Your Company Retirement Plan

Thank you for allowing us the opportunity to assist you in selecting a diversified portfolio for your company retirement plan - 401(k). We have created a two step process for you to follow. The first part requires you to select an investment objective that is suitable to your age and risk tolerance. The second part requires you to share with us some information and submit a request. With this information we will create a portfolio from the choices available in your company’s retirement plan. Under no circumstances will your information be shared or released to anyone outside of Davis Williams Wealth Management.

If you are within five years of retirement and would like a complimentary consultation regarding appropriate planning techniques, we invite you to contact us at 800-473-9797. You may also request a free informative guide entitled Planning for a Successful Retirement written by the firm’s two principals.

Before we get started we need some basic information from you. Please fill out the information below to begin the process. Please note you must be a resident of: AL, CA, CO, FL, GA, NC, NY, SC, PA, VA or WA in order to use this service.

Acknowledgement:

I have taken the Fidelity Investor Profile Questionnaire from Step 1, and answered all the questions to the best of my ability. I am comfortable with the associated risk profile. I instruct Davis Williams Wealth Management to provide a portfolio allocation based on the selected investment objective. I understand this recommendation does NOT apply to any optional self-directed accounts, and may not reflect a suitable recommendation based on any other investment accounts or other personal circumstances. This is voluntary and I am under no obligation to accept the recommendation. It is my responsibility to allocate the portfolio using the appropriate company’s website. I understand that there is a risk of loss when using these allocations and I should review my account regularly and make the necessary adjustments based upon my investment objectives and risk profile. Further, I hold Davis Williams Wealth Management, their representatives, Securities America, Inc. and Securities America Advisors, Inc. harmless against any loss I might incur using this service. Davis Williams Wealth Management is not affiliated with your company and is not compensated or endorsed by it. This service is solely provided by Davis Williams Wealth Management for their clients and prospective clients.

There is no charge for submitting this request, and does not obligate Davis Williams Wealth Management to provide this service. If a fee is required, you will be notified and you will need to sign a Financial Planning Agreement. All applicable fees are due prior to services being rendered.