New Client Form Please fill out the form below and we will contact you for an appointment, if you don't already have one. Client Personal InformationPlease list your information here. You will have the opportunity to list your spouse/partner information below.Client Name(Required) First Middle Last Client Nickname (preferred name) First Client Cell Phone #(Required)Client Preferred Email(Required) Client Date of Birth(Required) Month Day Year Client Social Security #(Required) Client Driver's License #(Required) Client Driver's License State(Required)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificClient Driver's License Issue Date(Required) Month Day Year Client Driver's License Expiration Date(Required) Month Day Year Client Employer(Required) Client Occupation(Required) Client Business Phone #Client Business Email Marital Status(Required)Please choose one below to finish the form. Single Married Partner Not Married But Planning Together What is the date of your wedding anniversary?(Required) Month Day Year On what date did you begin the relationship with your partner?(Required) Month Day Year Spouse Personal InformationSpouse Name(Required) First Middle Last Spouse Nickname (preferred name) First Spouse Cell Phone #(Required)Spouse Preferred Email(Required) Spouse Date of Birth(Required) Month Day Year Spouse Social Security #(Required) Spouse Driver's License #(Required) Spouse Driver's License State(Required)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificSpouse Driver's License Issue Date(Required) Month Day Year Spouse Driver's License Expiration Date(Required) Month Day Year Spouse Employer(Required) Spouse Occupation(Required) Spouse Business Phone #Spouse Business Email Partner Personal InformationPartner Name(Required) First Middle Last Partner Nickname (preferred name) First Partner Cell Phone #(Required)Partner Preferred Email(Required) Partner Employer(Required) Partner Occupation(Required) Partner Date of Birth(Required) Month Day Year Partner Social Security #(Required) Partner Driver's License #(Required) Partner Driver's License State(Required)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPartner Driver's License Issue Date(Required) Month Day Year Partner Driver's License Expiration Date(Required) Month Day Year Partner Business Phone #Partner Business Email Home InformationHome Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone #Client Home InformationClient Home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Client Home Phone #Partner Home InformationPartner Home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Partner Home Phone #Interests & HobbiesPlease list all hobbies that both you and your spouse/partner enjoy.Interests & Hobbies(Required) Individual Sports/Golf/Tennis/Swimming Church/Volunteering Reading/Writing Hunting/Fishing/Guns Exercise/Dance Shopping/Antiques Team Sports/Football/Basketball/Baseball Crafts/Scrapbooking TV/Movies/Podcasts/Video Games interior Design/Home Improvement Music/Theatre/Playing Instruments Photography/Artwork/Painting Cooking/Food/Eating Out Traveling Sewing/Quilting Camping/Hiking/Nature Playing Cards/Board Games Automobiles/Motorcycles/Racing Family/Grandchildren Farming/Horses/Cows Gardening/Yard Work Computers/Video Games Woodworking ChildrenHow many children do you have?How many children do you have?0 Children1 Child2 Children3 Children4 Children5 Children6 ChildrenChild 1 Name(Required) First Middle Last Child 1 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 1 Date of Birth(Required) Month Day Year Child 1 Social Security #(Required) Child 1 Cell Phone #(Required)Child 1 Preferred Email(Required) Child 2 Name(Required) First Middle Last Child 2 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 2 Date of Birth(Required) Month Day Year Child 2 Social Security #(Required) Child 2 Cell Phone #(Required)Child 2 Preferred Email(Required) Child 3 Name(Required) First Middle Last Child 3 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 3 Date of Birth(Required) Month Day Year Child 3 Social Security #(Required) Child 3 Cell Phone #(Required)Child 3 Preferred Email(Required) Child 4 Name(Required) First Middle Last Child 4 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 4 Date of Birth(Required) Month Day Year Child 4 Social Security #(Required) Child 4 Cell Phone #(Required)Child 4 Preferred Email(Required) Child 5 Name(Required) First Middle Last Child 5 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 5 Date of Birth(Required) Month Day Year Child 5 Social Security #(Required) Child 5 Cell Phone #(Required)Child 5 Preferred Email(Required) Child 6 Name(Required) First Middle Last Child 6 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child 6 Date of Birth(Required) Month Day Year Child 6 Social Security #(Required) Child 6 Cell Phone #(Required)Child 6 Preferred Email(Required) QuestionsHow did you hear about us?(Required) Referral by Someone Radio, Ad or Commercial Social Media Other Please tell us who referred you so that we can thank them...(Required)If it is more than one person, please list all of them here. LegalThe SEC requires all Investment Advisors to provide the following documents to prospective clients as well as current clients. You are consenting that you are ok with receiving these electronically. We will also provide them in paper format at your first meeting with us. And if you have any questions, please contact us at 205-871-7526 or you can discuss them in our first meeting. Please view our PRIVACY POLICY. Please view our ADV PART II. Please view our CRS FORM.(Required) I agree to receive the Privacy Policy, ADV Part II and CRS Form in electronic format.Section BreakIf you would like to attach any financial documents to this form, please do so below. Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 500 MB. PhoneThis field is for validation purposes and should be left unchanged. Δ
