Client Name *
Client Name
Spouse Name (if applicable)
Spouse Name (if applicable)
Client DOB *
Client DOB
Spouse DOB (if applicable)
Spouse DOB (if applicable)
Estimated value of invested assets plus residence minus any liabilities.
Current Investment Holdings *
Check All That Apply (Most BRP clients are invested in Mutual Funds & ETFs)
Describes the total length of time an investor expects to invest in the account. (Most Common Over 7 years)
Describes the total portfolio percentage loss you would be willing to accept before selling investments.
Describes the target rate of return annualized over a 7 year period of time.
Estimated Annual Inflation Rate *
Chose what best describes your view toward inflation in the next 10 years.
One whose rates Capital Preservation as a "Major Importance" would not be willing to take any risk, such as equities, in portfolio.
One who rates Growth as "Very Important" is willing to invest most or all of their portfolio in higher risk investments, such as stocks, to achieve long term growth.
Describes the up and down swings in the portfolio. One who rates Low Volatility as "Not at All" would be comfortable with larger swings in portfolio value.
Describes how important it is that your portfolio return keeps up with inflation.
One who rates Current Cash Flow as a "Major Importance" is currently (or expecting to in next year) taking periodic distributions from portfolio to meet living expenses.
Describes the amount of higher risk investments, such as stocks and equity mutual funds, you are willing to accept in portfolio.
Please Type Your Name Below
Electronic Signature Agreement *
Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide Bolmgren Retireplan, Inc. or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Bolmgren Retireplan. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement. You further agree that your E-Signature in your agreement to be bound by the terms and conditions of the Bolmgren Retireplan Disclosures and Agreements as they exist on the date of your E-Signature.