Brown | Miller Questionnaire - Brown | Miller Wealth Management

✦ Contact Information

Email Address *

Phone Number

✦ Personal Information

Primary Client

Full Name *

Age

Home City / State

Spouse / Partner

Full Name

Age

✦ Planning Priorities

✦ Career

Primary Client

Occupation / Title

Compensation Type

W-2 Employee 1099 / Self-Employed Both

Career Stage

Early Career (building / learning) Mid-Career (established, high earning) Senior / Executive Level Pre-Retirement Career Transition / Pivot Self-Employed / Business Owner Retired

Expected Career Changes in Next 1–3 Years? new role, promotion, retirement, business sale, sabbatical, etc.

Spouse / Partner

Occupation / Title

Compensation Type

W-2 Employee 1099 / Self-Employed Both N/A

✦ Income

Approx. Annual Household Income (Gross)

Other Forms of Compensation bonus, RSUs, stock options, commission, rental income, business income, etc.

Currently Saving Monthly Toward Investments or Specific Goals?

Yes No Not Consistently

If yes — what are you saving toward and approximately how much per month?

✦ Net Worth

Approximate Net Worth excluding primary residence

<$500K $500K–$1M $1M–$2M $2M–$5M $5M–$10M $10M+

My Net Worth Primarily Consists of Select all that apply

Investment / Brokerage Accounts Real Estate / Home Equity Cash / Savings Accounts Pension / Defined Benefit Retirement Accounts (401k, IRA, etc.) Business / Private Equity Equity Comp (RSUs, Options, ESPP) Other

Asset Details types, approximate values, location

Outstanding Debt

Type	Approx. Balance	Interest Rate

✦ Investments & Retirement Accounts

Approximate Combined Balance of All Investment & Retirement Accounts

<$500K $500K–$1M $1M–$2M $2M–$5M $5M–$10M $10M+

Investment Objective

Capital Preservation Income Growth

Risk Appetite

Conservative Moderate Aggressive Unsure / Open to Guidance

How Do You Currently Make Investment Decisions?

I manage everything myself I work with an advisor I follow my employer / 401k defaults I rely on recommendations from others I don't have an active strategy Other

Additional Context on Investments, Current Providers, or Concerns

✦ Looking Ahead

What Does Success Look Like to You When Working with a Financial Advisor? Be as specific or as broad as you'd like

Is There Anything Else That Would Be Helpful to Know Before Our First Meeting? Family dynamics, past experiences with advisors, concerns, timing — anything at all

Brown | Miller Questionnaire

Prospective Client Questionnaire

Thank You!

Brown
Miller

Wealth
Management

Brown | Miller Wealth Management