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13
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1
Name
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First Name
Last Name
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2
Date of Birth
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3
Primary Personal Email Address
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example@example.com
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4
When do you expect to start drawing income from your investments?
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Not for at least 20 years
In 11 to 19 years
In 6 to 10 years
In 1 to 5 years
Within 1 year
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5
How would you describe your level of knowledge with regard to finance and investing?
Minimal. I have very little interest in understanding finance and investing, or I have not had the opportunity to learn.
Low. I have basic knowledge of finance, such as understanding what stocks, bonds, and mutual funds are.
Medium. I have knowledge beyond basic products and I understand diversification and other financial and investing terminology and strategy.
High. In addition to understanding most financial products and terminology, I understand factors that affect the price of stocks and bonds.
Advanced. I have an in-depth knowledge of most financial products, including stocks, bonds, and options. I understand overall market risk as well as company specific risk.
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6
For how many years, if any, have you owned each of the following types of investments?
Mutual Funds
ETFs
Stocks
Bonds
Options
Variable Annuities
REITs
Limited Partnerships/Private Placements
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7
For this investment, I intend to take:
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Higher risk in return for potentially superior returns
Moderate to higher risk in return for potentially greater return
Moderate risk in return for some growth opportunity
Low risk in return for a little growth opportunity
Slight to no risk in return gor general stability of principal
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8
Assuming normal market conditions, what would you expect from this investment over time?
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To generally keep pace with the stock market
To slightly trail the stock market, but make a good profit
To trail the stock market, but make a moderate profit
To have some stability, but make modest profits
To have a high degree of stability, but make small profits
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9
Suppose the stock market performs unusually poor over the next decade. What would you expect from this investment?
To also perform poorly
To make very little or nothing
To make a little gain
To make a modest gain
To make gains, regardless of the stock market's performance
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10
Which of these statements would best describe your attitude about the next THREE YEARS' performance of this investment?
I understand a loss of principal is a realistic possibility
I can tolerate a loss
I can tolerate a small loss
I'd have a hard time tolerating any losses
I need to at least see some return
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11
Which of these statements would best describe your attitudes about the next THREE MONTH'S performance of this investment
I wouldn't worry about market fluctuations in that time frame
If my investment declined greater than 20%, I'd be concerned
If my investment declined greater than 10%, I'd be concerned
I can only tolerate small short-term fluctuations in my investment
I'd have a hard time accepting any investment declines
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12
During the decline in stock market values that took place during the Financial Crisis (from 2007 through 2009) or COVID-19 Recession (2020), what action did you take with respect to your investments?
Sold all equity holdings
Moderately decreased equity holdings
No changes
Moderately increased equity holdings
Significantly increased stock holdings
Not applicable
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13
Please feel free to add any comments, questions, or anything that will help communicate your expectations for your investments.
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