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Client Initial Questionnaire

Client Initial Questionnaire

Investment Adviser Representative: Nathan David Roberts

Date / Time

First Name

Middle Name

Last Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Date of Birth

Occupation

Name & Address of Employer

Are you an associated person of another member firm (FINRA)?

Yes

Investment Time Horizon

Short Term (1-3 years)

Medium Term (4-7 years)

Long term (7+ Years)

Income Objective

Preservation of Capital (maintain principal, minimal risk)

Income (generate income, e.g. dividends)

Growth (long-term appreciation, moderate risk)

Aggressive Growth (maximum appreciation, higher risk)

Speculation (shorter term and potentially higher profits, highest risk)

Risk Tolerance

CONSERVATIVE – (My primary goal is to avoid losing money, even if it means missing out on potential gains. I am uncomfortable with volatility and seek to avoid as much risk as possible)

MODERATELY CONSERVATIVE – (I am willing to take a small amount of risk to achieve modest returns, but protecting my principal is still very important.)

MODERATE – (I am comfortable with some market fluctuations in exchange for potential higher returns. I accept the possibility of a temporary loss in search of a longer term gain.)

MODERATELY AGGRESSIVE – (I am comfortable with significant market fluctuations and seek higher returns. I am willing to accept the risk of a material loss to achieve my goals.)

AGGRESSIVE – (My primary goal is to achieve maximum growth and I am willing to accept the risk of substantial losses for the possibility of very high returns.)

SPECULATIVE – (I am comfortable with very high levels of risk and potentially extremely large losses in my quest for astronomical profits.)

Liquidity Needs: Do you anticipate needing these funds for any reason in the near future? If so, when and for what?

Investment Experience

Beginner – (little to no experience)

Intermediate – (some experience with basic investments like mutual funds)

Advanced – (experience with a variety of investments, including stocks, bonds, and ETFs)

Expert – (deep knowledge of complex investments, derivatives, and market dynamics)

Annual Gross Income

Estimated Amount To Invest

Liquid Net Worth (cash, savings, publicly traded securities)

Total Net Worth (include real estate, other assets)

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