Name : Age:

Designation : Company Name:

Mobile : Alternate Contact Number:
Email ID :
Address :

1. What is your gross annual income ?

A Less than 1,00,000 B 1,00,001 to 2,00,000
C 2,00,001 to 4,00,000 D 4,00,001 to 6,00,000
E 6,00,001 or more F confidential

2. What is your current financial situation?

A precarious A lot of debt, No savings
B Somewhat precarious Some debts with very few savings
C Somewhat stable Some debts and Few savings
D Good Somewhat in debts and Good savings
E Very good no debts and solid savings
F Confidential

3. How would you rate your level of knowledge in the area of investments?
A Poor B Limited C Moderate
D Good E Very good

4. What kind of investments do you prefer?

A Stocks B Mutual funds
C Bonds D Bank savings
E Others ________________

5. Do you have a D-mat Account?

A. Yes B. No

6. Are you interested in taking D-mat Account (or) another D-mat Account ?
A. Yes B. No

7. How much potential do you have to invest over a 1-year period?

A less than 50 thousand B less than 1 lakh
C 2 lakh D more than 5 lakh

8. For this investment, your goal is:

A. To grow aggressively
B. To grow with caution
C. To avoid losing money ______

9. Is anybody in your family doing Trading?

A. Yes ( Mobile No:__________________ ) B. No

10. Who is your Financial Adviser ?

A. Stock broker B. TV
C. Paper D. Your own analysis

11. Who is your stock broker ?__________________________________

The brokerage they are charging for Intraday ______ and delivery ________

12. Are you satisfied with your financial adviser ?

A Yes B No
Reason:_________________________________________________________
13. What kind of services are you expecting from your stock broker?

_____________________________________________

14. You have just received a substantial amount of money. How would you invest it?
a)I would invest in something safe, even if it only offered a very low return
b)I might take a little risk if it meant getting a moderate rate of return
c)I would probably invest in something that offered some current income but
d)also had growth potential, even though it involved a greater degree of risk.

15. Approximately how often do you review the value of your investment portfolio?
A. Annually B. Quarterly C. Monthly
D. Weekly E. Daily

16. When would you start drawing income from your investments?
A. Not for at least 4 years B. In 1 to 4 years
C. 6 months to 1 year D. 3 months to 6 months
E. Immediately, whenever I got profit

17. How much risk would you like to take?

A I won't accept any variation in returns.
B I can tolerate yield variations but with difficulty.
C I can accept minimal return variations from time to time.
D I can accept regular return variations.
E I can accept regular and significant variations in returns

18. Suppose the markets go through a difficult period, what decrease in the value of
your investments could you tolerate?
A No decrease B Less than 5%
C Between 5% and 10% D Between 10% and 20%
E Over 20%

19. If we provide any Financial Advices and information at free of cost, are you
interested to avail them ?
A Yes B No

Comments and suggestions:

Please provide few references of Prospective Traders:

Name Mobile

1.______________________________ _______________________________
2.______________________________ _______________________________
3.______________________________ _______________________________
4.______________________________ _______________________________
5.______________________________ _______________________________
_______________________________________________________________________
Questionnaire filled by :

Mobile No:
Remarks: