Wealth Management Client Profile Template
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3WEALTH MANAGEMENT
CLIENT PROFILE
Name (First, Middle, Last)
Type(s) of Account
□ Individual □ Joint
□Trust
□ IRA
□ Corporation
Home/Legal Street Address Line 1 (No P.O. box maybe used)
Line 2
City
State
ZIP Code
Social Security/Tax ID Number
Date of Birth (mm/dd/yyyy)
Email address
Home Phone Number
Business Phone Number
Cellular Phone Number
(
)
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(
)
-
(
)
-
Country(ies) Of Citizenship (must list all)
Country of Legal Residence
ID Number (Passport, US Driver’s License)
State of Issuance
Issue Date (mm/dd/yyyy)
Expiration (mm/dd/yyyy)
□
□
Employer Name
Occupation/Position
Employed
Retired
□
□
Self-Employed
Non-Employed
Business Address Line 1 (No P.O. box)
Line 2
City
State
ZIP Code
SPOUSE INFORMATION
□
□
Spouse Name (First, Middle, Last)
Citizenship
Phone Number:
Cell
Other:______
(
)
-
Social Security/Tax ID Number
Date of Birth (mm/dd/yyyy)
Email address
ID Number (Passport, US Driver’s License)
State of Issuance
Issue Date (mm/dd/yyyy)
Expiration (mm/dd/yyyy)
□
□
Employer Name
Occupation/Position
Employed
Retired
□
□
Self-Employed
Non-Employed
Business Address Line 1 (No P.O. box)
Line 2
City
State
ZIP Code
FINANCIAL & INVESTMENT INFORMATION
Annual Income (from all sources)
Estimated Liquid Net Worth:
Estimated Net Worth:
□ Under $25,000 (amount): __________
□ Under $100,000: __________
□ Under $100,000: __________
□ $25,000 - $50,000
□ $100,000 - $500,000
□ $100,000 - $500,000
□ $50,000 - $100,000
□ $500,000 - $1,000,000
□ $500,000 - $1,000,000
□ $100,000 - $200,000
□ $1,000,000 - $1,500,000
□ $1,000,000 - $1,500,000
□ $200,000+ (amount): _____________
□ $1,500,000+ : _____________
□ $1,500,000+ : _____________
Investment Experience (# of years)
Investment Objectives
Email Consent
(check all that apply):
I/We consent to receiving e-mail
Stocks & Bonds
communication from Apriem
□ Preservation
Mutual Funds
Advisors which may contain
□ Income
CDs & Money Markets
personal financial information.
□ Long Term Growth
Options
□ Trading Profits
Insurance/Annuities
(please initial) _______ / _______
Risk Tolerance:
(Most Conservative) 1
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4
5
6
7
8
9
10 (Most Aggressive)
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Parent category: Business