Personal information (You)

* Required Fields
*Name (last, first)
Date of birth:
Address (street):
Address (city):
Address (state, zip)
*Home phone:
Cell phone:
*Email address:
Occupation:
Employer:
Business address (street):
Business address (city, state, zip):
Number of dependents:
Children's ages:
Marital status:	Single Married Partnered Divorced Widowed
Tax bracket(s): If you're not sure, check with your tax advisor or find your bracket on your most recent tax return¹	Unsure 10% 15% 25% 28% 33% 35% 39.6%
1. Equitable Advisors does not provide accounting or tax advice.

Personal information (Spouse/partner)

Name (last, first)
Date of birth:
Address (street):
Address (city):
Address (state, zip)
Home phone:
Cell phone:
Email address:
Occupation:
Employer:
Business address (street):
Business address (city, state, zip):

Retirement strategies

How concerned are you about:
Knowing how much income, in today's dollars, you will need upon retirement?	High Low
Knowing how much income your current strategy will provide during retirement?	High Low
Having a systematic program for savings and investments?	High Low
Accumulating retirement funds without paying current taxes on any growth?	High Low
Reducing current taxation on a portion of your retirement income?	High Low
Maintaining the buying power of your savings and investments?	High Low
Does your company provide a retirement plan?	Yes No
Does your spouse's/partner's company provide a retirement plan?	Yes No
Are you satisfied with the amount you currently save and invest?	Yes No
Are you satisfied with your asset diversification?	Yes No
Have you confirmed your Social Security earnings and benefits in the last 12 months?	Yes No
At what age would you like to retire?
At what age would your spouse/partner like to retire?
In current dollars, what amount will you need monthly?
What amount will your spouse/partner need monthly?

Accumulation strategies

How concerned are you about:
Providing funds for your child's/grandchild's education?	High Low
Saving for a new or second home?	High Low
Saving for a special vacation?	High Low
Saving for a special project or purchase?	High Low
Saving to buy a business or practice?	High Low
Do you know how much money you will need for your accumulation goal(s)?	Yes No

Income protection strategies

How concerned are you about:
Paying off your mortgage and other debts in the event of death or disability?	High Low
Providing adequate income for your family in the event of death or disability?	High Low
Providing long-term care for yourself, your spouse/partner or your parents?	High Low
Does your company provide group term life insurance?	Yes No
Does your company provide survivor's benefits for your spouse/partner?	Yes No
Does your company provide a disability income program?	Yes No
Would you like to review your current insurance coverage?	Yes No
Do you believe you may have to support a parent or other family member?	Yes No
Are there any special needs situations?	Yes No
If yes, please explain

Wealth preservation strategies¹

How concerned are you about:
Reducing estate taxes your heirs may have to pay?	High Low
Providing for the efficient transfer of assets to your heirs?	High Low
Managing an inheritance or potential inheritance?	High Low
How soon would you like to have an up-to-date will or trust?	Not a priority Within 30 days Within 60 days
Do you have an attorney?	Yes No
Do you have a CPA/tax advisor?	Yes No
Would you consider starting a gifting program to reduce the size of your estate?	Yes No
Would you consider making charitable gifts?	Yes No
1. Equitable Advisors does not provide legal, accounting or tax advice. You should consult your own legal, accounting and/or tax professional for such advice.

Other strategies

Do you have written financial goals?	Yes No
Have you implemented a plan for achieving your goals?	Yes No
Do you have a current inventory of your major assets?	Yes No
Do you have a current copy of your company's benefit program?	Yes No
Would you like a review of existing financial arrangements?	Yes No
Is it important for you to have access to a team of financial professionals?	Yes No
Would you like a comprehensive financial planning analysis?¹	Yes No
If not, are there any areas on which you would like to focus?	Yes No
If yes, which areas?
How much would you like to set aside on a monthly/yearly basis to achieve your financial goals?
1. Only investment advisory representatives may offer and provide financial planning services.

Anticipated changes

Check all that are likely to occur in the next 12 months
Marriage/civil union/commitment ceremony Have or adopt a child Graduation Divorce Care for a dependent parent Obtain or pay off a loan Increase savings Buy or sell an investment	Inheritance Buy or sell a home Living arrangements/co-habitation changes Job change or promotion Bonus or salary increase Buy or sell a business/practice Retirement

Annual household income

Under $50,000 $50,000 - $74,999 $75,000 - $99,999	$100,000 - $199,999 $200,000 - $499,999 $500,000 or more

Types of assets or insurance

Assets and liabilities

Total assets (excluding home)	Total liabilities (excluding of home)
Under $100,000 $100,000 - $199,999 $200,000 - $299,999 $300,000 - $499,999 $500,000 - $999,999 Over $1,000,000 Liquid net worth	Under $50,000 $50,000 - $99,999 $100,000 - $149,999 $150,000 - $249,999 $250,000 - $499,999 Over $500,000

How much of a financial risk-taker are you?

Conservative asset allocation strategies are most appropriate for investors seeking low volatility and a steady average rate of return. The rate of return may be equal to, or exceed, the targeted rate of return on a fixed-income portfolio by investing a small portion in stocks. Conservative-Plus asset allocation strategies are most appropriate for investors seeking potential returns above the average targeted return from a fixed-income portfolio, accompanied with some volatility experienced from investing a portion in stocks. Moderate asset allocation strategies are most appropriate for investors seeking above-average returns with increased volatility experienced from investing in a balanced portfolio of both fixed-income investments and stocks. Moderate-Plus asset allocation strategies are most appropriate for investors seeking high potential returns with the expectation of significant volatility in any given year resulting from a portfolio with more stocks than fixed-income investments. Aggressive asset allocation strategies are most appropriate for investors seeking the greatest potential return with extreme volatility in any given year from a portfolio invested mostly in stocks.	Conservative Conservative-Plus Moderate Moderate-Plus Aggressive
What is the best investment you ever made?
What is the worst investment you ever made?
What is the most important thing in your life right now?
In the next 5 years, what has to happen for you to have financial success?

Discovery Survey