Cindy Skaggs, CFP® - Initial Discovery Questionnaire : C Skaggs, Asset Allocation Questionnaire, 270363, 030707jh

Securities and advisory services offered through LPL Financial, a Registered Investment Advisor, Member FINRA/SIPC.

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HOW CAN WE HELP YOU?
Check all that apply:	Mutual Discovery Meeting Comprehensive Planning Process Investments (401K Rollover / IRA's / Retirement / College / etc.) Insurance (Life / Disability / LTC / Estate Planning)

PERSONAL INFORMATION
» * Full Name:
» * Date of Birth:
Address 1:
Address 2:
City:
State:
Zip:
» * Home Phone:
Cell Phone:
» * E-mail:
Employment Status:
Age to Retire:
Employer:
Occupation:
Marital Status:
# Children:
Age(s) of Children:
Spouse's Full Name:
Spouse's Date of Birth:
Spouse's Employment Status:
Spouse's Age to Retire:
Spouse's Employer:
Spouse's Occupation:

FINANCIAL INFORMATION
Asset Values:
Your Home:
Other Real Estate:
Checking, Savings/CD's, Money Market Funds:
Stocks, Bonds, Mutual Funds:
Retirement Accounts (IRAs, 401Ks, SEPs, Keoghs):
Other Assets:
Liability Amounts:
Outstanding installment Loans, Credit Card Balances:
Mortgage(s) on your home:
Mortgage(s) on other Real Estate:
Other Liabilities:
Income & Expenditure Amounts:
Annual Household Income:
Is Income fairly uniform and predictable?
Annual Living Expenditures (including Federal, State & Local Taxes):
Annual Savings (including company savings plans, personal savings & contributions to retirement plans):
Estate Planning Information:
Do you and your spouse (if applicable) each have a will?
Do your will(s) have trust arrangement?
Do you and your spouse (if applicable) have a living trust?
Do you and your spouse (if applicable) have powers of attorney for healthcare and financial matters?
Insurance Information
Do you have Homeowners Insurance?
Do you have Disability Insurance?
Do you have Life Insurance?
Total death benefit of life insurance for yourself?
Total death benefit of life insurance for spouse (if applicable)?

RISK TOLERANCE QUESTIONNAIRE
This questionnaire is designed to help us define your time horizon and tolerance for risk. Your answers will help determine the asset allocation best suited to meet your needs.
* 1. When do you expect to begin withdrawing money from your investment account?
»	Less than 1 year 1 to 2 years 3 to 4 years 5 to 7 years 8 to 10 years 11 years or more

* 2. Once you begin withdrawing money from your investment account, how long do you expect the withdrawals to last?
»	Lump Sum 1 to 4 years 5 to 7 years 8 to 10 years 11 years or more

* 3. Inflation, the rise in prices over time, can erode your investment return. Long-term investors should be aware that, if portfolio returns are less than the inflation rate, their ability to purchase goods and services in the future might actually decline. However, portfolios with long-term returns that significantly exceed inflation are associated with a higher degree of risk. Which of the following portfolios is most consistent with your investment philosophy?
»	Portfolio 1 - Will most likely exceed long-term inflation by a significant margin and has a high degree of risk Portfolio 2 - Will most likely exceed long-term inflation by a moderate margin and has a high to moderate degree of risk Portfolio 3 - Will most likely exceed long-term inflation by a small margin and has a moderate degree of risk Portfolio 4 - Will most likely match long-term inflation and has a low degree of risk

* 4. Portfolios with the highest average returns also tend to have the highest chance of short-term losses. The table below provides the average dollar return of for hypothetical investments of $100,000 and the possibility of losing money (ending value of less than $100,00) over a one-year holding period. Please select the portfolio with which you are most comfortable. Probabilities after 1 year:
»	Portfolio A - Possible Average Value $106,000 - Chance of Losing Money 16% Portfolio B - Possible Average Value $107,000 - Chance of Losing Money 21% Portfolio C - Possible Average Value $108,000 - Chance of Losing Money 25% Portfolio D - Possible Average Value $109,000 - Chance of Losing Money 28%

* 5. Investing involves a trade-off between risk and return. Historically, investors who have received high long-term average returns have experienced greater fluctuations in the value of their portfolio and more frequent short-term losses than have investors in more conservative investments. Considering the above, which statement best describes your investment goals?
»	Protect the value of my account. In order to minimize the chance for loss, I am willing to accept the lower long- term returns provided by conservative investments. Keep risk to a minimum while trying to achieve slightly higher returns than the returns provided by investments that are more conservative. Balance moderate levels of risk with moderate levels of returns. Maximize long-term investment returns. I am willing to accept large and sometimes dramatic fluctuations in the value of my investments.

* 6. Historically, markets have experienced downturns, both short-term and prolonged, followed by market recoveries. Suppose you owned a well-diversified portfolio that fell by 20% (i.e. $1,000 initial investment would now be worth $800) over the short period, consistent with the overall market. Assuming you still have 10 years until you begin withdrawals, how would you react.
»	I would not change my portfolio. I would wait at least one year before changing to options that are more conservative. I would wait at least three months before changing to options that are more conservative. I would immediately change to options that are more conservative.

* 7. The following choices are the hypothetical results of four sample portfolios over a one-year holding period. The best potential gains and worst potential losses are presented. Due to risk, the portfolio with the best potential gain also has the largest potential loss.
»	Portfolio A - Potential Gain +45% - Potential Loss -26% Portfolio B - Potential Gain +34% - Potential Loss -20% Portfolio C - Potential Gain +26% - Potential Loss -15% Portfolio D - Potential Gain +15% - Potential Loss -7%

* 8. I am comfortable with investments that may frequently experience large declines in value if there is a potential for higher returns.
»	Agree Disagree Strongly disagree


ADDITIONAL COMMENTS