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Investment Objectives and Risk Tolerance

We will use this form to supplement our discussions in determining the proper asset allocation, consistent with your tolerance for risk and volatility.

Please complete this questionnaire and return it to me at your nearest convince.

Name:____________________________________________ Date:_______________________

1.What is your primary goal for these invested assets?

Preservation of principal

Generate income

Income with some growth

Growth with some income

Capital appreciation & growth

2.How many years do you plan to invest these assets before you anticipate making withdrawals?

3.Once you have reached the point where you would like to take withdrawals from these assets, how long will you be making withdrawals from this investment?

4.At times, extremely conservative investments may earn less than the rate of inflation. This may result in the loss of purchasing power.

Witch of the following statements best aligns with your goals and objectives?

This is a long-term investment and my goal is to significantly exceed the rate of inflation. I am willing to accept considerable risk and substantial market volatility to achieve this goal.

Over time, I can ignore fluctuations in the investment value to achieve my goal of meaningful growth and exceeding the rate of inflation.

It is important that these investments match or exceed the rate of inflation. I am comfortable with moderate fluctuations in the value of these investments.

I am willing to tolerate small fluctuations in the principal value to allow for the opportunity of my investments to grow at the same rate of inflation

These assets should be safe, even if it means the returns do not keep pace with the rate of inflation

	6.The degree in which the value of an investment increases and decreases is one measure of risk. More volatile investments generally offer greater long-term growth potential than less volatile investments; however, they may produce greater losses. With how much volatility are you comfortable?


I’m not comfortable with any volatility.
(-14)

	7.Other secure assets that I own, such as permanent cash-value life insurance, personal savings accounts, pensions, and fixed income assets, form a substantial portion of my net worth and should be taken into consideration when determining my asset allocation.


Strongly Disagree
(-1)

	8.I believe the stability of my current and future income sources, (not including these investments), is:


Very Stable
(11)

	9.If you could increase the opportunity to improve your returns by investing in riskier assets, would be willing to take:


A small amount of risk with some of your money
(-4)

	10.Carefully consider the following hypothetical portfolios and the hypothetical returns. With which portfolio are you most comfortable?


Hypothetical outcome of $100,000 invested for three years.