Investment Agreement Template (Page 4 of 4) in pdf

INVESTMENT OBJECTIVE QUESTIONNAIRE (cont.)

What percentage of your investable assets does this managed account represent? ___________%

What is your estimated net worth? ________________

How much investing experience do you have?______ no experience ______1 to 5 years ______5 to 10 years ______longer than 10yrs.

What is your marginal tax rate? ________________

Do you have other managed accounts, or own stocks individually?______Yes ______No

Although investment performance is not guaranteed, do you have an annual total return in mind for the portfolio?

______ No ______Yes, If yes, what is the return? ________________

Total return is the sum of dividends, interest and capital appreciation. Generally, the greater the emphasis on high income (dividends and interest only), the less potential

for capital appreciation. Do you have any specific requirements for annual income to be earned from this managed account?

______ Yes. Please indicated the rate

______ % or $ ________

_____ No. It is up to the investment advisor to determine the appropriate portion of income return for the portfolio.

Are there any quality restrictions for the fixed income instruments in the portfolio?

______No ______Yes

If yes, please indicate specific quality levels (e.g., Standard and Poor’s or Moody’s bond ratings)

___________________________________________

Are there any constraints on holding any specific security or industry group within the portfolio or any tax or legal issues related to the portfolio’s investment holdings?

______ No ______Yes

If yes, please indicate securities that are not acceptable for holding in the portfolio and/or other related issues.

__________________________________________

10. The time horizon used in evaluating investment return has significant impact on the probability of realizing the stated return objectives. The longer the time period, the

better the chance that up and down market cycles will average out and your desired return can be achieved. Please check the investment time horizon that seems most

appropriate for your account.

______10 yrs. or more ______ 5 to 10 yrs. ______ 3 to 5 yrs (usually a complete market cycle)

11. My investment objective for this portfolio over a market cycle would be:

______Preservation of capital and returns exceeding those of risk-free investments. (A low risk level means the portfolio is subject to minimal price

fluctuations.)

______A combination of modest growth of capital and income via high-quality investments. (Diversification and risk control through a balanced portfolio of

stocks, bonds and/or cash equivalents.)

______Growth of capital. (Exposure to increased levels of price volatility with expectations to outperform an equity index.)

______Aggressive growth of capital. (Exposure to yet higher levels of volatility with a greater expectation for outperforming a growth equity index. Income

is incidental and not a major investment consideration.)

12. Investment volatility you are comfortable with:

______Can tolerate more than one to two years of negative absolute returns in difficult market cycles.

______Can tolerate 4 to 5 quarters of negative absolute returns through difficult market cycles.

______Can tolerate infrequent, very moderate losses through a market cycle.

13. An increase in investment total return is usually associated with an increase in the acceptable level of fluctuation of the portfolio market value during market cycles.

Investment “risk” can be defined in different ways. Please indicate the single item that best describes how you tend to describe risk.

______The possibility of not achieving my established goals.

______Not at least equaling the rate of inflation

______High degree of fluctuation in the market value of the total portfolio within a market cycle.

______The chance of a great loss in market cycle of an individual security regardless of how well the total portfolio of securities might perform.

14. This risk/return graph compares the historical risk vs. performance relationship of several market indices. The vertical axis indicates rates of return, and the horizontal axis

indicates risk. The further right your portfolio falls on the graph, the more volatility it is likely to undergo in periodic returns. The closer to the top, the higher the return.

The relationships indicated here generally reflect a complete market cycle. Please put an “X” in the section (Chart Below) which best fits your investment objectives.

15.

Please provide any additional information you feel is relevant to the management of this portfolio

High

Return

More Aggressive

Aggressive

S&P 500

Balanced

Conservative

Low

More Conservative

Return