Professional Profile

Member FINRA, SIPC, MSRB

3232 South Vance Street, Suite 210* Lakewood, Colorado 80227
303-984-2558 * 888-984-2558 * Facsimile 303-985-2323
Contact Us In Complete Confidence
stephen.kohn@sakohn.com

^{Name Do you grant permission to view your CRD information?}	^Date	^CRD#		^SS#^{Month/Day of Birth (mm/dd)}
^Address	^{Phone (Day)}		^Facsimile
^{City, State, Zip}	^{Phone (Evening)}		^{E-mail Address}

Professional History

^{Are you an RIA?}	^{Other special designations (CFP, etc.)}		^{Any job related courses?}
^{Do you have any securities industry management experience? How long?}		^{Do you have other business management experience? How long?}
^{What licenses do you have? (include insurance if appropriate)}
Are you a(n)

Production History

^{Most
recent month's production?}

^{Most
recent full year's}^production?

^{Highest
production month of career?}

^A^{nticipated
production for year?}

Your Product Mix and Client Base

In general, what is the product mix in your book?	^{Conservative Equities (%)}	^{Speculative Equities (%)}	^{Low Priced Stocks (%)}	^{Municipal Bonds (%)}
In general, what is the product mix in your book?	^{Mutual Funds (%)}	^{Fixed Income (%)}	^{Insurance Products (%)}	^{Limited Partnerships (%)}
Average size of Trade?	^Equities	^{Mutual Funds}	^{Municipal Bonds}	^{Special Products (LP's, etc.)}
Assets Under Management?	^{Assets Under Management}	^{Total Number of Accounts}	^{Number of Active Accounts}
Managed/Wrap Account Assets?	^{Assets Under Management}	^{Total Number of Accounts}	Average Management Fee

What are you looking for in a Broker/Dealer?

^{What kind of assistance can the
Firm provide to help you be as successful as you can
be?}

^{What are your outside
interests/hobbies, etc.?}

^{Please provide a statement of
your investment theories or ideas.}

Stephen A Kohn and Associates, Ltd.
3232 South Vance Street, Suite 210 * Lakewood, CO 80227
303-984-2558 * 888-984-2558 * Facsimile 303-985-2323
stephen.kohn@sakohn.com