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e more we know about you before we meet, the more value and benefit we can be to you. 

In fact, we are required by law state regulations to know most of the information requested before we can provide to you information about the specific investments that can most benefit you.

Our service for clients tends toward the portfolio approach.  With sufficient information and after our professional analysis of your overall portfolio and investment objectives, we will know and explain to you, if and to what degree the investments we currently specialize in are appropriate for you and your portfolio and your goals.  We will also be happy to opine on any of your other investments you may have.

Most of the information requested on this form is optional.  The more you tell us in advance, the better we can serve you.  This information is 100% CONFIDENTIAL!

Thank you.

E-mail Address: *  Name and contact information Current Investment Objectives Higher Yield for better Accumulation Higher Yield for more Current Income Greater Safety and Principal Protection Stock Market Growth Participation Other than listed Investment or Portfolio Problems Investments I dont understand Too Much Risk or Volitality Investment Capital Not Working Satisfactorily Current Advisor Unsatisfactory Other than listed Other problems not listed Date or time frame for next investment decision * Required

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