Financial Profile Info & Income Assets Liabilities Risk Assessment Goals Phone The Financial Profile submission page allows our advisors to receive a brief overview of your general financial standing. Collecting this information ahead of time helps the advisor spend more time getting to know you, and less time collecting data during the initial meeting. The result is a more efficient meeting where both parties cover more ground. The requested information for income, assets, and debts is intended to be general. Your submission is encrypted and sent directly to your financial advisor. The advisor will use the profile as a guide for the meeting and will ask questions for the specific details. Refer to the Discovery Meeting Prep Guide for more information on what to bring to the meeting. If you would like to provide additional information or list your top priorities, please use the Notes sections. Contact Information Primary Contact Person Name Email Address Phone Number Advisor Who is your Advisor? Ken Bellavance Andrew Castleberry Pat Paxton Austin Rowland Not Determined Current Age What is your current age range? Less than 45 46 to 55 56 to 65 66 to 76 Older than 75 Income Information Income — Individual 1 Name 1 Salary 1 Social Security 1 Pension 1 Bonus (regular) 1 Other Income 1 A Other Income 1 B Other Income Notes 1 Income — Individual 2 Name 2 Salary 2 Social Security 2 Pension 2 Bonus (regular) 2 Other Income 2 A Other Income 2 B Other Income Notes 2 Monthly Expenses Monthly Expenses Next Page Cash Assets Cash & Cash Equivalents Checking Assets Savings Assets Money Market Assets CD Assets Investment Assets Taxable Accounts Brokerage Asset Other Investment Assets Retirement Accounts IRA Account Roth IRA Account 401 K 403 B Account Roth 401 K Account SEP IRA Account Pension Value Annuity Other Retirement Accounts Business Ownership Interests Real Estate Assets Sole Proprietorship Assets C Corporation Assets S Corporation Assets Limited Liability Company Assets Other Business Ownership Assets Personal Use Assets Primary Residence Principal Other Cars Boats Etc Collectibles Assets Other Personal Use Assets Next Page Liabilities Current Liabilities Credit Cards Outstanding Bills Other Current Liabilities Long Term Liabilities Home Mortgage Home Equity Loans Other Property Mortgages Auto Loans Student Loans Other Loans Additional Liability Notes Next Page Risk Assessment To help us better understand your financial goals, please answer the following questions. 1. What is your current age? Question 1 20 or Younger 21 - 30 31 - 40 41 - 50 51 - 60 61 - 70 70+ 2. When do you plan to begin making withdrawals from your account? Question 2 Less than 3 years 3 - 5 Years 6 - 10 Years 10 - 15 Years 15+ 3. I would describe my knowledge of investments as: Question 3 None Limited Good Excellent 4. Which of these statements best represents your attitude towards risk and return? Question 4 I'm willing to accept more risk to achieve higher possible return. I'd prefer a balanced amount of risk and return. I'd rather avoid losses even if it means lower return. 5. How would you describe yourself as an investor? Question 5 Aggressive Somewhat Aggressive Somewhat Conservative Conservative 6. If you could chose between a job that was salary, commission, or a mix of both which would you pick? Question 6 All salary Mainly salary Equal mix of salary and commission Mainly commission All commission 7. How long do you expect your retirement account to last once you begin drawing income? Question 7 10 - 15 Years 16 - 20 Years 21 - 25 Years 26 - 30 Years 30+ 8. What is the primary goal for your investments? Question 8 This will be my primary source of income in retirement I will use this account along with other sources of income in retirement (i.e. Pension, 401k, etc) I will use this account for exclusively for lump sum purchases or goals I don't have any specific retirement income purpose for my investments. My investments should leave a legacy to the next generation. 9. If you have an account with $200,000, how much of a decline in value would make you uncomfortable in one year? Question 9 Any fall in value would make me uncomfortable $20,000 decrease $40,000 decrease $60,000 decrease $100,000+ decrease 10. Suppose you have an account with $100,000. Out of the potential ranges of highs and lows your account balance may experience in one year, which appeals to you the most? Question 10 High: $110,000; Low: $90,000 High: $120,000; Low: $80,000 High: $130,000; Low: $70,000 High: $140,000; Low: $60,000 11. There have been several periods in history in which the stock market has dropped 25% or more in a short period of time. If the value of your portfolio fell from $200,000 to $150,000 (25%) in one year, how would you react? Question 11 Sell all of the remaining investment to avoid anymore losses. Sell portion of the remaining investment. Don't sell anything. I would see this as an opportunity and invest more. 12. Assuming normal market conditions what would you expect from this investment over time? Question 12 To meet or exceed general stock market returns To generally keep pace with the stock market To slightly trail the stock market, but make a good profit To trail the stock market, but make a moderate profit To have some stability, but make modest profits To have a high degree of stability, but make small profits 13. Which of these statements would best describe your attitudes about the next three MONTHS' performance of this investment? Question 15 One calendar quarter means nothing. I wouldn't worry about losses in that time frame If I suffered a loss of greater than 10%, I'd get concerned I can only tolerate small short-term losses I'd have a hard time stomaching any losses 14. Which of these statements would best describe your attitudes about the next three YEARS' performance of this investment? Question 14 I don't mind if I lose money I can tolerate a loss I can tolerate a small loss. I'd have a hard time tolerating any losses. I need to see at least some return. 15. Suppose the stock market has below average returns over the next decade (10 yrs), what would you expect from this investment? Question 15 To lose money To make very little or nothing To make out a little gain To make a modest gain To be little affected by the stock market Next Page Goals To help us better understand your financial goals, please answer the following questions. 1. What are your three highest priority financial goals? Check all that apply and or write in your goal. Highest Priorities Investing for the Future Saving for Retirement Saving for your Kids' College Education Starting a Business Financial Independence Retiring Early Leave a Legacy Paying Off Debt Saving for an Emergency Fund Buying a Home Other If other, please explain. 2. What prompted you to reach out to a Financial Planner at this time? What prompted you to reach out? Upon hitting submit it might take up to 2 to 3 minutes to see a confirmation on the screen. Thank you for your patience while your form is submitted. Submit