Investor Profile Questionnaire

1
Your Name
First Name
Last Name
2
Spouse's Name
First Name
Last Name
3
Your Age
4
Spouse's Age
5
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Phone Number
Area Code
Phone Number
7
Preferred Contact Method
Phone
Email
Text
8
Your Current Employer
9
Your Job Title
10
Approximate Annual IncomeGross - before withholding
11
Spouse's Employer
12
Spouse's Job Title
13
Spouse's Approximate Annual IncomeGross - before withholding
14
Do you or your spouse expect any significant changes to your income in the next 5 years? If so, please explain.
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Large
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Small
Ok
Ok
15
Do you or your spouse have a retirement plan (or plans) through work (403b, 401k, pension) or previous employment? If so, please tell us as much as you know about your plan(s), including balances, vesting schedules, annual contributions, employer matching etc.
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Ok
16
Do you or your spouse have any IRAs (individual retirement accounts)? If so, please tell us as much as you know about your IRA(s), including type, balances, where they are held, etc.
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Small
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Ok
17
Do you or your spouse have any taxable investment accounts? If so, please tell us as much as you know about your account(s), including type, balances, where they are held, etc.
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Small
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Ok
18
Do you or your spouse have any other significant assets (real estate, business interests, etc.)? If so, please tell us as much as you would like us to know about your other assets.
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Ok
19
What is the approximate total value of you and your spouse's checking/savings accounts?
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Ok
20
Do you own your home? If so, please let us know if you have a mortgage, and the approximate remaining balance.
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Large
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Small
Ok
Ok
21
Do you have any non-mortgage debt (car loans, student loans, credit card debt, etc)? If so, please list the balances and interest rates of your debt.
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Small
Ok
Ok
22
When do you hope to retire?
23
When does your spouse hope to retire?
24
Have you estimated how much annual income you will need in retirement? If so, what is that estimate?
25
What are your financial goals (retirement, major purchases, leaving money to heirs...) List as many as you you would like.
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26
Have you checked your estimated Social Security benefit? If yes, what is your estimated monthly benefit at full retirement age (67)?
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Ok
Ok
27
Has your spouse checked their estimated Social Security benefit? If yes, what is their estimated monthly benefit at full retirement age (67)?
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Small
Ok
Ok
28
At what age are you planning to claim Social Security?
62 (reduced benefit)
Full retirement age (67)
70 (maximum benefit)
Haven't decided
29
How would you describe your investment knowledge?
Novice – I know very little about investing
Basic – I understand stocks and bonds generally
Intermediate – I'm comfortable with most investment concepts
Advanced – I have significant investment experience
30
When you think about investing your assets, which statement best describes your feelings?
I can't afford to lose any of it – safety is my priority
I can tolerate small fluctuations but significant losses would be very stressful
I understand markets go up and down and can handle moderate swings
I'm comfortable with significant volatility in pursuit of higher long-term returns
31
If your portfolio dropped 20% in a market downturn, what would you most likely do?
Sell everything to prevent further losses
Sell some to reduce risk
Do nothing and wait for recovery
Buy more at lower prices
32
How long can you leave this money invested without needing to access it?
Less than 3 years
3-5 years
5-10 years
10+ years
33
Do you anticipate needing to draw regular income from this portfolio?
Yes, immediately
Yes, within 5 years
Not until retirement
No, this is purely for growth
34
Do you work with an accountant or tax preparer? If yes, please share their name and contact info (optional, but helpful for coordination):
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35
Do you have a will?
YESNO
36
Do you have any trusts established?
YESNO
37
Are your beneficiary designations on retirement accounts up to date (if applicable)?
Yes
No
Not sure
Not applicable
38
Do you have a power of attorney designated?
YESNO
39
Do you have a healthcare proxy/advance directive?
YESNO
40
Do you have life insurance?
Yes, through work
Yes, personally owned
Both
No
41
Do you have disability insurance?
YESNO
42
Do you have long-term care insurance?
YESNO
43
Is there anything else about your financial situation, goals, or concerns that would be helpful for me to know?
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Ok
44
What questions do you have for me?
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Should be Empty: