Choosing the right investment strategy is not as complicated as it seems. This questionnaire will provide us guidance on the type of investor you

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1 Choosing the right investment strategy is not as complicated as it seems. This questionnaire will provide us guidance on the type of investor you might be and also assist us in selecting the best suited investments for you and your family.

2 Customer Information Occupation: Employer: Years Employed: Salary: Less than 50K 50K to 100K 100K to 200K Over 200K Marital Status: Single Married Divorced Widowed Occupation: Employer: Years Employed: Spouse Information Salary: Less than 50K 50K to 100K 100K to 200K Over 200K Child Information Customer Insurance Information Insurance Type: Auto Business Cash Disability Group Home Owner Life Medical Mortgage Not Sure Term Umbrella Life Ins. Value Under 100K 100K to 250K 250K to 500K 500K to 1 Mil Spouse Insurance Information Insurance Type: Auto Business Cash Disability Group Home Owner Life Medical Mortgage Not Sure Term Umbrella Life Ins. Value Under 100K 100K to 250K 250K to 500K 500K to 1 Mil

3 Assets & Liabilities Primary Residence: Home Rent Other Secondary Residence: Income Mortgage Own Pleasure Total Estimated Assets: Under 100K 100K to 250K 250K to 500K 500K to 1 Mil Over 1 Mil Total Estimated Liabilities: Under 100K 100K to 250K 250K to 500K 500K to 1 Mil Over 1 Mil Other: Objectives & Goals Next 18 Months Borrow money Buy a home Change employment Expand a business Graduate Have a child Invest more money Marry Pay off a loan Purchase property Receive a promotion Receive an inheritance Retire Save more money Sell a business Sell property Start a business Start a financial plan Investment Values or Concerns 401(k) investments 401(k) plan allocation Accumulation plans Asset allocation Budgeting Business insurance College planning Disability protection Estate planning Financial planning Inflation Insurance for my spouse Investment management Investment ideas Long term care insurance Mortgage insurance Personal life insurance Portfolio review Retirement income Review of policies Tax planning Other: Other: 3

4 Retirement Planning #1. Have you developed a personalized retirement planning strategy? Yes No n/a #2. Are you taking advantage of tax deferred retirement plans like 401k? Yes No n/a #3. Do you have a pension plan provided by your employer? Yes No n/a #4. Do you fully understand the impact of inflation on retirement income? Yes No n/a #5. Do you understand the Social Security retirement program? Yes No n/a #6. Do you feel you can rely on the SS to provide income at retirement? Yes No n/a #7. Do you plan to move after retirement? Yes No n/a #8. Do you want to maintain your present standard of living at retirement? Yes No n/a #9. At what age do you plan on retiring? Yes No n/a #10. At what age does your spouse plan on retiring? Yes No n/a Financial Knowledge #1. Do you know what you want to accomplish financially? Yes No n/a #2. Do you think you are good at managing income/expense flow? Yes No n/a #3. Have you outlined your financial plans on paper? Yes No n/a #4. Do you maintain a current list of your assets and liabilities? Yes No n/a #5. Do you have a complete understanding of your financial situation? Yes No n/a #6. Do you have a complete understanding of your financial objectives? Yes No n/a #7. Do you actively participate in your financial affairs? Yes No n/a #8. Do you desire assistance in organizing your financial affairs? Yes No n/a Insurance #1. Do you want all loans and mortgages paid off upon death? Yes No n/a #2. Do you want your family to maintain their standard of living after death? Yes No n/a #3. Do you want to guarantee college education funding after your death? Yes No n/a #4. Do you have adequate life insurance to cover the above? Yes No n/a #5. Do you understand your life insurance policy? Yes No n/a #6. Do you understand your employer death benefit plan? Yes No n/a #7. Are you familiar with the death benefits under Social Security? Yes No n/a #8. Do you want to maintain your current standard of living if disabled? Yes No n/a #9. Does your employer provide adequate disability insurance? Yes No n/a #10. Do you carry individual disability coverage? Yes No n/a #11. Do you understand the disability benefit under Social Security? Yes No n/a #12. Has your health been a hindrance in getting insurance coverage? Yes No n/a #13. Do you have an insurance planning advisor? Yes No n/a #14. Do they help in setting up your needs in understandable programs? Yes No n/a 4

5 Taxes #1. Do you prepare my own income tax return? Yes No n/a #2. Are you familiar with tax savings techniques / tax law changes? Yes No n/a #3. Are you familiar with the potential benefits of tax deferred investments? Yes No n/a #4. Does your tax situation need additional tax strategies to reduce taxes? Yes No n/a #5. Do you expect your income to increase significantly, the next few years? Yes No n/a #6. Are you concerned about getting all the tax relief you are entitled to? Yes No n/a #7. Do you need help in developing a comprehensive tax planning strategy? Yes No n/a Estate Planning #1. Are you well informed on estate planning? Yes No n/a #2. Have you made specific plans of asset distribution in the event of death? Yes No n/a #3. Is your will current and consistent with your estate plan? Yes No n/a #4. Do you have a complete understanding of your estate plan? Yes No n/a #5. Do you have a list of important documents and their location? Yes No n/a #6. Have you named guardians, executors and trustees? Yes No n/a #7. Does your spouse/family know the location of your estate documents? Yes No n/a #8. Is the executor familiar with your will, estate plan, & location of documents? Yes No n/a #9. Does your estate plan provide for inflation / standard of living changes? Yes No n/a #10. Do you need to develop strategies to reduce fed estate tax liability? Yes No n/a #11. Does your estate plan include trust agreements? Yes No n/a #12. Does your E.P. have durable power of attorney for health or financial matters? Yes No n/a Financial Interests #1. Is saving money regularly a priority? Yes No n/a #2. Are Investments that offer high growth potential important? Yes No n/a #3. Is Investing in the stock market a preference? Yes No n/a #4. Is a low risk factor in my investments critical? Yes No n/a #5. Does investing in tax free investments appeals to you? Yes No n/a #6. Do Mutual fund investments interest you? Yes No n/a #7. Do you have investments in annuities? Yes No n/a #8. Does investing in tax deferred investments appeal to you? Yes No n/a #9. Does investment in real estate/reits interests me? Yes No n/a #10. Are you satisfied with you present rate of investment accumulation? Yes No n/a #11. Are you satisfied with the rate on your investments? Yes No n/a #12. Do you know the difference between Rate of Return and Yield? Yes No n/a #13. Do you know that higher returns usually have higher risk? Yes No n/a #14. Do you desire assistance in developing an investment plan? Yes No n/a 5

6 Paisley Financial Prescreen - General Client Profile I have answered the questions above to the best of my ability. I understand my advisor will be utilizing some or all of this information I have supplied to help determine to the best of their ability, suitable investments for me. I will notify my advisor of any changes to my time horizon, risk tolerance, or any other material developments or changes that may potentially affect his or her perception or understanding of my financial needs within a reasonable period of time. Client s Signature: Date: Client s Name (Print) Client s Signature: Date: Client s Name (Print) PAISLEY FINANCIAL LLC BY: Anthony Krcmar, Chief Compliance Officer 6

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