Client Suitability Questionnaire

Gerritz Wealth Management Client Suitability Questionnaire

The State of Oregon Securities Division requires “Registered Investment Advisors” to maintain and periodically update key client suitability information. Please complete and submit the following questionnaire at your earliest convenience. Thank you in advance for helping us comply with State regulations.

Answer each question the best you can (your best estimate of the numbers is all that is required).

After completing the form, input the CaptCha code and click the [Submit] button.

*(denotes required field)

Name: *

What is your annual household income? *

What is your Net Worth? *

What is your liquid net worth? (exclusive of house) *

What is your Federal Tax Bracket?:
(0 – 19%) Low Bracket
( 20 – 28%) Medium Bracket
(29% Plus) High Bracket

What is your investment objective?:
Growth & Income (All 3 GWM Standard Model Portfolio)
Income Only (Required Custom Model Portfolio)
Growth Only (Requires Custom Model Portfolio)
Capital Preservation ( No Securities)

What is your investment horizon?:
(1 – 3 Years) = Short Term
(3 – 10 Years) = Medium Term
(10 – 20 Years) = Long Term

What is your risk Tolerance Level?:
Low Risk (Golden Years Model)
Medium Risk (In Betweener Model
High Risk ( Go Getter Model)

What is your preferred management style?:
Buy & Hold (Requires Custom Model Portfolio)
Annual Rebalance (Requires Custom Model Portfolio)
Active Portfolio Management

CAPTCHA Code: *

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Gerritz Wealth Management, Inc.

Client Suitability Questionnaire

Gerritz Wealth Management Client Suitability Questionnaire

Retirement Success in the New Economy

Free Offer!