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  Money Management Services - Initial Information Request

 

Initial Information Request Form

Please provide the following contact information (All information is confidential):

First Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

E-mail

Which of the following best describes your investor type?

Please enter any major brokerage firm that you or your advisor (if individual investor) is affiliated with:

 

How much of your assets would you be willing to commit?

 

      Comments:

 

 
 
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Hays Advisory, LLC does not guarantee the accuracy or completeness of this report, nor does the Hays Advisory, LLC assume any liability for any loss that may result from reliance by any person upon any such information or opinions. Such information and opinions are subject to change without notice and are for general information only. The information contained in this report may not be published, broadcast, rewritten or otherwise distributed without prior written consent from Hays Advisory, LLC.

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