1. I keep track of my personal income, expenses, assets, debts and savings rate *

Yes

No

2. I have a budget and financial goals that I am working towards *

Yes

No

3. I am saving and investing sufficiently and effectively to retire or become financially independent *

Yes

No

4. I own a home and have a trust to avoid probate and asset transition costs *

Yes

No

5. I expect to receive an inheritance and I have a strategy to protect and maintain it *

Yes

No

6. I have a financial plan and it addresses asset needs (savings rates, return on investment), account structures and tax strategy *

Yes

No

7. I discuss money management with my spouse and children *

Yes

No

8. I have a financial issue or concern to navigate and may need some guidance *

Yes

No

9. I am aware of my investments, understand them and know how they are performing (profits, dividends, etc) *

Yes

No

10. My investment selections are based on my goals, needs and requirements *

Yes

No

11. My risk-taking aligns with my cash flow needs and capacity for potential loss *

Yes

No

12. My investments are diversified but include unique individual holdings *

Yes

No

13. I understand and am satisfied with the fees charged by my current investment brokerage and/or advisor(s) *

Yes

No

14. My ethical values are reflected in my investment decisions *

Yes

No

15. I am patient and have an even temperament when asset prices in my portfolio fluctuate *

Yes

No

16. I am confident in my investment holdings and/or management *

Yes

No

Name *

First Name

Last Name

Phone *

Country

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