Client Assessment Survey

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* 1. Do you rent or own your home?

Rent

Own

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* 2. Do you have a will(s) in place?

Yes

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* 3. Do you have children?

Yes

Not Yet

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* 4. What do your goals look like for a secure future for your spouse / family?

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* 5. Have you or anyone in your family ever been a victim of identity theft?

Yes

Unknown

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* 6. Is the amount of debt you have a concern for you and your family's security and wellbeing?

Yes

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* 7. If there is not a change made to the system that you are on to eliminate debt, could that create future problems for you and the goals you wish to achieve?

Yes

Other (please specify)

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* 8. If there were a solution that cut your debt repayments in half without adjusting your current operating budget, would that be a benefit to you and your family? Would you want to see it?

Yes

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* 9. Do you have a trust in place?

Yes

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* 10. Do you own a business?

Yes

Not Yet

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* 11. Have you ever had to hire an attorney?

Yes

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* 12. Do you have any investments?

Yes, I have investments.

No, I do not have investments.

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* 13. If you investments have lost money in the last year, is that concerning for you? Can you afford to lose another 20-30%?

Yes

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* 14. Would one of your goals moving forward be to maximize your returns?

Yes

I don't know

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* 15. If there were an account that could provide both protection from downside markets, as well as provide strong upside gains, do you believe that would be beneficial?

Yes

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* 16. At what age do you plan to retire?

Before age 50

51-60

61-70

After age 70

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* 17. How would you rate your current plans for retirement

Nonexistent

I have some plans in place

I have my retirement completely mapped out

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* 18. How would you rate the performance of the person / entity who is currently managing your accounts?

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* 19. If a change is not made to your current strategy, could it create future problems to your retirement goals?

Yes, it could create future problems

No, I don't think it would create future problems.

Client Assessment

Question Title

* 1. Do you rent or own your home?

Question Title

* 2. Do you have a will(s) in place?

Question Title

* 3. Do you have children?

Question Title

* 4. What do your goals look like for a secure future for your spouse / family?

Question Title

* 5. Have you or anyone in your family ever been a victim of identity theft?

Question Title

* 6. Is the amount of debt you have a concern for you and your family's security and wellbeing?

Question Title

* 7. If there is not a change made to the system that you are on to eliminate debt, could that create future problems for you and the goals you wish to achieve?

Question Title

* 8. If there were a solution that cut your debt repayments in half without adjusting your current operating budget, would that be a benefit to you and your family? Would you want to see it?

Question Title

* 9. Do you have a trust in place?

Question Title

* 10. Do you own a business?

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* 11. Have you ever had to hire an attorney?

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* 12. Do you have any investments?

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* 13. If you investments have lost money in the last year, is that concerning for you? Can you afford to lose another 20-30%?

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* 14. Would one of your goals moving forward be to maximize your returns?

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* 15. If there were an account that could provide both protection from downside markets, as well as provide strong upside gains, do you believe that would be beneficial?

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* 16. At what age do you plan to retire?

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* 17. How would you rate your current plans for retirement

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* 18. How would you rate the performance of the person / entity who is currently managing your accounts?

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* 19. If a change is not made to your current strategy, could it create future problems to your retirement goals?

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* 20. Is there anything else you would like to communicate to us?