Suitability Information

Your Account Title / Name*

1. What is your employment status?*

2. What is your occupation (former occupation if retired) ?*

3. What is your net worth (excluding your primary residence)?*

4. This investment is what percentage of your net worth (listed above)?*

5. What is your approximate annual income (for joint accounts include combined incomes)?*

6. What is your primary source of income?*

7. How would you describe your income?*