MARKET SURVEY

Name __________________________________ Date of Birth ___________________________

Occupation: ____________________________ Company: ______________________________

Address _________________________________________ Phone No. ____________________

Family Status ___ Single ___ Married ___ Others Please specify __________________________

Spouse's Name ___________________ Occupation: _______________ Company:______________

No. of children ______ and their ages:________________________________________________

1.What does the term financial planning mean to you?

_____________________________________________________________________________________

2. Do you have a financial advisor? ___ Yes ___ No. If no, why? __________________________________

2a. If yes, do you feel obligated to have all your financials plan handled by the same advisor? ___ Yes ___ No.

If yes, why? ____________________________________________________________________________

3. Do you believe in insurance? ___ Yes ___ No If no, why? ______________________________________

______________________________________________________________________________________

3a. If yes, please rate these items from 1-3, 1 being the most critical factor in life insurance in your opinion.

____ Disability ____ Living too long ____ Dying too soon

4. How much insurance do you own? Yourself ___________ Spouse __________ Children ___________

5. If you were to purchase a new plan and/or upgrade your existing plan, which among these items would be your considerations?
Please choose your top 3 considerations and rate them from 1-3, 1 being the most important.

____ Income continuation in the event of breadwinner's sudden death

____ Income in case of disability or illness

____ Retirement benefit

____ Savings for future plans (ex. Education Fund, Capital for Business, Etc)

____ Mortgage redemption

____ Investment/Wealth accumulation

6. Would you agree to a meeting in the future allowing me to discuss with you financial planning and our financial services?

___ Yes ___ No

If no, why? _______________________________________________________________

7. What is you opinion of a career in financial services?
______________________________________________________________________________

8. Can you recommend 3 people for me to talk to?

Name of a relative : _______________________________ Contact no:__________________

Name of your co-worker: ____________________________ Contact no:__________________

Name of a friend: _________________________________ Contact no:__________________

Thank you very much for taking time to answer this survey.