The purpose of this survey is to ensure that our files are up-to-date, that our clients are receiving the level of service they deserve and to enable us to provide new services and appreciation events that you will enjoy. Please feel free to add any further information that you think would be of value to us in the additional comments section at the end of the questionnaire. Thank you. Note, required fields are marked with a *. *Name: Spouse: *Occupation: Occupation: *Current Address: *Contact Phone Number: Primary Beneficiary(ies): Do you have a Power of Attorney? Name: Yes No Do you have a valid Will? Last Updated: Yes No Do you have an accountant? Name: Yes No Do you have a lawyer? Name: Yes No Do you have a mortgage? Where: Yes No Will your estate include charitable bequests? Yes No What do you value most about your relationship with Brown Financial & Insurance Services? What percentage of your insurance and investment needs are managed by the following: %  Brown Financial Provide details for Bank/Advisor/Other below: %  Bank %  Advisor %  Other Would you like Brown Financial & Insurance Services to provide you with a comprehensive review of your investment portfolio? Yes No The following are the elements considered to be most important in a relationship with a financial advisor. Please rank the following in order of importance to you (1 = most important, 8 = least important). Availability 1 2 3 4 5 6 7 8 Experience 1 2 3 4 5 6 7 8 Expertise 1 2 3 4 5 6 7 8 Good Advise 1 2 3 4 5 6 7 8 Performance 1 2 3 4 5 6 7 8 Qualifications 1 2 3 4 5 6 7 8 Reputation 1 2 3 4 5 6 7 8 Trust and Ethics 1 2 3 4 5 6 7 8 How often do you like to be contacted? Monthly Semi-Annually Quarterly Annually Don't call me, I'll call you Never What form of communication do you prefer for purposes other than review of your portfolio? Telephone Face-to-face E-mail => address: What other forms of communication would you like to receive? (Please select all that apply.) Direct mail Small workshop Large seminars Telephone calls Personal newsletter Other: Which of these lifestyle changes do you expect over the next twelve to eighteen months? (Please select all that apply.) Graduate Start a business Start a financial plan Marry Receive an inheritance Invest more money Buy a home Borrow money Sell property Have a child Pay off a loan Sell a business Change employment Save more money Retire Receive a promotion Purchase property Other: What hobbies or special interests do you have? (Please select all that apply.) Travel Interior Design & Renovating Wine making & Tasting Golf Home entertainment & Cooking Gardening & Landscaping Internet Antique collecting & Refinishing Hiking & Mountain biking Art & Music Bird watching & Photography Other: Which of these topics do you feel are priorities to you? (Please select all that apply.) Personal/Spousal life insurance Charitable giving Review existing coverages Non-RRSP investing strategies Mortgage life/disability insurance Personal estate organization Disability income protection Planning for retirement Long-term care insurance Business insurance planning Retirement saving Business succession planning Education plans Employee Benefits Estate planning Other: Brown Financial should contact the following people regarding financial/insurance matters: Additional Comments: *Once we have received your completed survey would you like us to contact you to discuss your responses? Yes No Thank you again for taking the time to complete this survey. We will inform you of some of the common responses in a letter to follow in the coming months. Please be sure to provide all mandatory information (marked by *) in this form prior to submitting. If you submit an incomplete form and your browser cache settings are not correct you may return to a blank form.