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 Investor Profile Form

 1.  My investment objective for this portfolio is:
Preservation of capital with minimal fluctuations in value.
Some income and modest growth of capital.
Growth of capital with exposure to some volatility.
Aggressive growth of capital with no income needs.
 2.  I expect the time horizon* for this investment to be:

* The time horizon used in an investment strategy has significant bearing on the probability of achieving the stated objectives. The longer the period, the better the chance that market volatility will average out to desired investment returns.

3.  I would describe my tolerance for capital fluctuation as:
Low - I can accept only small and infrequent losses in portfolio value.
Moderate - I can accept negative returns during difficult times in the market.
High - I can accept substantial losses during difficult stages of the market cycle.
4.  My current income requirement from this investment is:
None - I have no need for current income.
Low - I have a small need for income from this investment.
Moderate - I have some income needs.
High - I have significant income needs.
 5.  My risk/return profile is as follows:

6.  The following portfolio structure is most appropriate for me:
Fixed Income and Cash Equivalents
Manager uses investment grade bonds and cash equivalents, such as money market funds.
Manager diversifies investment risk by investing in a combination of stocks, bonds, and cash equivalents.
Equities and Cash Equivalents
Manager uses stocks predominately, but may also use cash equivalents to reduce portfolio volatility.
Fully Invested in Equities
Manager uses stocks exclusively, and remains fully invested under all market conditions.
Let the Investment Manager Decide
Manager determines portfolio makeup based on your investment objectives, time horizon, and willingness to accept risk.
 7.  I have a preference for the following types of stocks (optional):

 8.  Value of assets to be professionally managed:

please include type of currency

 9.  Will you be adding funds to your account at a later date?
  No   Yes  
10.  Will you be withdrawing from your account at any time?
  No   Yes

First Name:
Last Name:

If you decide to print out this form and fax it to us, please sign below.

By signing below, I confirm that the information detailed above is accurate. Further, I confirm that no guarantees have been made or implied about the achievement of any investment objectives set forth herein.

SIGNATURE:  _____________________________________

SIGNATURE:  _____________________________________

DATE:  __________________________________________

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