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Tina Tannery, Wealth Advisor
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Confidential Personal & Financial Profile
In order to avoid asking you for the same information over and over again, it's best if we collect some basic information up front. Please take a moment to fill out the following profile.
Name
*
Nickname
Birthdate (mm/dd/year)
Spouse's Name
Spouse's Nickname
Spouse's Birthdate (mm/dd/year)
Children's Names & Ages
Residence Address
*
Residence City
*
Residence State
*
Residence Zip
*
Mailing Address
*
Home Phone
Cell Phone
Additonal Cell Phone
Work Phone
Email Address
*
Additional Email Address
*
Who referred you to us?
What is your investment objective?
*
Aggressive growth Growth
Growth with income
Income
What is your approximate annual income?
*
$0 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000
What is the approximate value of your investable assets?
*
$0 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000
What is your approximate liquid net worth?
*
$0 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000 -$1,999,999
$2,000,000
What is your approximate net worth?
*
$0 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000 - $1,999,999
$2,000,000
What tax bracket do you fall into?
15%
25%
28%
33%
35%