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Investment Appointment – Client Information Form

Let’s get ready for our meeting!

Please complete the information below to help me understand your current situation and prepare for our conversation.

During our appointment, we’ll discuss your goals, review your answers together, and explore the options that fit your needs.

If you’re unsure how to answer a question, we can go through it together.

Kevin Giroux

PFSL Investments Canada Ltd.

About You

First name?

*

Last name?

*

Date of birth

*

Address

*

Telephone

*

Email address

*

How many dependents do you have?

*

Employment

Untitled multiple choice field

A

Employed

*

B

Self-employed

C

Retired

D

Student

Financial Overview

Gross Annual Income

(Your individual annual income before taxes, from all sources.)

A

Less than $25,000

B

$25,001 to $50,000

C

$50,001 to $100,000

D

$100,000 to $200,000

E

$200,001 to $400,000

F

Greater than $400,000

Net Worth

*

(The estimated value of everything you own, minus everything you owe.)

A

Less than $25,000

B

$25,001 to $50,000

C

$50,001 to $100,000

D

$100,000 to $200,000

E

$200,001 to $400,000

F

Greater than $400,000

Total Investment Portfolio Value

*

(The estimated total value of your investment accounts. We’ll clarify account ownership and details during our meeting.)

A

Less than $25,000

B

$25,001 to $50,000

C

$50,001 to $100,000

D

$100,000 to $200,000

E

$200,001 to $400,000

F

Greater than $400,000

Monthly Disposable Income

*

(Approximately how much is left after taxes, bills and regular expenses?)

What would you most like help with during our meeting?

*