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Investor Questionnaire
PERSONAL INFO
CURRENT ASSETS
– 401k, IRA, Brokerage etc.
TIMEFRAME
&
RISK TOLERANCE
Name:
*
First
Last
Spouse Name:
First
Last
Primary Phone:
*
Secondary Phone:
Email:
*
Social Security #:
Address:
*
City / State:
*
Zip Code:
*
Employer:
Job Title:
Salary & Bonus:
Type of Investment / Institution Name:
*
Value:
*
Type of Investment / Institution Name:
Value:
Type of Investment / Institution Name:
Value:
Type of Investment / Institution Name:
Value:
Type of Investment / Institution Name:
Value:
Type of Investment / Institution Name:
Value:
Business Name:
Business Type:
Base Value:
Business Name:
Business Type:
Base Value:
On the whole, which best describes your Investment objective?
Capital preservation
A regular stream of income
A combination of income and capital growth
High capital appreciation
What is your overall knowledge of investments?
Very little experience outside of savings accounts and money market accounts
Some experience investing in mutual funds and bonds but not much
I have managed accounts on my own in the past with mutual funds and individual stocks
I truly enjoy investing in the markets and I follow my accounts daily
How much money do you plan on withdrawing from this account in the next 3-6 months?
75-100%
25-75%
25% or less
How much of this account will be preserved for retirement?
75-100%
25-75%
25% or less
Which answer best describes your feelings on risk and return?
Increase my portfolio as quickly as possible, while accepting higher risk
Increase my portfolio at a moderate pace, with moderate risk
I am seeking income, while accepting moderate to low risk
Preservation of capital is key, take very little risk
An original investment of $15,000 is now worth $25,000 suddenly declines 15%, which best describes your response?
I would look for a way to invest more
I would take no action
I would be somewhat concerned
I would be calling my advisor for an explanation
How would you feel if an investment lost 20% of its value in the first year?
Extremely concerned and would sell my investment
Concerned and may consider selling my investment
Concerned, but I would not consider selling my investment
Not overly concerned, I have a long term investing philosophy
Comments or Concerns:
Message
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