Initial Planning Questionnaire … · Initial Planning Questionnaire Registered representative offering securities and advisory services through Independent Financial Group, LLC (IFG)

Initial PlanningQuestionnaire

Registered representative offering securities and advisory services through Independent Financial Group, LLC (IFG). Member FINRA and SIPC. IFG and GD Financial Services, Inc. are unaffiliated.

Office of Supervisory Jurisdiction: 12671 High Bluff Dr. Suite 200 San Diego, CA 92130

Your Name

Social Security #

Citizenship

Date of Birth Age

Wedding Anniversary Date

Employer/Position Years

Home Address

Work Address

Home Phone

Work Phone

Cell Phone

Email

Spouse’s Name

Social Security #

Citizenship

Date of Birth Age

Wedding Anniversary Date

Employer/Position Years

Mailing Address

Work Address

Home Phone

Work Phone

Cell Phone

Email

General Information 2

CPA Information

Bank Information

Attorney Information

Broker/Agent Information

Total Family Income $

Value of Liquid Assets $

Value of Primary Residence $

Total Family Net Worth $

# of Dependents Ages

Mortgage Amount $

Notes/Concerns

CONFIDENTIAL PREMIER WEALTH ADVISORS, LLC IPQ Rev. 12/16

Savings 3What do you consider an adequate cash reserve? $

Investment Planning

Is your investment portfolio providing an acceptable growth rate? Yes No Uncertain

Is your investment portfolio providing acceptable income? Yes No Uncertain

Are you expecting any major gains or losses soon? Yes No Uncertain

Do you have a stock margin (loan) account? Yes No Uncertain

Are there any investments you are planning on making in the near future? Yes No Uncertain

If yes, what are they?

Some investments lock up your principal for a specific period of time. For example, after purchasing a one-year certificate of deposit, your principal cannot be withdrawn without paying a penalty to get the principal back until the end of the one-year period. Regarding your investments, you want your principal to be:

Mainly liquid asssets (i.e. convertible to cash within 7–14 days)

Short lock-ups are acceptable (1–3 years)

Longer lock-ups are acceptable (4–10 years)

Life Insurance

How much total life insurance do you have on yourself? $

How much total life insurance do you have on your spouse? $

Tax Planning

Is your current tax liability acceptable? Yes No Uncertain

Have you been, or do you expect to be, audited by the IRS? Yes No Uncertain

Do you have Capital Loss Carry Forward? Yes No Uncertain

If yes, how much?

Estate Planning

Do you have a current Will? Yes No Date ____________

Do you have a current Revocable Living Trust? Yes No Date ____________

Do you have a current Durable Power of Attorney? Yes No Date ____________

Do you have a current Health Care Power of Attorney? Yes No Date ____________


Investment Objectives 4 1. Which of the following investments, if any, would you feel uncomfortable owning (select all that apply)?

Corporate Bonds Stocks of U.S. Companies Stocks of International Companies

Real Estate Limited Partnerships Alternative Investments

2. How much experience do you have with the following investments and savings vehicles:

(List number of years experience for each category)

_____ Large U.S. Company Stocks _____ Large U.S. Company Stocks

_____ Small U.S. Company Stocks _____ Real Estate Investment Trusts (REITs)

_____ International Stocks _____ Variable/Fixed Annuities

_____ Emerging Markets Stocks _____ Money Market Funds

_____ International Bonds _____ U.S. Savings Bonds (EE or H series)

_____ Limited Partnerships _____ Certificates of Deposit

_____ Alternative Investments _____ U.S. Treasury Notes/Bills

3. Is your investment portfolio intended primarily for retirement? Yes No

If yes, how many more years until you retire? __________ If already retired, check here

4. If this portfolio is for other than retirement, what is the portfolio for? ___________________________________

5. Based on the above investment goal(s), which of the objectives below best describes your desired approach towards your investments? ___________________________________

Emphasis on preserving principle rather than growin asset value.

Emphasis on maintaining purchasing power while generating moderate to high current income.

Emphasis on increasing portfolio value with small potential for loss.

Emphasis on creating strong growth in asset value with moderate fluctuations in value.

Emphasis on maximizing growth with high likelihood of large fluctuations in asset value.

Not sure/need to discuss.

6. Investment management styles are termed as being active or passive. Active management entails actively buying and selling stocks or funds attempting to select the best picks for the immediate future. Passive management entails an allocation of index–type stocks or funds with the emphasis on maintaining a consistent diversified mix of various investment classes and allowing the market to generate the return. Which statement reflects your feeling on portfolio management style?

I prefer an active management style.

I prefer a passive management style.

I would like a mix of active and passive management.

I pay you to make this decision.



Investment Objectives 5 7. Historically, smaller companies tend to have higher levels of risk (price volatility) than large company stocks.

However, small company stocks have tended to outperform large company stocks over long periods of time. Knowing that past performance never guarantees future results, which statement most accurately describes your attitude towards small company stock investing?

I definitely do not want any small company stock exposure in my portfolio.

I would dedicate a small portion of the portfolio to small company stock investments.

I would dedicate a large portion of the portfolio to small company stock investments.


8. Similar to above, International (non-U.S.) stocks have tended to perform counter-cyclical to U.S. stocks through multi-year cycles, sometimes higher, sometimes lower. Given that foreign securities involve additional risks (such as currency valuation changes) and potential for additional returns, which statement most accu-rately reflects your view on international investing?

I definitely do not want any international investment exposure in my portfolio.

I would dedicate a small portion of the portfolio to international stock investments.

I would dedicate a large portion of the portfolio to international stock investments.

I would like significant exposure to international investments—including emerging countries.


9. Five years from now, what do you expect your earnings to be?

I expect my earnings increases will outpace inflation (due to promotions, new job, etc.).

I expect my earnings increases to stay somewhat ahead of inflation.

I expect my earnings to keep pace with inflation.

I expect my earnings to decrease (retirement, part time work, etc.).


10. What percentage of your portfolio’s present value do you need to currently withdraw for annual income? (e.g. 4% of a $500,000 portfolio equals $20,000 per year)

None 0%–2% 2%–4% 4%–6% More than 6%

11. Except for income as noted in Question 10, in approximately how many years do you expect to need to withdraw cash from your investments (home purchase, college tuition, other major need)?

2–3 years 4–6 years 7–10 years 10+ years

12. What do you do with the income (interest, dividends and capital gains) generated by your portfolio

Receive all income Receive some income and reinvest some Reinvest all income

13. What is the approximate average annual return that you consider reasonable from your portfolio over the next 10 years

4% 6% 8% 10% or more


14. At right is a series of hypothetical portfolios. The best potential gains, worst potential losses and average returns are presented. Note that the portfolio with the best potential gain and average return also had the largest potential loss. Which portfolio would you be most comfortable owning?

Portfolio A

Portfolio B

Portfolio C

Portfolio D

Portfolio E

Portfolio F

15. Which of the following would concern you the most regarding the return of your portfolio in a one year period?

Have a negative return representing a loss in value.

Have a return less than my income withdrawal goal.

Under-perform the market index returns.

Under-perform my investment goal.

16. Which of the following statements best describes your reaction if the value of your portfolio suddenly declined 15%? (e.g. $500,000 goes to $425,000)

I would be very concerned.

If the amount of income I received was unaffected, it would not bother me

I invest for long-term growth and accept temporary changes due to market fluctuations

17. Approximately what portion of your monthly take–home pay goes towards paying off installment debt (auto loans, credit cards etc.) other than home mortgage?

Less than 10% 10%–25% 25%–50% More than 50%

18. How many dependents, other than your spouse, do you support (children, elderly parents, family members, etc.)?

None 1–2 3–4 More than 4

19. Do you have an emergency cash fund (savings equal to 3–6 months of after tax income)?

No

Yes, but less than six months of after-tax income.

Yes, I have an adequate emergency fund.

20. If you expect to have major expenses (college, house down payment, home repair, etc.) do you have a separate savings plan for these expenses?

Yes I do.

I do not expect any such expenses.

I intend to withdraw only a portion of the money needed from savings.

I have no separate savings plan for these items at this time.

Risk Tolerance & Sensitivity 6


$70,000

$0

-$70,000

$34,708 $39,668 $43,045 $48,256$55,463 $60,277

-$8,852 -$15,127 -$19,401-$26,644

-$36,198-$42,377

Por

tfol

io A

Por

tfol

io B

Por

tfol

io C

Por

tfol

io D

Por

tfol

io E

Por

tfol

io F

For illustrative purposes only

Investment Objectives 7 21. If you could increase the value of your portfolio by taking more risk, would you be:

Willing to take a lot more risk with all of your money.

Willing to take a lot more risk with some of the money.

Willing to take a little more risk with all of your money.

Willing to take a little more risk with some of the money.

Unlikely to take much more risk.

22. When you think of the word risk as it relates to your investments, how would you describe your feelings

___________________________________________________________________________________________

___________________________________________________________________________________________

23. How often do you want your portfolio performance to be evaluated for the purpose of possibly making changes in the investments?

Quarterly Annually Every 3 years 3 years or more

24. Will you be making additions to your investment portfolio over the next five years? Yes No


Are there any unique factors or concerns that we should understand regarding the management of your investment portfolio or risk tolerance?

Additional Considerations

Privacy Statement 8Your Privacy Is Important to Us We are committed to maintaining the confidentiality, integrity and security of your personal information. When you provide personal information, we believe that you should be aware of our policies to protect the confidentiality of that information.

Information We Collect We collect nonpublic personal information about you from the following sources: • Information we receive from you on planning documents, statements, applications or other forms such as tax

returns and estate planning documents; • Information about your transactions with us, our service providers, or others.

Disclosure of Your Information We restrict access to nonpublic personal information about you to those employees with a legitimate business need for the information. We maintain physical, electronic, and procedural safeguards that comply with federal standards to guard your nonpublic personal information.

We reserve the right to disclose all of the information that we collect, as described above, to any affiliates that we may have at that time and to the following types of nonaffiliated third parties: • Our Broker-Dealer, Independent Financial Group, LLC; • Financial service providers, such as securities broker-dealers, third-party investment advisors, investment

sponsors, custodians, mortgage bankers and insurance agents/brokers; • Any new Broker-Dealer with whom we become registered.

We do not sell, share or disclose your nonpublic personal information with non-affiliated third party or marketing companies for unrelated purposes.


Client’s Signature Date

Spouse’s Signature Date

Advisor’s Signature Date

Documents

Initial Planning Questionnaire … · Initial Planning Questionnaire Registered representative offering securities and advisory services through Independent Financial Group, LLC (IFG)