Name: Email:

Phone Number:

1) What is your current employment status? (Please select one.)

Full-time-employee Part-time employee Between jobs
Full-time-business owner Homemaker/Stay at home Retired
Other:

2) At what age do you plan to retire?

Age Don't Know Never Already retired

Investment Overview and Preferences

This section will help us determine your primary purpose for investing, your investment timeline, your cash needs during that period and your tolerance for risk.

3) What is your primary purpose for investing with James Russell IV?

Wealth Accumulation Educational Planning Retirement
Current Income Major Purchase
Other:

4) Do you need current income (that is, will you take regular withdrawals from this account)?

Yes* No

If "Yes", approximately what percentage of the account's current value will you need annually?

Less than 2% Greater than 4%, but less than 6% Greater than 2%, but less than 4% Greater than 6%

*If your primary purpose in B1 is "Current Income", please complete B2 and then skip to B5 otherwise, continue to B3.

5) In approximately how many years do you expect to begin withdrawing funds for your primary investment objective?

Immediately 1-5 years 6-10 years 11-20 years Over 20 years

6) Once you begin to withdraw funds for your primary investment objective, over how long a period do you anticipate the withdrawals to continue?

expect to withdraw all funds in a single lump sum 1-5 years
6-10 years 11-20 years Over 20 years

7) Which one of the following statements best describes your attitude toward the trade-off between risk and return?

I am primarily concerned with limiting risk.
Limiting risk and maximizing return are of equal importance to me.
I am primarily concerned with maximizing the returns of my investments. I am willing to accept high risk and a high chance of loss in order to maximize my investment return potential.

8) The following graphs show the historical year-by-year returns for three hypothetical portfolios over a 20-year period. The average annual return over the 20-year period is also indicated. Again, please note that these are hypothetical examples only, for the purpose of gauging your tolerance for risk. Actual results of any particular investment will vary and may be negative.

Also note that Investment Y's risk is substantially greater than Investment X's and Investment Z's is substantially greater than Investment Y's.

Given your investment goals for this account, which portfolio would you choose?

Portfolio X Portfolio Y Portfolio Z

9) The risk of a portfolio suffering a decrease in value (having a negative return) is often a primary concern for investors. In seeking to achieve potentially higher returns, however, an investor must be willing to accept greater risk, The following table portrays four different hypothetical $100,000 portfolios.

For each portfolio the assumed value at the end of one year is shown, along with the probability of suffering a decline that year rather than a gain. Given your investment objective, in which of the four hypothetical portfolios would you be most comfortable investing?

PORTFOLIO

EXPECTED VALUE OF $lOO.OOO AFTER 1 YEAR

CHANCE OF LOSING MONEY AFTER 1 YEAR

INVESTMENT CHOICE (CHOOSE ONE)

PORTFOLIO A

$107,000

19%

PORTFOLIO B

$108,000

23%

PORTFOLIO C

$109,000

26%

PORTFOLIO D

$110,000

28%

10) Each bar below shows a range of possible one-year ending values for a $100,000 initial investment in one of four hypothetical portfolios. The assumed value of the average return for that portfolio is shown in the center of the bar.

The four bars represent the four hypothetical portfolios.
(Please note that these are only examples-actual results will vary.)

Given the assumed possible average, best and worst outcomes for each portfolio, please indicate which of the four options you would consider most suitable for this investment objective.

Portfolio A Portfolio B Portfolio C Portfolio D

11) Inflation can greatly erode the return on your investments, especially over time. For example, assume a year with a 3.5% inflation rate, an investment with a 6% return before inflation would have a real return of only 2.5% (6%-3.5% = 2.5%).

I prefer a portfolio that has the potential to return substantially more than inflation over the long run (and a greater potential for loss) to achieve this goal.
I prefer a portfolio that has the potential to exceed inflation moderately over the long run.
I prefer to minimize short-term fluctuations in portfolio value (and the potential for loss).

12) Sometimes investment losses are permanent, sometimes they are prolonged, and sometimes they are short-lived. How might you respond when you experience investment losses?

I would sell my investments immediately if they suffered substantial declines.
Although declines in investment value make me uncomfortable, I would wait one to two quarters before adjusting my portfolio.
I can endure significant declines in the value of my investments and would wait at least one year before adjusting my portfolio.
Even if my investments suffered a significant decline over several years, I would continue to follow my long-term investment strategy and not adjust my portfolio.

Investment Overview and Preferences

This set of questions helps us understand your preferences for certain asset classes. Please note that your final investment selection mayor may not include the asset classes selected below.

13) Would you consider allocating a portion of your portfolio to international investments?
Yes No

14) Would you consider allocating a portion of your portfolio to real estate investments?
Yes No

15) Would you prefer your fixed-income investments to be in tax-exempt municipal bond investments rather than taxable government or corporate bond investments?
Yes No

16) Would you consider allocating a portion of your portfolio to high-yield fixed income?
Yes No

17) Would you consider allocating a portion of your portfolio to emerging markets investments? Yes No