Pinsker Wealth Management Intake Questionnaire

The purpose of this form is to gather the information necessary for us to help you. Please complete it to the best of your ability. If anything is unclear or if you have questions, please contact us for assistance.

After you have completed it, click the green "Generate PDF" button at the bottom. A PDF version of this form will appear in your Downloads folder. Please upload that document to the secure file sharing folder link that we sent to you via email. If you don't have that email, please email Preston Neal at [email protected].

⚠️ Important Notice: This form does not save your progress. For your security and privacy, no data is stored in your browser. Please complete the entire form in one session before clicking "Generate PDF" at the bottom. If you close or navigate away from this page, you will need to start over.

Additionally, for your security, the form will automatically clear all entered data after 20 minutes of inactivity.

Once we receive your PDF, we will review it and reach out with next steps.

Thank you, and we look forward to helping you pursue your financial goals.

- Pinsker Wealth Management

Spouse 1 Information

If married filing jointly, list combined income here only

If known - for married filing jointly, list joint rate here only

Please estimate if you don't know the exact number

Spouse 2 Informationclick to expand, if applicable

If married filing jointly, leave blank as combined income is entered in Spouse 1 section

If married filing jointly, leave blank as joint rate is entered in Spouse 1 section

Please estimate if you don't know the exact number

Financial Information

Total assets minus total debts - if married, include combined assets and debts. Estimates are acceptable.

Assets that can be quickly converted to cash such as bank accounts, stocks, bonds, minus total debts - if married, include combined assets and debts

Children (if applicable)

Name Date of Birth Social Security #

Trusted Contact Information

A trusted contact is the person we contact regarding any account of yours that we may manage if we are unable to contact you. By designating a trusted contact, you authorize us to contact your trusted contact for limited reasons, including when you cannot be contacted due to natural disaster, health, or other circumstances, or when unusual requests or activities potentially indicate a health issue or fraud. A trusted contact does not have power of attorney to make decisions or to make changes to an account, but can provide limited information to help establish communication channels and keep accounts secure.

Spouses may name each other as trusted contacts. If you are naming each other as trusted contacts, you only need to list each other's names below.

Spouse 1's Trusted Contact

Spouse 2's Trusted Contact (if applicable)


Additional Information

Securities and advisory services offered through LPL Financial, a registered investment advisor.
Member FINRA/SIPC.