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Suitability Form
Suitability Form
Byron Green
2017-08-29T14:50:58-05:00
Green Investment Management, Inc.
Investor Suitability Questionnaire
Date
(mm/dd/yyyy)
Client name:
*
Advisor's/Representative's Name
The purpose of this questionnaire is to help us understand your financial needs and investment preferences so we will be able to help you develop or maintain an appropriate financial strategy.
Please answer the following questions with reference to the particular Green Investment Management account you are opening or updating now.
1. What is your estimated liquid net worth (including cash and securities)?
*
less than $50,000
$50,000 to $199,999
$200,000 to $1,000,000
over $1,000,000
2. This investment is what percentage of your estimated liquid net worth?
*
under 20%
20% to 40%
41% to 60%
61% to 80%
over 80%
3. What is your approximate annual income (for joint accounts include combined incomes)?
*
less than $25,000
$25,000 to $49,999
$50,000 to $99,999
$100,000 to $200,000
over $200,000
4. What is your primary source of income?
*
retirement savings
current earnings
other investments or savings
5. How would you describe your income?
*
declining
stable
rising
rising rapidly
6. How many months of emergency funds, separate from this investment, do you have?
*
under 3 months
3 to 8 months
9 to 12 months
over 12 months
7. What is your experience in investing in stocks and bonds or stock and bond mutual funds? In the case of a custodial or trust account, this question refers to the Custodian or Trustee(s) experience.
*
I have a very limited knowledge about stocks and bonds and I dependent on advice from professionals.
I have a basic understanding of the markets, stocks, bonds and mutual funds.
I have a good understanding of investments and I can discuss financial concepts.
I understand asset allocation and have researched and selected securities as investments.
8. How long do you plan to hold this investment?
*
3-5 years
6-9 years
over 10 years
9. What are your general investment objectives?
*
income
income and growth
growth
aggressive growth
10. When do you need income from this investment?
*
immediately
in 1- 2 years
in 3 - 5 years
in 6 - 9 years
in 10 or more years
10 (b). How much annual income do you need as a percentage of the current value of your account?
*
1-2%
3-5%
6-7%
over 7%
11. What is your risk tolerance or ability to accept short-term fluctuations in the value of your account?
*
low
medium
high
12. What is your current age bracket?
*
1 to 20
21 to 35
36 to 50
51 to 64
65 and over
not applicable
*
Payment options
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