| First Name: |
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| Last Name: |
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| Address Street 1: |
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| Address Street 2: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Daytime Phone: |
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| Evening Phone: |
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| Email: |
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| 1) I plan to take money from my investments in... |
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| 2) As I withdraw money from this investment, I plan to spend it over a period of ... |
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| 3) When making a long-term investment, I plan to keep the money invested for ... |
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| 4) Let us assume from 8/31/08 through 3/31/09, stocks lost more than 25%. If you owned a stock investment that fell more than 25% in 7 months, you would...(If you owned stocks during this period, please select the answer that matches your actions at the time.) |
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| 5) Generally, I prefer an investment with little of no ups or downs in value, and I am willing to accept the lower returns these investments may make. |
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| 6) When the market goes down, I tend to sell some of my riskier investments and put the money in safer investments. |
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| 7) Risk tolerance is the relative ability to accept measurable losses in the short-term in exchange for expected higher returns long-term. My tolerance for risk is: |
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| 8) Let us assume from 1/31/08 through 12/31/08 some bonds lost almost 9%. If you owned a bond investment that lost 9% in eleven months, you would... (if you owned bonds during this period, please select the answer that matches your actions at that time) |
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| 9) Given the following potential gains or loss in any one year, where would you invest $10,000? |
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| 10) How stable are your current and future income sources (salary, Social Security, pension, etc.)? |
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| 11) When it comes to investing in stock or bond mutual funds (or individual stocks and bonds), I would describe myself as a/an... |
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| 12) I have consulted with the following professional advisors in the last 12 months... |
Business insurance advisor |
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Tax Professional |
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Financial advisor |
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Personal insurance advisor |
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Estate planning attorney |
