Strategy Questionnaire Upon completion of this questionnaire, you will be scheduled to look deeper into the possibilities of securing your vault with the AIS Triangle.Step 1 of 175%Name* First Last Birth Date* MM DD YYYYEmail* Cell Phone Number*Receive Text Messages*YesNoTerms*This document represents an application to meet with a Vault AIS™ advisor and neither guarantees nor implies acceptance into Vault AIS™ or a meeting with one of its advisors. I acceptAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country I Prefer to be contacted via:*We may, from time to time, send you mail, email, and phone calls. However, we would like to know how you prefer to be contacted?PhoneText MessagingEmailPostal MailPlease select one of the following that best describes your situation.*Married (No Children)Married (With Children)Divorced (No Children)Divorced (With Children)SingleSpouse or Partner Full Name First Last Birth Date MM DD YYYYAges of ChildrenPlease select one of the following that best describes your Employment Situation?EmployedSelf Employed - IncorporatedSelf Employed - Not IncorporatedPlease select one of the following that best describes your Annual Income Situation?*$0-$100k$100 - $250k$250 - $500k500k - $1Million$1Million+Please select one of the following that best describes your Total Savings & Net worth Situation?*$0-$100k$100k - $500k$500k - $1Million$1Million - $5Million$5Million+Check all that you have as part of your current Financial Plan? Life Insurance Health Insurance Mortgage Estate Plan 401k IRA Stocks & Bonds OtherCheck all that you have as part of your current Financial Team? Attorney Accountant Banker Financial Planner Stock Broker Life Insurance Agent Real Estate Agent Mortgage BrokerPlease list the areas that you currently Invest and Save your money:*What kind of Life Insurance do you own and what are the amounts of coverage?*Seriously, why are you not where you want to be financially at this stage in the game?*What is WORKING with your current financial strategy and why?*What is NOT WORKING with your current financial strategy and why?*What have you tried to do already to remedy that #1 challenge or obstacle?*If you were to meet with a Vault AIS™ advisor, what would you hope to take away from the meeting?*What is the #1 challenge or obstacle you are facing with your current financial strategies?*CAPTCHAFunnel
