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  2. 2016
  3. February
  4. C
  5. Confidential Client Data Form
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Exit Survey
 
 
We're excited to take the first steps with you toward your financial goals. Now that you've completed your Risk Number questionnaire, we are preparing a few example portfolios based on your risk tolerance and investment objectives.

This confidential client data form allows us to dive a little deeper into your financial situation ahead of time so that our first meeting can focus on the things that are important to you -- whether that's learning about us, our values, the current economic landscape, or whatever else you'd like to discuss.

We really appreciate you taking the time to complete this short form, and we look forward to meeting with you! If you have any questions, please call us at 1-888-832-4939 or write us at [email protected]. When you're ready, just click the "Next" button below to begin.

Kindest regards,
The TWS Team
 
 
Contact Information
First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
Phone : 
Email Address : 
 
 
Spouse's Information (if married / applicable)
First Name : 
Last Name : 
Email Address : 
 
 
 
Occupation
   
Employer
   
Salary
   
Spouse's Occupation (if applicable)
   
Spouse's Employer
   
Spouse's Salary
   
 
 
 
Liquid net worth (checking, savings, stocks, brokerage accounts, etc.)
   
Total net worth (excluding the value of your primary residence)
   
Other annual income (for example, from a rental property or insurance benefit)
   
Total number of children / dependents (not including spouse)
   
Do you use the services of an accountant?
   
Do you have a family or personal attorney?
   
 
 
 
What are your current investment objectives? You can choose as many as are applicable.
 
Retirement
 
Current income
 
Tax-favored income
 
Long-term growth
 
Growth and income
 
Preservation of capital
 
Speculation
 
Hedging
 
Large purchase

 
 
 
How many years until your first investment objective? For example, if your objectives are a large purchase in 6 years and retirement in 20 years, please enter 6. If your needs are immediate -- like current income -- please enter 0.
   
 
 
 
How many years of experience do you have managing your investments? What investments have you primarily used?
   
 
 
To help us understand your current investment composition and liquid asset levels, please fill in the following table. Your best estimates are fine, and don't worry if you can't recall everything right now -- we can add the information later!
Type (IRA, 529, checking, etc) Value Investment Types (mutual funds, cash, ETFs, etc) Financial Institution
Account 1
Account 2
Account 3
Account 4
Account 5
Account 6
Account 7
Account 8
Account 9
Account 10
 
 
 
Estate Planning Information

Please select all of the up-to-date legal documents/plans that you have. If anything is outdated, or you think something should be updated, please leave the selection blank.
 
Will
 
Durable Power of Attorney
 
Limited Power of Attorney
 
Medical Power of Attorney (or Living Will)
 
Estate Plan prepared by attorney

 
Copyright 2016 Targeted Wealth Solutions LLC. Confidential Client Data Form