Customer Financial Information. Financial Information The more we know about you and your goals for this account, the better we can serve you. Please answer the following questions about your investment experience and financial situation to help us determine which investment products and strategies are suitable for you. For Office Use Only: Acct.# Office: Financial Professional: Name for Filing: Investment Experience (Include Years of Experience) Annual Income1 (From all Sources) Net Worth2 (Exclusive of Residence) Liquid Net Worth3 (Cash, Securities, etc.) Federal Tax Rate Stocks Bonds Options Commodities Futures Mutual Funds Other (List) Under $25,000 $25,000-$49,999 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000-$3,000,000 Over $3,000,000 Under $50,000 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000$3,000,000 Over $3,000,000 Under $50,000 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000-$3,000,000 Over $3,000,000 10% 12% 22% 24% 32% 35% 37% Additional Customer Information Annual Expenses4 Special Expenses5 Description of Terms 1 Annual income includes income from sources such as employment, alimony, social security, investment income, etc. 2 Net worth is the value of your assets minus your liabilities. For purposes of this application, assets include stocks, bonds, mutual funds, other securities, bank accounts, and other personal property. Do not include your primary residence among your assets. For liabilities, include any outstanding loans, credit card balances, taxes, etc. Do not include your mortgage. 3 Liquid net worth is your net worth minus assets that cannot be converted quickly and easily into cash, such as real estate, business equity, personal property and automobiles, expected inheritances, assets earmarked for other purposes, and investments or accounts subject to substantial penalties if they were sold or if assets were withdrawn from them. 4 Annual expenses might include mortgage payments, rent, long-term debts, utilities, alimony or child support payments, etc. 5 Special expenses might include a home purchase, remodeling a home, a car purchase, education, medical expenses, etc. (Recurring) (Future/ Non-Recurring) $50,000 and under $50,000 and under $50,001-100,000 $50,001-100,000 $100,001-250,000 $100,001-250,000 $250,001-500,000 Over $500,000 Over $250,000 The investments in this account will be: Timeframe for Special Expenses (Check one) Less than 1/3 of my financial portfolio Special Expense: Roughly1/3 to 2/3 of my financial portfolio Within 2 years 3-5 years More than 2/3 of my financial portfolio 6-10 years 11 years or more Investment Time Horizon - When is the earliest that you expect to need funds from this account? Under 3 years 3-5 years 6-10 years 11-20 years Over 20 years Unknown I plan to use this account for the following (Check all that apply) What is your source of funds for this account (Check all that apply) Generate income for current or future expenses Partially fund my retirement Wholly fund my retirement Steadily accumulate wealth over the long term Preserve wealth and pass it on to my heirs Pay for educational expenses Market speculation Other: Income from Earnings Investments/ Transfer from Brokerage Account Gift Sale of Business or Real Estate Inheritance Pension/ IRA/ Retirement Savings Spouse/ Parent/ Relative Legal/ Insurance Settlement Lottery/Gaming Other: Other Investment Information (Optional) - Please consider providing us with additional information about your other investments to help us more fully understand your financial situation and the types of investments or strategies that may be appropriate for your total investment portfolio. (Use additional pages if needed) Investment Type/Description Firm Holding Your Investment Amount of Investment $ $ $
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Samples: www.eoption.com, www.eregal.com, www.infi.biz
Customer Financial Information. Financial Information The more we know about you and your goals for this account, the better we can serve you. Please answer the following questions about your investment experience and financial situation to help us determine which investment products and strategies are suitable for you. For Office Use Only: Acct.# Office: Financial Professional: Name for Filing: Investment Experience (Include Years of Experience) Annual Income1 (From all Sources) Net Worth2 (Exclusive of Residence) Liquid Net Worth3 (Cash, Securities, etc.) Federal Tax Rate Stocks Bonds Options Commodities Futures Mutual Funds Other (List) Under $25,000 $25,000-$49,999 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000-$3,000,000 Over $3,000,000 Under $50,000 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000$3,000,000 Over $3,000,000 Under $50,000 $50,000-$99,999 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999 $1,000,000-$3,000,000 Over $3,000,000 10% 12% 22% 24% 32% 35% 37% Additional Customer Information Annual Expenses4 Special Expenses5 Description of Terms 1 Annual income includes income from sources such as employment, alimony, social security, investment income, etc. 2 Net worth is the value of your assets minus your liabilities. For purposes of this application, assets include stocks, bonds, mutual funds, other securities, bank accounts, and other personal property. Do not include your primary residence among your assets. For liabilities, include any outstanding loans, credit card balances, taxes, etc. Do not include your mortgage. 3 Liquid net worth is your net worth minus assets that cannot be converted quickly and easily into cash, such as real estate, business equity, personal property and automobiles, expected inheritances, assets earmarked for other purposes, and investments or accounts subject to substantial penalties if they were sold or if assets were withdrawn from them. 4 Annual expenses might include mortgage payments, rent, long-term debts, utilities, alimony or child support payments, etc. 5 Special expenses might include a home purchase, remodeling a home, a car purchase, education, medical expenses, etc. (Recurring) (Future/ Non-Recurring) $50,000 and under $50,000 and under $50,001-100,000 $50,001-100,000 $100,001-250,000 $100,001-250,000 $250,001-500,000 Over $500,000 Over $250,000 The investments in this account will be: Timeframe for Special Expenses (Check one) Less than 1/3 of my financial portfolio Special Expense: Roughly1/3 to 2/3 of my financial portfolio Within 2 years 3-5 years More than 2/3 of my financial portfolio 6-10 years 11 years or more Investment Time Horizon - When is the earliest that you expect to need funds from this account? Under 3 years 3-5 years 6-10 years 11-20 years Over 20 years Unknown I plan to use this account for the following (Check all that apply) What is your source of funds for this account (Check all that apply) Generate income for current or future expenses Partially fund my retirement Wholly fund my retirement Steadily accumulate wealth over the long term Preserve wealth and pass it on to my heirs Pay for educational expenses Market speculation Other: Income from Earnings Investments/ Transfer from Brokerage Account Gift Sale of Business or Real Estate Inheritance Pension/ IRA/ XXX/ Retirement Savings Spouse/ Parent/ Relative Legal/ Insurance Settlement Lottery/Gaming Other: Other Investment Information (Optional) - Please consider providing us with additional information about your other investments to help us more fully understand your financial situation and the types of investments or strategies that may be appropriate for your total investment portfolio. (Use additional pages if needed) Investment Type/Description Firm Holding Your Investment Amount of Investment $ $ $
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Samples: Customer Information Brochure