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Entity's Financial Details
Annual Income:
O Less than $50.000
El 50,000-99.999
O 100,000-249.999
O 250.000-499,999
O 500,000.999,999
O 1,000.000 2.499,999
O 2,500,000-4,999.999
CI 5,000,000 and over
Net Worth:
CI Less than $50.000
0 50.000-99,999
K 100.000-249,999
O 250.000-499.999
K 500,000.999.999
O 1.000.000-2.499.999
O 2,500,000-4,999,999
K 5.000,000 and over
Entity's Source of Wealth (Check all that apply)
O Inheritance or Gifts
O Corporate Executive
O Sale of Other Assets
O Professional Earnings
O Sale of Securities
O Public or Gov't Official
O Lottery or Gaming
O Sale of Business
O Individual Earnings
O Sale of Real Estate
O Corporate Earnings
O Business Owner
Federal Tax Status (check ono):
0 0-15%
0 15.1-32%
0 32.1-50%
0 50.1% or more
Approx % of net worth that is
investable assets:
0 Other (please provide):
Please further describe the Primary Account Holders source of wealth including but not limited to employment (history if retired) earnings (salary.
bonus, commission), name of businesses owned/sold (history of growth & revenues, assets & fiabifities, proceeds of sale). For inheritance/gifts include
the amount from whom, and how originally earned.
Entity's Investment Experience
Investment Type
Experience
Annual Activity Level (Select one)
(Required)
Years of
Investing
None
No history
of any
transactions
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Heal Estate Property (excluding Primary
Residence)
Alternative Investments
(Hodge Funds, Private Equity)
Structured Products
Foreign Currency
Account Investment Objectives/Risk Tolerance
Investment Objectives (please select up to two consecutive investment objectives):
O Aggressive Growth: Investor is willing to accept substantial risk of loss to the portfolio to obtain growth of capital with minimal or no current
income. Investor seeks return mainly from potential capital appreciation; liquidity is of no primary concern.
O Growth: Investor is willing to accept increased risk of loss to the portfolio with greater exposure to the equity markets or equivalent markets. The
objective is long-term growth of capital. Investor seeks return mainly from capital appreciation and/or higher yielding instruments.
O Income: Investor is willing to accept some risk of loss to the portfolio with exposure to income producing securities in equity, fixed income or
equivalent markets. Investor seeks return mainly from income.
O Capital Preservation: Risk averse investor who is willing to accept limited risk of loss to the portfolio with limited exposure to equity markets risk
or equivalent risks. The objective is capital preservation with limited potential for capital appreciation and current income. Investor seeks stability
and a modest return on capital.
2
12-PWM-0355
011224.091212
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0110607
CONFIDENTIAL
SDNY_GM_00256791
EFTA01453155