annual review questionnaire

Primary Account Holder Name *

First Name

Last Name

Primary Account Holder Phone #

(###)

###

####

Secondary Account Holder Name *

First Name

Last Name

Secondary Account Holder Phone #

(###)

###

####

Is there anything that is incomplete from your financial plan? *

Yes

No

What topics would you like to discuss at our review meeting?

Day to day budgeting

Managing debt

A big purchase in the future

Reviewing my car/ home/ life/ disability insurance

Reviewing your long-term care options

How my accounts are invested and what changes need to be made

Reviewing my current approach to retirement

Reviewing ways to give to charity

Reviewing my Estate Plan

College Planning

Involving relevant family members into financial discussions

Market review

How would you like to conduct our review meeting?

Video conference (Sharing documents on the computer screen)

Phone Call

In-Person

E-mail Observations

1. How long will it be before you expect to begin making regular withdrawals from this account? *

Less than 2 years

2 - 4 years

4 - 6 years

7 - 10 years

More than 10 years

2. What percentage of the portfolio's current value do you believe you'll need to withdraw annually once withdrawals begin *

Greater than 8%

Greater than 5%, but less than 8%

Greater than 2%, but less than 5%

Less than 2%

I do not intend on withdrawing money from this account in the foreseeable future

3. Is it likely that a large percentage of the account will be withdrawn in the next 5 years? *

Strongly agree

Agree

Somewhat agree

Disagree

Strongly disagree

4. Which of the following best summarizes your attitudes regarding investing and inflation? *

My money should be "safe" with little or no volatility, even it it means my returns do not keep up with inflation.

I prefer to minimize short-term volatility (and the potential for loss), even if it means that my portfolio is only expected to keep pace with or slightly exceed inflation.

I prefer a portfolio that seeks to moderately exceed inflation over the long run and I am willing to accept moderate short-term fluctuations in value (and a moderate potential for loss) to achieve this goal.

I prefer a portfolio that seeks to substantially exceed inflation over the long run and I am willing to accept large, short-term fluctuations in value (and a greater potential for loss) to achieve this goal.

5. Future projected income levels are important to understand when assessing risk. How would you describe your future income cash flow? *

Unpredictable or unstable

Fairly consistent

Expected to be stable or slightly increase

Stable and I have high confidence level it will continue to increase

6. Which response best represents your view about the following statement? "In my portfolio, I am comfortable with investments that may lose money from time to time, if they offer the potential for higher returns. *

Strongly disagree

Disagree

Somewhat agree

Agree

Strongly agree

7. If the market were to drop 20% in a short period, your most likely reaction would be: *

I would sell everything, and it would confirm that I am not comfortable with the market.

I would sell some positions in the portfolio, and move to "safer"investments.

I would stay the course, choosing to pay less attention to the financial news.

I would invest more in attempt to take advantage of low prices.

8. With respect to volatility, how much volatility are you willing to accept? *

Minimal - I do not want to risk losing money, even if it means my returns are relatively small.

Some - I am willing to accept occasional short term losses as long as my portfolio is generally structured to grow over time.

Moderate - I am willing to accept moderate ups and downs of the market to pursue higher returns.

Considerable - I am willing to take substantial risk to pursue significantly higher returns.

9. Of the 5 hypothetical portfolios of $100,000, and their potential gains and losses over a 1 year period, which portfolio would you invest in? *

$105,000 / $95,000

$110,000 / $90,000

$115,000 / $85,000

$120,000 / $80,000

$125,000 / $75,000

10. Your investment objective summarizes the primary purpose of your account. It serves to define how assets should be managed. Select the objective that best fits the purpose of your account. *

Preserve asset value

Generate current income

Achieve asset growth with moderate current income

Achieve strong asset growth with nominal income

Achieve maximum asset growth