APPENDIX A

Confidential Lifestyle Questionnaire

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How would you like to see your assets distributed after your death? In lump sums? Over time as some type of payment program?

Who would you like to supervise the distribution of your assets? Is that person(s) emotionally and financially capable?

The answers you provide to the following questions will help us to determine whether or not we think there is a fit between us. In our experience, successful financial planning can only take place if we share a similar philosophy about financial planning, and if we both agree that we can work together.

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2. What stage are you at in your career? (check all that apply):

a. Mid-career image
b. Nearing retirement image
c. Semi-retired image
d. Retired image
e. Not planning to retire image

3. Do you own and operate your own ...

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