What has prompted you to consider professional money management services?

Please select one Lack of time to effectively manage portfolio on your own Concern with regard to market uncertainty and volatility An inheritance, bonus, lump-sum from sale of business As part of planning process for spouse or heirs To improve overall investment results

Please provide the following contact information:

Please select one Conservative Moderate Venturesome

Conservative - Seeks steady long-term growth of capital with limited volatility, 
while preserving principal value
Moderate - Seeks greater long-term growth while taking prudent risks
Venturesome- Seeks maximum long-term growth, 
while accepting greater volatility and potential for principal loss

How do you make investment decisions (Check all that may apply)?
I rely on my own market research
I use an investment newsletter or newsletters for investment recommendations
I do not have time to make investment decisions
I do not make changes in my investment as I am a long-term investor
I currently use an investment advisor or stock broker

Describe your relationship with your current Investment Advisor (Check all that apply)?
I do not currently have an advisor, but I am looking for one
I do not have an advisor and would not use one
I am interested in learning how an advisor may help me with my investments
I am pleased with my current advisor
I am pleased with my advisor, but would consider a change
I am unhappy with my current advisor

How can PRI assist you with your portfolio (Check all that apply)?
I would like to improve my overall investment returns
I do not have sufficient time to devote to my investments
I need to supplement my current income

What types of investments would you like PRI to manage for you (Check all that apply)?
Individual
IRA
Trust
Keogh
401 (k)
403 (b)
Joint

Please list your top ten mutual fund holdings, symbols, and dollar allocations:

1 Name of Mutual Fund
2 Ticker Symbol
3 Account Type*
4 Fund Family/Broker/Custodian
5 Value

1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
1    2      3    4    5
*Indicate IRA, Trust, Ind, Custodial, etc.

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Please contact me as soon as possible regarding this matter.