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BFM_Questionnaire_2011

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Confiden’al © Bourbon Financial Management, LLC. All Rights Reserved 1 BFM Questionnaire The purpose of this questionnaire is to get to know you a little better and understand your situation, your needs and what you would like to accomplish. It may also help you define important factors including the length of time you have to invest, your tax considerations, and your ability to withstand downside risk that may affect the value of your investment. Your feelings about investing and taking risks are also very important. Your answers will help build the base of information needed for the development of an appropriate asset allocation policy and financial plan. The information you provide is strictly confidential and will not be disclosed to anyone without your consent. Our goal is to understand which personal and financial measures are most important to you, and to exceed them. Congratulations on your decision to develop a customized financial strategy! This document is also a tool to help you review your whole financial situation and get a better vision of where you stand today. Please keep in mind that we can also construct this review together if you have any doubts about some of the elements listed below. If you are unsure of a certain response, please use a close estimate. For the initial consultation and the financial review, you may bring your financial materials (retirement/brokerage accounts statements, tax return, benefit statements from Social Security or employers, estate planning documents, insurance policies, mortgage and other loan statements,...). Our value proposition to you is to help you find out what is important to you and accomplish it. We look forward to providing you and your family with your customized financial plan.
Transcript
Page 1: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 1

BFM Questionnaire

The purpose of this questionnaire is to get to know you a little better and understand your situation, your needs and what you wouldlike to accomplish. It may also help you define important factors including the length of time you have to invest, your taxconsiderations, and your ability to withstand downside risk that may affect the value of your investment. Your feelings aboutinvesting and taking risks are also very important. Your answers will help build the base of information needed for the developmentof an appropriate asset allocation policy and financial plan.

The information you provide is strictly confidential and will not be disclosed to anyone without your consent. Our goal is tounderstand which personal and financial measures are most important to you, and to exceed them.

Congratulations on your decision to develop a customized financial strategy!

This document is also a tool to help you review your whole financial situation and get a better vision of where you stand today.Please keep in mind that we can also construct this review together if you have any doubts about some of the elements listedbelow. If you are unsure of a certain response, please use a close estimate.

For the initial consultation and the financial review, you may bring your financial materials (retirement/brokerage accountsstatements, tax return, benefit statements from Social Security or employers, estate planning documents, insurance policies,mortgage and other loan statements,...).

Our value proposition to you is to help you find out what is important to you and accomplish it. We look forward to providing you and your family with your customized financial plan.

Page 2: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 2

Date NameDate and Location of BirthAddressHome phoneMobile phoneEmail

OccupationBusiness nameBusiness addressBusiness phoneWhen did you start there

Preferred way to contact you

Have you been unhappy with the recommendations of an advisor before? Why?

Address Phone Number / E-mail

Accountant

May we have your permission to contact your advisors, if needed?

Personal AttorneyBusiness Attorney

Insurance Advisor

OtherInvestment Advisor

Other members of your family

Your (and your spouse) information

RelationshipName Date and Location of Birth Tax Dependent (yes/no)

Other information

Name

Do you receive other financial or legal advice? (Optional)

Page 3: BFM_Questionnaire_2011

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What are your experiences with other advisers?

Qualitative / Behavioral Questions

- To generally keep pace with the stock market - To slightly trail the stock market, but make a good profit - To trail the stock market, but make a moderate profit - To have some stability, but make modest profits - To have a high degree of stability, but make small profits

- I wouldn't worry about losses in that time frame - One year means nothing - If I suffered a loss of greater than 25%, I'd get concerned - I can only tolerate small (10%) short-term losses - I'd have a hard time stomaching any losses

How disciplined are you in funding a retirement plan?

What keeps you up at night?

What is the most painful experience or lesson you had in the financial area?

How are you feeling about these days?

What are you looking forward to with excitement?

How often do you exercice / go to the gym

What are your top 3 values (Happinness, Safety, Wealth, Friendship, Family…)?Tell us how are you handling your finances?What do you have in place for managing your wealth?

How successful has this approach been so far? Any areas you would like to improve?

How would you know that you pick the right financial planner in 5 years from now?

How did you react in the past to market ups and downs (in 2001-2002 and in 2008)?

Imagine you awaken tomorrow and magically it’s 2020-you are leading your ideal life-Describe your ideal life at that time-what’s bringing you joy, satisfaction, and meaning. What are the 3 major areas where we should develop goals, and incorporate them into financial plan?

What three things would cause you to leave BFM?

How do you visualize your life in 10 - 30 years?

When do you expect to start drawing income?

Which of these statements would best describe your attitudes about the next twelve months' performance of your assets? (select one sentence)

Assuming normal market conditions, what would you expect from your asset over time? (select one sentence)

What’s a good adviser-client relationship ?

Are you happy with your career? Any career change plans?

What would you do with infinite money and free time?

Describe your perfect calendar, your first year of retirement after achieving your wealth objectives.

What are your hopes and dreams?

Envision us meeting in about three or five years in the future. What has happened between then and today, to have made you happy about your progress?

Ultimately, what do you want your wealth to accomplish?

Page 4: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 4

1

2

3

How often do you wantus to call you or meet you per year?

Investment Goals and Concerns

Think about your ideal life in the future. What are the three major areas where we should develop goals, and incorporate them into a financial plan? What leads you to select each of these three? Tell us about your timeframe for meeting your

goals.

How many years of investment experience do you have?

What would you expect from BFM? How do you see us helping you?

What is your investment horizon (in years)?

What does money mean to you? If freedom, why freedom is important to you?

Page 5: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 5

Priority How much? By when?

Protect against a major catastrophe.

Estate Planning

Income Tax

Protection

Other?

Maximize long term investment income.

Your priority can be High/Medium/Low and you can quantify with any figure that is relevant (amount, percentage, other in How Much?) and estimate time frame (By When?).

Diversify investment portfolio.

Investment objectives

Establish an emergency fund.

Protect assets against inflation erosion.

Reduce amount paid in income taxes.

Other?

Lifestyle

Reduce debt.

Please rate the following investment goals (High/Neutral/Low) and quantify if possible

Accumulate an estate in order to pass to heir.

Other?

Invest in own business.

Do you feel optimistic about the future? (From 1-pessimistic to 10-very optimistic)

Giving

Other

Make gifts of particular property.

Maintain/Increase giving.

Provide a college education for our children.

Be able to retire at a chosen lifestyle.

Assist your parent financially.

Protect family lifestyle in the event of death.

Travel.

Protect family lifestyle in the event of disability.

Provide assets for a surviving spouse and family.

Establish a family budget.

Manage and minimize future income tax liabilities.

Make a large purchase (car, house, etc.).

Page 6: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 6

60 000$ 75 000$ 90 000$ 100 000$

Newspapers Own research / models

Education Friends' recommendations

What Return on Investment do you expect (% per year) ?

Do you want to minimize losses (1) or maximize accumulation regardless of risk (10)?

How would you rate your knowledge of the stock market?(From 1-minimal to 10-expert)

What ressources do you rely on for your investment decisions? (If applies)

What do you do with your time away from work?

When did you take risks in your life?

If you have $100,000 in January, what would be the worst amount you would accept in December?

Have you ever made investment decisions (No - Rarely - Ofen - Very Often)?

Other?

Page 7: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 7

Cost Ownership

Category Date Institution Original Value Rate/Duration Current Value Monthly Ownership

MortgagesCredit CardAuto/SchoolOther

Institution Insured Beneficiary Cash Value Premium Ownership

Who will take care of you if you become ill or disable?

Description Date of Purchase

Real Estate

Insurance

Current Value

Category

Life InsuranceMedical Insurance

Other

Long Term CareDisability Insurance

Furnishing/Art

Personal Residence

Other

Secondary ResidenceReal Estate Investment

Liabilities

If it applies, at what age your parents have passed away?

Institution

Please provide in a separate document, the name, tickers, and amount for each investment in your taxable and non taxable accounts. We will also need the funds tickers that are available in your 401k. For each asset listed, designate ownership (husband = H, wife = W, joint = J,

community property = CP).

Category

Checking Accounts

Bank Accounts and Investment

Other Bank Accounts

Amount Ownership

Assets and Liabilities

Hybrid Funds

Stocks/Equity Funds

Cash/Equivalents

Savings Accounts

Certificates of Deposit

Hedge Fund / Private Equity

Bonds Funds

Other

Business OwnershipCompany Stocks/Options

Page 8: BFM_Questionnaire_2011

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Institution Ownership

Annual Expected Benefits from your Pension Plan / Defined Benefit Plan (if you have one)

Expected Year of RetirementIdeal PlanCurrent Annual Income neededExpected Annual Income neededPension/Defined Benefits Income ExpectedBeneficiaries

Other

Planning for your future

Category Present Amount

401k-403b

Retirement Planning

Institution

Will

Power of Attorney

Estate Planning

Trusts

Category Existing

Tax strategies

Roth IRA

Gifting strategies

Description Amount

Year

Health care proxy

Category Institution Amount

College SavingsOther

Annual CostEstimated Costs

Savings

Traditional IRA

Other

Annual Contribution

Education Planning

Page 9: BFM_Questionnaire_2011

Confiden'al ©  Bourbon  Financial  Management,  LLC.    All  Rights  Reserved 9

Charitable giving

-$ -$

-$

* Food, Clothing, Transportation, Children activities, etc.

Do you expect an inheritance or major gift?

Value Value

-$

-$

-$

Name: Signature:

Date:

Car payments

Other

BonusSalary

Annual Income and Expenses (After Tax)

Utilities

CASH FLOW

Estimated Total Net Worth

Assets and Liabilities

Assets Liabilities

Assets (excluding Real Estate) Total Liabilities (excluding Mortgages)

Liquid Net Worth

Real Estate Current Value Mortgages

Real Estate Equity

Next 5 Years

Interest

Income projections (estimates)

Average Last 5 Years

Savings/Retirement (401k, IRA, Other)

Your Financial Situation

Housing (Rent, Mortgage, Insurance)

Interests

Education costs

Other Expenses*

TOTAL TOTAL

SalaryBonus

Year-End

Medical ExpensesOther Insurance premiums

This  ques'onnaire  contains  9  pages.  The  client  has  to  sign  all  the  pages  must  understand  and  read  all  the  content  before  signing.  


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