Aris. Client Information Form & Asset Allocation Questionnaire. Delivery Instructions: Address:
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1 Client Information Form & Asset Allocation Questionnaire Please fax or this completed form along with a copy of the client s most recent investment account statement to the Aris Business Center at (814) or newbiz@ariscorporation.com. If you have any questions, please call (814) or (800) Investment Advisor Representative s Name: Phone #:( ) Client Name: Retirement Plan Name (if applicable): Services & Format Requested: Proposal Only / PDF Proposal & Contract Paperwork / PDF Proposal & Contract Paperwork / Hard Copy Proposal / PDF & Contract Paperwork / Hard Copy Proposal / Hard Copy & Contract Paperwork / PDF Date Needed: / / (Please allow up to three (3) days for delivery time if requesting hard copy) Delivery Instructions: Address: Street Address: What is the total amount of investment assets to be included in all portfolios at Aris? $ What percentage of total net worth is represented by these portfolios? Approximate annual family income $ If money will be withdrawn from the portfolio immediately or in the near term, state how much and how often it will be distributed? $ Mo Qtr S/A Yr If this portfolio is taxable, what tax rates should be used for planning purposes? Federal Tax % Check box if this portfolio is NOT taxable: State Tax %
2 Client Information Form Account Details (Check All That Apply) Aris Service Offering: Asset Builder Faith Based Privately Managed Account Wealth Manager Biblically Responsible Aris Recommendation Income Builder Socially Responsible Aris Diversified Alternatives Portfolio (ADAPT) 403(b) Account Type: Joint IRA Rollover UGMA Individual Roth IRA SOLO K Trust IRA IRA/BDA SEP-IRA Billing: Deduct fees from account Deduct IRA fees from non-qualified account (Specify Registration) Other (Please describe in Special Instructions section on page 5) Dividends/Interest/Capital: Reinvested Paid in Cash Paid to Client Is anyone (i.e. client, spouse, trustee, etc.) affiliated with or employed by a stock exchange or member firm of either an exchange or FINRA, a municipal securities broker dealer or Fidelity? Yes No If Yes, Company: Is anyone a control person or affiliate of a public company as defined in SEC Rule 144? (This would include, but is not necessarily limited to: 10% shareholder, policy-making executive and/or member of the board of directors.) Yes No If Yes, Company: Trading Symbol: Primary Client Information Owner Trustee Mr. Mrs. Client Name: Ms. Dr Date of Birth: / / Client Social Security #: Mailing Address: Legal Address (if different): Phone:( ) Fax:( ) Address: Client Occupation: Name of Employer: Client Marital Status: Single Married Client Citizen Status: U.S. Resident Alien Other Client Driver s License # and State of Issuance: 2
3 Client Information Form Secondary Client Information Joint Owner Trustee Minor Guardian/POA Mr. Mrs. Client Name: Ms. Dr. Date of Birth: / / or Retirement Plan / Trust Name: Client Social Security #: Trust Tax Identification #: Trust Date: / / Mailing Address: Legal Address (if different): Phone:( ) Fax:( ) Address: Client Occupation: Name of Employer: Client Marital Status: Single Married Client Citizen Status: U.S. Resident Alien Other Client Driver s License # and State of Issuance: Affiliation with Broker Dealer: Yes No If yes, please provide Broker Dealer address: Please attach copy of legal document granting fiduciary authority. Client Beneficiaries (Qualified Assets Only) Primary Beneficiary Name: Relationship: Social Security #: Date of Birth: / / Contingent Beneficiary Name: Relationship: Social Security #: Date of Birth: / / Percent*: Percent*: *Please note: Percentages must equal 100%. Do not use fractional percentages or dollar amounts. If additional beneficiaries are required, please attach separate page. 3
4 Client Information Form Business / Partnership Accounts (Complete if Applicable to Account Type) Business / Partnership Name: Primary Contact Name: Mailing Address: Legal Address (if different): Date of Board Resolution Authorizing AWS Relationship: / / Account Type: Partnership 401(k) Money Purchase Incorporated Business Profit Sharing Defined Benefit Unincorporated Business Daily Valuation Other: Names of Officers: Titles: Authorized to Act on Behalf of Business? Yes No Yes No Yes No Number of Officers that Must Sign Contract Execution Fee Schedule (Representative Fee) This fee is in addition to Aris advisory fee: Asset Builder / Wealth Manager / Privately Managed Account / Income Builder / Socially Responsible / Faith-Based / Biblically Responsible $0 - $1,000,000 bps $1,000,001 - $3,000,000 bps $3,000,001 + bps Please indicate any fee split applicable to this client: Investment Advisor Representative: Split %: Additional Representative: Split %: Additional Representative: Split %: 4
5 Client Information Form Special Instructions / Additional Information To the best of my knowledge, this information is accurate and complete. Investment Advisor Representative Signature: Date: / / Investment Advisor Representative Signature: Date: / / 270 Walker Drive State College, PA Fax: Investment Management Retirement Services Trust Services 2012 Aris Corporation of America 5
6 Asset Allocation Questionnaire Willingness to Tolerate Risk Utilizing the following questions, we attempt to develop an expectation for your reaction to different market environments. It is important that your answers are not overly influenced by recent market activity. For example, after experiencing very strong market returns in the late 1990 s, answers to these questions may tend to lean towards growth and capital appreciation. Conversely, following periods of very poor market returns, such as those experienced in 2008, it may be tempting to answer these questions in an overly-cautious manner. 1. Prior investment experience may make investors more comfortable handling the financial markets ups and downs. How experienced an investor do you consider yourself: Inexperienced (1) Somewhat Experienced (3) Somewhat Inexperienced (2) Experienced (4) 2. When faced with an investment decision, are you generally more focused on the possible losses or the possible gains? Always the Losses (1) Usually the Gains (3) Usually the Losses (2) Always the Gains (4) 3. The statements of four investors regarding risk and return are listed below. Which statement most closely matches your own attitude? My biggest priority is not losing money. (1) The stability of my account is somewhat more important than the long-term return. (2) The long-term return of my account is somewhat more important than the stability. (3) My biggest priority is the return on my investments. (4) 4. Select the number that most correctly reflects your investment priority: (circle only one) Capital Preservation Capital Growth A higher allocation to equities increases the expected long-term portfolio return but also increases expected volatility. The bar graph below is a representation of hypothetical one-year returns for four different portfolios. The top of each bar represents an above-average one-year return for that portfolio. The bottom of each bar represents a below-average one-year return for that portfolio. Which portfolio would you prefer? (Check only one) Hypothetical One-Year Returns 40% Portfolio A (1) Portfolio B (2) Portfolio C (3) Portfolio D (4) 20% 0% -20% A B C D Portfolios Please add your scores from the Willingness section (questions 1-5) here: 6
7 Asset Allocation Questionnaire Ability to Tolerate Investment Risk With the following questions, we attempt to assess your ability to withstand investment risk based on some fundamental factors such as your time horizon, liquidity needs and general financial situation. It is important that if you experience significant changes to any of these factors that these changes are communicated with your financial advisor so any necessary adjustments can be made to your asset allocation. 6. How stable do you consider your overall financial situation (consider income and income sources, expenses, assets, debt, health, etc.)? Unstable (1) Somewhat Stable (3) Somewhat Unstable (2) Stable (4) 7. In the event you lost your primary sources of income, approximately how long could you cover your expenses from sources other than this account? I would need cash from this account immediately. (1) Less than six months. (2) Six months to one year. (3) More than one year. (4) 8. What is the likelihood that you will need more than 10 percent of this account in the next five years for a major purchase (consider real estate, car, school, medical bills, etc.)? A major purchase or expense is already planned and will come from this account. (1) This account would be a likely source of funds. (2) This account would be an unlikely source of funds. (3) No major purchases or expenses are already planned that would impact this account. (4) 9. I plan to begin taking regular distributions from this account in: Less than 3 Years (1) Years (3) 4-9 Years (2) Greater than 15 Years (4) 10. Time Horizon is the minimum time the portfolio is reasonably expected to be invested before liquidation or substantial modification. What is the time horizon for this portfolio? Less than 3 Years (1) Years (3) 4-9 Years (2) Greater than 15 Years (4) Please add your scores from the Ability section (questions 6-10) here: 7
8 Score Aris Asset Allocation Questionnaire Your target asset allocation will be determined by an Aris Investment Professional using the scoring chart below, along with any other unique circumstances. Ability to Tolerate Risk Willingness to Tolerate Risk Score % Bonds 100% Bonds 100% Bonds 100 % Bonds % Bonds % Bondss % Bonds Moderate Moderate Moderate Moderate Moderate Aggressive Aggressive Aggressive Moderate Aggressive Moderate Aggressive Aggressive Aggressive Aggressive Aggressive 100% Equities Asset Allocation Override (Optional) - I understand that my recommended risk tolerance is based upon the answers to the Asset Allocation Questionnaire above, along with any other unique circumstances to my situation. However, I instruct Aris to invest my portfolio in the following manner: 100% Bonds (80% Fixed Income, 20% Equities) (60% Fixed Income, 40% Equities) (50% Fixed Income, 50% Equities) Moderate (35% Fixed Income, 65% Equities) Aggressive (25% Fixed Income, 75% Equities) Aggressive (15% Fixed Income, 85% Equities) 100% Equities I agree with the above answers and will notify AWS, Inc., in writing, of any changes. I understand that rate of return and account value projections developed from the above answers are based upon economic estimates and statistical models, which do not constitute any guarantee that such results will be achieved. Furthermore, I maintain that the information provided in this questionnaire pertains to all of my accounts, and if it does not, I will provide a questionnaire for each account with different risk/return parameters. Client/Trustee Signature (not required for proposal-only requests) Date Client/Trustee Signature (not required for proposal-only requests) Date Investment Advisor Representative Signature Date 270 Walker Drive State College, PA Fax: Investment Management Retirement Services Trust Services 2012 Aris Corporation of America 8
9 Business Center 270 Walker Drive P.O. Box 1318 State College, PA ARIS Fax: * Indicates Required Information Consultant Registration Form *Salutation (check one): Mr. Ms. Dr. Other: *First Name: *M.I.: *Last Name: *Nickname: *Suffix (check one): Jr. II III IV Other: *Agency or Company Name: Rep. Number: *Broker/Dealer Affiliate Name: *Business Title/Agency Position: *Business Address: (City) (State) (Zip) *Business Phone: ( ) Cell Phone: ( ) *Business Fax: ( ) Business *Do you already have an Aris Web login & password? YES NO *Is the above your Mailing Address? YES NO, use home address below. *Where do you want all future CLIENT REPORTS mailed? My office Directly to client My home Home Address: Phone: ( ) Date of Birth: (City) (State) (Zip) Professional Designations (Check all that apply): CLU CFP CPA LUTCF LUTC MSFS FLMI CFA ChFC JD Series 7 Series 24 Series 63 Series 65 Series 66 Other: Assistant s Name: Phone: ( ) Fax: ( ) Attach Your Business Card Here For Aris Use: Route to Finance Date: Initials: to Systems Date: Initials: to Mail Admin. Date: Initials: to Web Admin. Date: Initials: to Aris Institute Date: Initials: Consultant Registration Form 1 A
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