• Confidential Client Data Worksheet

  • Format: (000) 000-0000.

  • Household income

  • Top financial goals and concerns

  • Have you recently experienced any changes...

  • In your financial condition?
  • In your investment goals?
  • In your risk tolerance?
  • In your perceptions of the market?
  • Is there anything I should be aware of that could affect your investments, such as large expected deposits or withdrawals, investment restrictions, health or family issues, or anything else?

  • Assets, liabilities, and life insurance: If a field doesn't apply to you, leave it blank

  • Liquid assets

  • Real estate assets

  • Investments (not those with Dale)

  • Liabilities

  • Life insurance policies

  • Securities offered through Registered Representatives of Cambridge Investment Research, Inc., a broker-dealer member FINRA/SIPC. Advisory services through Cambridge Investment Research Advisors, Inc., a Registered Investment Adviser. Cambridge and Financial Independence Wealth Management, LLC are not affiliated.

    Recommendations relating to this questionnaire will be based on the assumption that the answers to this questionnaire are complete, accurate, and reflect your current situation. Please notify your financial professional promptly if your financial situation or any of the information contained in your questionnaire changes. This form collects data for informational purposes only and does not supersede any data or information reported on official Cambridge forms.

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