Risk Tolerance Questionnaire This field is hidden when viewing the formAdministrative DataThis field is hidden when viewing the formRep Code– No Results –This field is hidden when viewing the formRep NameThis field is hidden when viewing the formRep NameThis field is hidden when viewing the formUser RoleThis field is hidden when viewing the formRep EmailClient InformationClient Name First Last Client Email Risk Tolerance InformationWhat type of returns are you seeking? 2: Income 3: Growth greater than Inflation 4: Maximum Growth Potential In approximately how many years would you expect to need this money? 2: 1 - 3 years 3: 3 - 7 years 4: 7+ years Which one of the following describes your expected future earnings over the next five years? 1: I expect my earnings to decrease (retirement, part-time work, economically-depressed industry, etc.) 2: I expect my earnings to keep pace with inflation. 3: I expect my earnings increase to stay somewhat ahead of inflation. 4: I expect my earnings increases will far outpace inflation (due to promotions, new job, etc.) How concerned are you that your savings and investment dollars outpace inflation? 2: Not very concerned 3: Moderately concerned 4: Highly concerned 5: Very highly concerned How would you react if the value of your long-term investments declined by 10% in one year? 1: I understand there may be market fluctuations, but I would be very concerned if my investments declined by 10%. 2: I accept some market fluctuations, but I would be somewhat concerned if my investments declined this much. 3: I generally invest for the long term and I would not be concerned with this decline. 4: I invest for the long term and would accept a 10% decline. How would you react if the value of your long-term investments declined by 20% in one year? 1: I understand there may be market fluctuations, but I would be very concerned if my investments declined 20%. 2: I accept some market fluctuations, but I would be somewhat concerned if my investments declined this much. 3: I generally invest for the long term and I would not be concerned with this decline. 4: I invest for the long term and would accept a 20% decline. Approximately what annual rate of return would you want / need to meet your goals? 2: Less than 5% 3: 5% - 10% 4: Greater than 10% Have you ever invested in individual bonds/stocks or bond/stock mutual funds? 1: No, but if I had, the fluctuations would make me uncomfortable. 2: No, but if I had, I would be comfortable with the fluctuations in order to receive the potential for higher returns. 3: Yes, I have, but I was uncomfortable at times with the fluctuations, despite the potential for higher returns. 4: Yes, I have, and I felt comfortable with the fluctuations in order to receive the potential for higher returns. Which of the following statements best describes your feelings toward choosing your investments? 2: I would select investments that have a low degree of risk associated with them. 4: I prefer investments with mostly a low degree of risk with a small portion that have a higher degree of risk. 6: I prefer to diversify with a balanced mix of investments. 8: I prefer investments with mostly an aggressive degree of risk with a small portion that have a lower degree of risk. 12: I would only select investments that have a higher degree of risk and a greater potential for higher returns. Δ
