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Item: Blue Barn Wealth
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Institutional Intelligent Portfolios^®

IMPORTANT NOTICE:

You are now leaving the website of Blue Barn Wealth® and will be entering the website for Institutional Intelligent Portfolios®, an automated investment management service made available to you exclusively through Blue Barn Wealth. Blue Barn Wealth is independent of and not owned by, affiliated with, or sponsored or supervised by Schwab. Schwab has no responsibility for the content of Blue Barn Wealth's website. This link to the Institutional Intelligent Portfolios website should not be considered to be either a recommendation by SPT, Schwab, or any of their affiliates, or a solicitation of any offer to purchase or sell any security.

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1. About You

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Note: All information is secure and confidential
Email*
First Name*
Last Name*
Age*
Cell Phone*
City & State of Resdience*
Employment Status*
- Student
- Employed
- Self-employed
- Homemaker
- Retired
- Disabled
What is your major and where are you studying?
While studying, are you also working?
- Yes
- No
Company Name*
Occupation*
How would you describe your relationship status?*
- Single
- Partnered
- Married
- Separated
- Divorced
- Widowed
Spouse/Partner's First Name*
Spouse/Partner's Last Name*
Spouse/Partner's Age (if applicable)*
Spouse/Partner's Cell Phone*
Spouse/Partner's Employment Status*
- Student
- Employed
- Self-employed
- Homemaker
- Retired
- Disabled
What is your Spouse/Partner's major? Where are they studying?
While studying, does your Spouse/Partner also work?
- Yes
- No
Spouse/Partner's Company Name*
Spouse/Partner's Occupation*
Do you have children/financial dependents?*
- Yes
- No
How many children/financial dependents do you have?*
Please describe any financial goals or concerns you have regarding your children/financial dependents.*

3. Financial Info
What type(s) of investment accounts do you own (Check all that apply)*
- Select All
- Employer Retirement Accounts: 401(k)/403(b)/401(a)
- IRA
- Roth IRA
- Brokerage
- Trust
- Other
Approximate value of all investment accounts?*
- Less than $300,000
- $300,000 - $1,000,000
- $1,000,000 - 3,000,000
- $3,000,000 - $10,000,000
- More than $10,000,000
What type of debt do you have (if any)?*
- Mortgage
- Auto loan
- Credit card balance
- Student loans
- Business loans
- Other
- None of the above
Approximate total balance of all liabilities/debt?*
- Less than $100,000
- $100,000 - $500,000
- $500,000 - $1,000,000
- $1,000,000 - $5,000,000
- More than $5,000,000
What is your approximate net worth? (Assets - Liabilities)*
- Less than $300,000
- $300,000 - $1,000,000
- $1,000,000 - $3,000,000
- $3,000,000 - $10,000,000
- More than $10,000,000
What's your estimated annual income?*
- Less than $50,000
- $50,000 - $100,000
- $100,000 - $250,000
- $250,000 - $500,000
- $500,000 - $1,000,000
- More than $1,000,000
How did you hear about Blue Barn Wealth?*
What are your top three priorities in working with Blue Barn Wealth?*
Please provide any additional information that you would like us to know to help you live a more simple, intentional, meaningful life.*

1. About You

Please fill out the following information so that we can reach out to you to start the process.

3. Financial Info