Confidential Investment Questionnaire

Zuraw Financial Advisors, LLC

Please complete to the best of your knowledge. Please know that all personal and financial information is treated with strict confidentiality. If clarification is needed, please contact our office at 336-290-7062.

Thank you so much for taking your time to provide us with information that will allow us to create a personalized investment plan tailored to your needs. We look forward to our next meeting with you!

Zuraw Financial Advisors is registered as an Investment Adviser with the U.S. Securities and Exchange Commission.

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* 1. I agree that I may be contacted by email or phone by Zuraw Financial Advisors.

Yes

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* 2. Please provide some information about yourself.

Name *

Company

Address *

Address 2

City/Town *

State *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

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* 3. Are you currently retired?

Yes

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* 4. If not, at what approximate age would you like to retire?

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* 5. What is your current age?

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* 6. What is the current age of your spouse/partner? (if applicable)

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* 7. How were you introduced to Zuraw Financial Advisors?

Family Member

Friend

Coworker

Zuraw Financial Advisors Website

Online Search

Magazine article

Social Media (Facebook, Twitter, LinkedIn)

Please note the name of the person or source

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* 8. So we can best determine how to help you, what are your total investable assets?

less than $100,000

$100,000 - $250,000

$250,000 - $500,000

$500,000 - $750,000

$750,000 - $1,000,000

Above $1,000,000

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* 9. What percent of your assets are currently in a 401(k) or IRA Retirement funds?

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* 10. What is your approximate total household income?

$0 - $25,000

$25,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 - $124,999

$125,000-$149,999

$150,000-$174,999

$175,000-$199,999

Above $200,000

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* 11. What are your approximate annual household expenses?

$0-$30,999

$31,000-$60,999

$61,000-$90,999

$91,000-$120,999

$121,000-$180,999

$181,000-$240,999

above $250,000

I do not know

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* 12. What is most important to you regarding your investments?

Having a complete financial plan

Outperforming the market

Protecting my hard-earned money

Low total investment expenses

Generating income to support my lifestyle

Other (please specify)

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* 13. What is least important to you regarding your investment?

Having a complete financial plan

Outperforming the market

Protecting my hard-earned money

Low total investment expenses

Generating income to support my lifestyle

Other (please specify)

Confidential Investment Questionnaire

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* 1. I agree that I may be contacted by email or phone by Zuraw Financial Advisors.

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* 2. Please provide some information about yourself.

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* 3. Are you currently retired?

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* 4. If not, at what approximate age would you like to retire?

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* 5. What is your current age?

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* 6. What is the current age of your spouse/partner? (if applicable)

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* 7. How were you introduced to Zuraw Financial Advisors?

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* 8. So we can best determine how to help you, what are your total investable assets?

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* 9. What percent of your assets are currently in a 401(k) or IRA Retirement funds?

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* 10. What is your approximate total household income?

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* 11. What are your approximate annual household expenses?

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* 12. What is most important to you regarding your investments?

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* 13. What is least important to you regarding your investment?

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* 14. Is there any other information regarding your financial situation, you would like to share with us?

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* 15. Please enter the name of the animal shown above.