450 - 550 550 - 650 650 - 750 above 750 I don't know

How much passive income would you need (monthly) to be able to not work and maintain current standard of living?

$ 5,000 - $ 10,000 $ 10,000 - $ 15,000 $ 15,000 - $ 20,000 $ 20,000 - $ 25,000 more than $ 25,000

Currently, how much passive income do you generate from investments?

None $ 1,000 per month $ 1,000 - $ 5,000 per month $ 5,000 - $ 10,000 per month Greater than $ 10,000 per month

Which of the following do you need the most help with in order to become financially independent?

Education / Strategies Credit / Working Capital Time Commitment / Time Management Analyzing Investments Procrastination Fear

If you continue doing what you’re doing right now, by what age will you retire?

Years of Age

From time to time our organization likes to work with individuals one on one and fast track them to success.  We then use those success stories in our advertising.  Would you like to be considered for something like that?

                                              Yes No

If you were to lose your job (or source of income) how long would you be able to maintain your standard of living before you ran out of money?

Less than one month 1 -3 months 3 -6 months More than 6 months

Do you own your home or rent? 

Own Lease Rent

Which of the following best sums up the amount of credit card debt you currently have?

Zero $ 0 - $ 500 $ 500 - $ 2,500 $ 2,500 - $ 10,000 $ 10,000 - $ 25,000 Greater than $ 25,000

According to Fair Isaac Credit having a balance between 20% and 35% of the extended credit limit will give you the highest credit score.  Example:  John Doe’s Visa card has a $10,000 limit and he has a balance of $2,250.  Currently, what is the % of balance that you carry on your revolving lines of credit?

I pay it off in full every month 5% - 20% 20% - 35% (ideal) 35% - 75% 75% - 95% I'm maxed out

When is the best time of day for a strategist to contact you?

Morning Afternoon Evening

Phone Number