Suitability Information

Your Account Title / Name*

1. What is your employment status?*

Employed
Retired
Unemployed

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

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

Less than $50,000
$50,000 to $199,999
$200,000 to $999,999
$1,000,000 or more

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)?*

Less than $25,000
$25,000 to $49,999
$50,000 to $99,999
$100,000 to $200,000
Over $200,000

6. What is your primary source of income?*

Retirement Savings
Current Earnings
Other Investments

7. How would you describe your income?*

Declining
Stable
Rising
Rising Rapidly

8. 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

9. 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.*

Severely limited. I am fully dependent on advice from professionals.
I have a basic understanding of the markets, stocks, bonds & mutual funds.
I have a good understanding of investments & can discuss financial concepts.
I understand asset allocation & how to research & select securities for investment.

10. How long do you plan to hold this investment?*

3-5 years
6-9 years
10 years or more

11. What are your general investment objectives?*

Investor Suitability Questionnaire