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1 Investor Profile

2 What s your path? Everyone s path toward retirement is different. That s why we want to get to know you. By better understanding your goals and objectives, we can work together to develop a personalized plan that fits your unique needs. Let s get started.

3 Investor Profile Some personal information Customer 1 Name Current Age Employed Self Employed Not Employed Retired Student Planned Retirement Age Customer 2 Name Current Age Employed Self Employed Not Employed Retired Student Planned Retirement Age Your financial goals 1. Please describe your most important short-term and long-term financial goals. Short-term: Long-term: 2. What keeps you up at night regarding your ability to achieve your financial goals? 3. Is there a need, now or in the future, for you to provide care or financial support to others? Yes No If yes, who? Please rate the following questions on a scale from 1-5 (1 = Least and 5 = Most). Circle the appropriate choice. 4. How important is it to you to improve your current standard of living? 5. How important is it to you to ensure a comfortable standard of living in retirement? 6. How important is it to you to have the ability to leave assets to heirs? 7. How important is the ability to fund (in whole or a portion) the education of your children or grandchildren? 8. How prepared are you for any personal healthcare issues that could arise? 3

4 Your investment preferences Please rate the following questions on a scale from 1-5 (1= Strongly Disagree 5= Strongly Agree). Circle the appropriate choice. 9. I am comfortable conducting my own investment research and making my own decisions. 10. I would prefer to work with someone to assist me in developing my investment profile and recommending a strategy to achieve my objectives. 11. I would prefer to pay for financial advice as it is received rather than an ongoing fee based on assets under management. 12. I prefer the investment options with the absolute lowest costs. 13. I prefer safe investments that cannot lose value even if that means that I will receive lower investment returns. 14. I am concerned about outliving my savings and I prefer an investment option that guarantees my retirement income for which I am willing to pay a higher cost for this option. 3

5 Your objectives What is the primary purpose for investing? (Please rank all that apply i.e. 1, 2, 3...) Accumulation Principal protection Income Wealth Transfer Other (e.g. Education Savings, Long-Term Care, Disability Income, etc.) Please rate the following questions on a scale from 1-5 (1 = Least and 5 = Most). Circle the appropriate choice. 15. How comfortable are you investing in the market where your account value may go up or down? 16. How comfortable are you owning an investment that limits upside potential to reduce downside exposure? 17. How important is it for you to know all of the holdings in your investments? 18. How concerned are you about the impact of inflation on your retirement income? 19. How comfortable are you paying for guarantees of income? 20. How comfortable are you with taking income from investments without guarantees? 21. How willing are you to accept limited investment choice for guaranteed lifetime income? 22. How important is knowing how much money you will leave to your heirs? 5

6 Customer/household profile Investment Objectives Please Rank (i.e. 1, 2, 3...) Preservation of Capital Income Growth - Capital Appreciation Speculation Tax Advantage Prioritize Your Goals Please Rank (i.e. 1, 2, 3...) Retirement Wealth Accumulation Education Provide for Heirs Emergencies Major Purchase Other Investment Time Horizon Check One Short term (0-5 years) Intermediate (6-10 years) Long term (10+ years) Risk Tolerance* Check One Investment Experience None yrs Estimated Federal Tax Bracket Check One Aggressive Moderately Aggressive Moderate Moderately Conservative Conservative Individual Stocks Individual Bonds Mutual Funds Variable Universal Life Fixed Annuities Variable Annuities 0-15% % Over 27.5% Estimated Net Worth Under $50,000 $50,000 - $100,000 $100,001 - $500,000 If over $500,000 list amount $ * Please refer to the Allstate Know Your Risk Tolerance (ALR2) 6

7 Household profile Monthly Household Income Salary before taxes Social Security payments Pension/retirement Annuity income Interest dividends Other (e.g. Rental income, unemployment benefits.) Total monthly income Total annual income Monthly Household Expenses Rent/mortgage payments Utilities/transportation/ food Debt repayment (e.g. car payments, credit cards, etc.) Health care/health insurance premiums Taxes Other (e.g. Dependent support, charitable donation.) Total monthly expenses Total annual expenses Total Household Assets Qualified Non-Qualified Checking/Savings/Money Market/CDs Stocks/Bonds Mutual Funds Fixed Indexed Annuities Fixed Annuities Variable Annuities 401(k), Pension, 457, etc. Cash Value of Life Insurance Other investment assets Total for each column: + Total Assets/Liquid Net Worth (both Qualified and Non-Qualified): = Total Household Debt What is your total household debt? (e.g. mortgage, car loan, etc.) 23. Of the above assets, what would you use in the event of an emergency? 24. At what age do you anticipate you will need to start taking income from your investments? 25. Investable dollars and assets to be used for discussion today: Thank you for completing the Allstate Investor Profile and giving us the opportunity to assist you with your financial future. 7

8 Possible proposed solutions If choosing to stay in the same investment, please notate under Proposed Solution below. Goal (e.g. Income, Accumulation, etc.) Proposed solutions Option 1: Option 2: Option 3: Signatures Customer 1 Name Signature Date Customer 2 Name Signature Date I have reviewed this document for completeness and accuracy. Agent Name Signature Date Contact Info: Overnight Allstate Financial Services, LLC 2920 South 84th St. Lincoln, NE AFSNAR@Allstate.com Fax (877) Phone (800) Option #3 Securities offered by Personal Financial Representatives through Allstate Financial Services, LLC (LSA Securities in LA and PA). Registered Broker-Dealer. Member FINRA, SIPC. Main Office: 2920 South 84th Street, Lincoln, NE (877) Check the background of this firm on FINRA s BrokerCheck website Allstate Insurance Company, allstate.com ALR5348 3/17

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