Test Page | Oakmont Capital Management, LLC: An Investment Advisor

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Name*

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Date of Birth*

Email*

Phone*

Social Security Number

Address*

Street Address Address Line 2 City State

Occupation*

Employer Name*

Employer Address*

Street Address Address Line 2 City State

Name

First Last

Date of Birth

Phone

Social Security Number

Address

Street Address Address Line 2 City State

Occupation

Employer Name

Employer Address

Street Address Address Line 2 City State

What is the Major Purpose of your Investment Portfolio?*

Average Yearly Withdrawal Total in $*

Average Yearly Contribution Total in $*

Type of Account - Approximate Market Value*

Please List Any Tax Considerations you may have Relating to your Investment Portfolio*

Please List Any Legal Concerns you may have Relating to your Investment Portfolio*

Please List Any Special Considerations or Restrictions you may have Relating to your Investment Portfolio*

What are your Expectations of Oakmont Capital Management, LLC?*

Please Attach a Copy of your Most Recent Bank, Brokerage, and/or Retirement Statements to this Questionnaire

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