Do You Have a Roth IRA

YESNO

9

Approximate Roth IRA Balance

10

Do You Have a Traditional IRA

YESNO

11

Approximate Traditional IRA Balance

12

Do You Have an Emergency Fund

YESNO

13

Approximate Emergency Fund Balance

14

Do You Have Investments in Non-Retirement Accounts?

YESNO

15

Approximate Non-Retirement Balance

16

Do You Have Life Insurance?

YESNO

18

What Is Your Estimated Investable Assets?

Less Than $50,000

$50,000 - $99,999

$100,000 - $249,999

$250,000 - $999,999

Over $1,000,000

19

How Much Are You Currently Saving Each Month?

Less Than $200

$200 - $499

$500 - $999

Over $1,000

21

Contact Information* This field is required.

Your Name

Your Email

Your Phone

Please Enter Your Zip Code

Anything Else You Would Like Us To Know?