Confidential Investment Profile

In order to help us better serve your investment needs, this questionnaire has been designed to give us a better understanding of your present financial situation, current investment needs and future goals and expectations. Please give careful consideration to these questions and answer each question as accurately and completely as possible.

Part One of the questionnaire contains questions regarding your personal and financial information that will be essential in helping us set up your account and structure your personal portfolio to meet your needs.

Part Two of the questionnaire contains questions regarding your general outlook on the markets, your investment goals and your overall tolerance for risk.

Part I - Personal and Financial Information Name: Year of Birth: Gender: Male Female What name would you like to appear on your Reports? Street Address: City/State/Zip: Home Phone: E-Mail: Education High School Years Completed College Years Completed Advanced Degree Years Completed   Employment Information:   Employer: Employers Address: Job Title / Position: Work Phone: Fax:   Spouse Information:   Name: Year of Birth: Employer: Employers Address: Job Title / Position: Work Phone: Fax:   Dependents:   Name Age Year of Birth   Primary Account Holder's Investment Experience Knowledge / Experience None Limited Average Extensive # Yrs Stocks / Bonds Mutual Funds Unit Annuities Options Commodities / Futures   Household Financial Overview Est. Annual Income (all sources) Liquid Assets (i.e. Cash, Money Market, CDs, etc.) 401K or other Retirement Assets Approximate Net Worth Face Amount of Life Insurance in force* Short Term Debt (Credit Cards, Car Loans, etc) * Long Term Debt (Home Mortgages, etc)* Interest Rate on Long Term Debt* What is the most important factor for you when choosing an investment? * Please provide this information if you would like for us to investigate ways to reduce your annual expenditures on these items. Part II - Investment Goals & Risk Profile Investment Goals 1. Which statement best describes your overall approach to investing: Pursue current income, forego capital gains and minimize risk to principal Increase investment value while minimizing potential for loss of principal Pursue investment growth; accept moderate levels of risk and principal fluctuation Seek maximum long-term returns, accepting maximum risk with principal fluctuation 2. What is the most important factor for you when choosing an investment? Safety of principal Primarily monthly income Long term growth with some monthly income How quickly I can increase my wealth 3. Which of the following best describes the purpose of your accounts at Alpha Capital Management? Source of future retirement income Future estate for my children Source of college funds Future business opportunity Source of current income Other 4. In how many years do you expect to need the money you are investing? Within 2-3 years Within 4-5 years Within 6-10 years More than 10 years 5. How far into the future would you anticipate the need to withdraw more than 20 percent of your portfolio to meet short term financial needs? More than 7 years Within 3 to 7 years Less than 3 years More than 10 years 6. Total Return has two components: appreciation and current income. Which answer below best describes you? I prefer most of my return to come from current income rather than appreciation I prefer a total return with elements of both appreciation and current income My goal is to achieve appreciation; current income is not important to me 7. Which statement best describes your portfolio needs? My present income is adequate for my needs I need at least 50% of my total current portfolio income I need at least 10% of my current portfolio income Other 8. In light of other resources of income you may have, how do you anticipate using the earnings of your investment portfolio? Reinvest 100% of my investment earnings Reinvest 50% to 99% of my investment earnings Reinvest 1% to 49% of my investment earnings Reinvest 0% (receive all investment earnings) Risk Profile 9. How would you describe your investment experience and knowledge: None Minimal Moderate Considerable 10. I would rather earn less on my money in order to achieve greater stability of capital and less risk Strongly Agree Mostly Agree Disagree 11. I am focused on long-term appreciation of my investments and am striving for above average returns Strongly Agree Mostly Agree Disagree 12. In the following boxes, please indicate which alternative is most important to you in each situation Select One Higher Reward Consistent Rewards Select One Income Capital Appreciation Select One No down years Outperform the market (S&P 500) 13. Are you willing to accept increased volatility in the value of your investment account in an attempt to achieve higher return? Yes No 14. What type of investment returns would you prefer (choose one)? Higher returns, but less stability Lower returns, but more stability 15. It would be difficult for me to replace money I have lost from a declining investment with my current income Strongly Agree Mostly Agree Disagree 16. If I lose the money I have invested, I can quickly replace it from my earnings Strongly Agree Mostly Agree Disagree 17. I will be satisfied if the money I've invested keeps pace with inflation Strongly Agree Mostly Agree Disagree 18. I expect the value of my investments to double in five years Strongly Agree Mostly Agree Disagree 19. I prefer to keep most of my money in my checking and savings accounts because I may need it at any time Strongly Agree Mostly Agree Disagree 20. I make enough money to cover any large sudden expenses and I want to invest my savings for maximum growth Strongly Agree Mostly Agree Disagree 21. Do you have emergency savings? Yes Yes, but less than I'd like No 22. Given interruptions of periodic income or other unforeseen circumstances some individuals are forced to tap their investment resources to meet living expenses. In such an instance, how many months of living expenses could be covered by your current liquid investments? Select One More than 12 months or not a concern Between 4 and 12 months Less than 4 months, or already withdrawing 23. What were the returns on the best financial investment you ever made? Gain greater than 5% Gain greater than 10% Gain greater than 15% Gain greater than 20% 24. What were the returns on the worst financial investment you ever made? Loss greater than 5% Loss greater than 10% Loss greater than 15% Loss greater than 20% 25. Please describe to us any other factors relating to your investment or financial situation which would impact Alpha Capital Management's management of your assets: Acknowledgement: By submitting this form I acknowledge that to the best of my knowledge, I believe the information contained in the above questionnaire is true and accurate. I will notify representatives of Alpha Capital Management if there are any significant changes to my employment status, income, risk tolerance or any other factors in my financial situation. All information gathered is to be held strictly confidential.