Objectives & Risk Tolerance Questionnaire

Objectives & Risk Tolerance Questionnaire
Please complete the following form as best you can.
Note, all information submitted in this form is highly confidential.

If you have any questions, please feel free
to call: 913-543-3836 or email: contact@wallastreet.com
Name

First NameLast Name
Email
example@example.com
Objectives: Retirement and Investment
Rate the importance of each item according to the following scale:

High, Medium, Low or NA
Your retirement goals:

HighMediumLowNA
Directing a portion of your personal savings or investment portfolio to a tax advantaged vehicle:

HighMediumLowNA
Having all of your portfolios consolidated and analyzed to make sure your overall plan is on track:

HighMediumLowNA
Matching your risk tolerance to that of your investment portfolio:

HighMediumLowNA
Reviewing your investment performance against that of an index:

HighMediumLowNA
Reviewing your investment performance against your plan:

HighMediumLowNA
Reviewing alternative retirement methods:

HighMediumLowNA
Minimizing the taxes on your investment accounts:

HighMediumLowNA
Reviewing techniques to save income tax and estate taxes on deferred money:

HighMediumLowNA
Asset protection in the result of a serious illness:

HighMediumLowNA
Protecting assets in the event that you require long term care in the future:

HighMediumLowNA
Receiving adequate income in the event of disability during your working years:

HighMediumLowNA
Planning for income for your spouse in the event of your premature death:

HighMediumLowNA
Generating a guaranteed retirement income stream:

HighMediumLowNA
Planning for income for your children in the event of your premature death:

HighMediumLowNA
Objectives: Estate
Rate the importance of each item according to the following scale:

High, Medium, Low or NA
Distributing assets equally to your children:

HighMediumLowNA
Protecting your assets transferred to your children from creditors, divorce, and bankruptcy:

HighMediumLowNA
Reviewing your insurance portfolio:

HighMediumLowNA
Reviewing different methods of meeting your estate tax liabilities:

HighMediumLowNA
Minimizing estate taxes:

HighMediumLowNA
Charitable planning to your estate's planning:

HighMediumLowNA
Contributing annually to charity:

HighMediumLowNA
Gifting to your children if it doesn't interfere with your financial independence:

HighMediumLowNA
Planning for your grandchildren's education:

HighMediumLowNA
Reviewing your current will structure to eliminate unnecessary taxes:

HighMediumLowNA
Protecting your residence and/or vacation home from estate taxes:

HighMediumLowNA
Having your estate in trust for your spouse in order to protect your children's inheritance:

HighMediumLowNA
Objectives: Business
Rate the importance of each item according to the following scale:

High, Medium, Low or NA
Maintaining control of your business throughout your lifetime:

HighMediumLowNA
Eliminating the need to liquidate your business to pay estate taxes:

HighMediumLowNA
Passing your business in a manner where it is sold to key employees:

HighMediumLowNA
Creating a planning concept to help you sell your business to key employees in an efficient manner:

HighMediumLowNA
Providing incentives to your key employees with non-stock compensation alternatives:

HighMediumLowNA
Having your key employees own stock in your company:

HighMediumLowNA
Protecting your business from the death of a key employee:

HighMediumLowNA
Protecting your key employees and their families from serious illness and disability:

HighMediumLowNA
Protecting your company from serious illness and disability of your employees:

HighMediumLowNA
Key employees to the continued success of your company:

HighMediumLowNA
Passing your business in a manner that maintains family ownership and control:

HighMediumLowNA
Maintaining family harmony after your estate has been settled:

HighMediumLowNA
Having your spouse take an active/ownership role in the business plan after you pass:

HighMediumLowNA
Creating a planing concept that shows how to gift/sell/bequest your business to your children/heirs:

HighMediumLowNA
Equalizing the inheritance for your children not active in the business:

HighMediumLowNA
Leaving the business only to active children/heirs versus all children/heirs:

HighMediumLowNA
Having your children/heirs active in the business regarding the future success of your business:

HighMediumLowNA
Passing your business in a manner where it is sold to a third party:

HighMediumLowNA
Reviewing your business' property and casualty coverages every two years:

HighMediumLowNA
Reviewing alternative sources for your existing line of credit:

HighMediumLowNA
Reviewing the efficiency of your existing long term debt structure:

HighMediumLowNA
Reviewing the efficiency of your existing long term debt structure:

HighMediumLowNA
Buying out a partner's interest in the event of his or her death:

HighMediumLowNA
Objectives: Client Defined
Provide any additional objectives in the boxes below based on their level of importance to you.
High Importance:
Medium Importance:
Low Importance:
Objectives: Client Defined
If you own a home, do you have more than 30% equity?

YesNo
Which of the following best describes your current employment situation:

Full-timePart-timeRetiredUnemployed
From an original investment of $15,000, your portfolio now worth $25,000 suddenly declines 15%.
Which best describes your response?

I would look for a way to invest moreI would take no actionI would be somewhat concernedI would avoid any investment that could lose 15%
Your portfolio (from the previous question) now worth $21,250 suddenly declines another 10%.
Which best describes your response?

I would look for a way to invest moreI would take no actionI would be somewhat concernedI would probably sellI would never have made this investment
Have you invested in Equities?

YesNo
Have you invested in Fixed Incomes?

YesNo
Have you invested in Mutual Funds?

YesNo
Have you invested in Options, Futures, or Derivatives?

YesNo
How would you describe your level of investment knowledge?

NoneLimitedGoodExtensive
How much investment experience do you have?

NoneLimited (1 - 3 years)Moderate (3 - 5 years)Extensive ( more than 5 years)
Do you have current income needs from this investment?

YesNo
When will you begin to use the money from your goal?

Less than 2 years2 - 5 years5 - 10 yearsMore than 10 years
Should be Empty: