RIA Referral with Product Descriptions Step 1 of 3 33% Name First Last PhoneEmail Product NameProduct DescriptionProduct Code Check box for more informationTracker Conservative Managed Utilizes TRACKER automated signals combined with portfolio manager market interpretation and trade weighting to deliver above index performance to single leveraged ETF portfolios (Long and Short) with low risk and increased alpha.Product Code [Conservative Managed] Tracker Aggressive Managed Utilizes TRACKER automated signals combined with portfolio manager market interpretation and trade weighting to deliver above index performance to triple leveraged ETF portfolios (Long and Short) with medium risk and high alpha.Product Code [Aggressive Managed] Tracker Conservative Automatic Utilizes TRACKER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to single leveraged ETF portfolios (Long and Short) with low risk and increased alpha.Product Code [Conservative auto] Tracker Aggressive AutomaticUtilizes TRACKER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to triple leveraged ETF portfolios (Long and Short) with medium risk and increased alpha.Product Code [Aggressive auto] Bear Trader Conservative Automatic Utilizes Bear TRADER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to trade unleveraged long and short index ETFs Product Code [Bear Conservative auto] Bear Trader Aggressive Automatic Utilizes TRADER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to trade triple leveraged long and short index ETFsProduct Code [Bear Aggressive auto] Bull Trader Conservative Automatic Utilizes TRADER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to trade unleveraged long index ETFs Product Code [Bull Conservative auto] Bull Trader Aggressive Automatic Utilizes TRADER automated signals direct to portfolio only without portfolio manager perspective to deliver above index performance to trade triple leveraged long index ETFsProduct Code [Bull Aggressive auto] Diversified Wealth Builder conservative (minimum portfolio $150,000)*Utilizes one of the TRACKER services for 80% of portfolio and 20% for: • venture capital, • private equity startups • penny stocks Positions limited to 1.0% of portfolio starting value Product Code [DWBC] Diversified Wealth Builder aggressive (minimum portfolio $150,000)*Utilizes one of the TRACKER services for 60% of portfolio and 40% for: • venture capital, • private equity startups • penny stocks Positions limited to 2.0% of portfolio starting value Product Code [DWBA] Diversified Wealth Manager (minimum portfolio $200,000)*Utilizes one of the TRACKER services for 50% of portfolio and 50% for: • venture capital, • private equity startups • penny stock stocks • precious metals • mining stocks • real estate • equipment leasing Positions limited to 2.5% of portfolio starting value Product Code [DWMN] Cash Accumulator (Feature) available for all TRACKER and TRADER servicesCash profits are accumulated instead of being reinvested or compounded. Never more than up to 100% of starting principal allocated to TRACKER or TRADER when CASH feature selectedProduct Code Yes No *Applicable to: Diversified Wealth Builder and Diversified Wealth Manager services * Note. When not fully invested venture capital, etc., cash is invested in selected TRACKER service[DWBC] [DWBA] [DWMN] Address State / Province / Region AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Date of Birth* Date Format: YYYY slash MM slash DD Date of BirthMarriedYesNoDo you have a financial adviser or money manager?YesNoEmployment StatusEmployedRetiredIndustry / OccupationWhat Is Your Investment Time Horizons?*Long TermTraderIncome ProducingWhat Types Of Accounts Do You Have? (Choose all that apply)IRA / Roth IRA401 KIndividual Investment AccountTrust AccountAnnuityWhat Investments Do You Now Own or Have Owned? (check all that apply)StocksBondsMutual FundsCommercial Real EstatePrivate Start UpsEquipment LeasingVenture CapitalPrecious Metals - Gold, Silver, etcEquipment LeasingOil & GasAnnuitiesWhich of the three below is most important to you?*Capital GainsIncomeEstate ProtectionDo you make the final decision in what to invest in?*YesNoIf not, who makes the final decision?Financial Advisor Or CPA, EtcSpouse Or Relative
