What licenses do you hold?

• Insurance
• Securities
• CPA
• J.D.
• Other

Are you personally licensed or registered as an investment adviser with the:

• State(s)?
• Federal Government?

If yes, how are you going to tell me when you are acting as a sales agent of the brokerage firm and when you are acting as an investment adviser?

If no, why not?

Is your firm licensed or registered as an investment adviser with the:

• State(s)?
• Federal Government?

If no, why not?

Will you provide me with your disclosure document Form ADV Part II or its state equivalent?

• Yes
• No

If no, why not?

Will you provide me with a written disclosure detailing any disciplinary history for you or your firm?