Brick Financial Management - Building Wealth One Brick At A Time®
IM QuestionnaireIM Agreement


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160 Maplewood Ave

P.O. Box 263

Maplewood, NJ 07040

phone: 973-486-9860


QuickStart Investment Management Questionnaire

Thank you for your interest in establishing an account with Brick Financial. We do not take custody of client assets. Your assets will be held in your name at online broker (they will serve as custodian) and Brick Financial is granted limited trading authority on the account. (We also use Ameritrade as a custodial broker for some accounts. After filling out this form we may determine that your account would be better placed with Ameritrade.)


Please fill out the following information to establish your account. This is a condensed version of our Investment Management Questionnaire (IMQ) paper form. Please make sure you review our ADV Form II. (Most of the information in this document can also be found on our website.)


Notes about each Section of the QuickStart IMQ:

  • All the information in Section I marked with a red asterisk (*) is required to open an Account with Foliofn.

  • Information in Sections II - V is not required to open an Account but failure to provide this information will impair Brick Financial's ability to serve you fully. We cannot fully fulfill our fiduciary responsibility without this information.

  • Section VI contains the online versions of the Investment Management Agreement (IMA) and Trading Authorization (TA). These require your electronic signature. Although we are able to open an account with Foliofn on your behalf, our relationship with you is not official until you review and sign the IMA and TA. Please provide your electronic signatures.

Brick Financial will keep your personal information private as stated in the privacy policy and terms & conditions. Federal anti-terrorism and anti-money laundering laws (USA Patriot Act) requires us to collect information that can be used to identify you (i.e. your Social Security number). However, Regulation S-P under Section 504 of the Gramm-Leach-Billey Act, requires us to protect your information unless otherwise required by law. This is for our protection as well as yours. We will never ask for more information than we need, we will never use your information unethically, and we will never share, rent or sell your information.


If you have any questions about the services we provide please feel free to contact us and we will respond directly.

Section I - Personal/Organization Information


Client One

What type of Account(s) do you plan to open?*

(Use ctrl + keys to make multiple selections)

Do you want the ability to trade options?*Yes No
Do you want the ability to use margin?*Yes No
Marital* Status Single Married Divorced Widowed
TitleName, First, Middle Initial, Last, Suffix*
Name your Account (i.e. John's IRA Account) 

Social Security/Tax ID*

Date of Birth*


Account User Name*

8 characters or more

Password (required)*

6 characters or more

Street Address Can Not Be PO Box*  
Mailing Address If Different From Above (PO Box Allowed) 
Confirmation delivery method:*

Email  Mail



 Providing a valid email will save you money [CLICK HERE]

Day Phone Number*


Evening Phone Number


Citizenship Status* U.S. Citizen Resident Alien Non-Resident Alien
Legal Residence* 
Check if you are a director, 10% shareholder, or policy-making officer of a publicly traded company. If you checked this box, specify the company name, address, city and state.*

Check if you are licensed or employed by a registered broker/dealer.

If you checked this box, list the broker/dealer. You must eventually supply a compliance letter.*

Employment information:*



Employer name:* 
Employer full address:* 


Client Two (If there is a Account Co-owner then the following information is required.)*


Is there a Co-owner on the Account?Yes No
Marital StatusSingle Married Divorced Widowed
TitleName, First, Middle Initial, Last, Suffix
Social Security/Tax ID

Date of Birth


Are you the Account Owner's spouse?

   Yes No 
Street Address Complete only if different from Account Owner, No PO Boxes 

Day Phone Number


Citizenship StatusU.S. Citizen Resident Alien Non-Resident Alien
Legal Residence  

Check if you are a director, 10% shareholder, or policy-making officer of a publicly traded company. If you checked this box, specify the company name, address, city and state.

Check if you are licensed or employed by a registered broker/dealer.

If you checked this box, list the broker/dealer. You must eventually supply a compliance letter.

Employment information: 
Employer name: 
Employer full address: 


Section II & III - Assets, Liabilities, Income, Taxes and Insurance


Please fill in the information as thoroughly as possible.


If you plan on making regular (monthly, quarterly) contributions to your Account, we can set up EFT (electronic funds transfer) instructions with the Custodian.


Bank NameAccount #Routing #Use for ETF?


What will be the amount and frequency of your contribution to your Account?



What will be the amount of your initial contribution to your Account?




If you plan on funding your Account by transferring existing positions (stocks, bonds, mutual funds, cash) then please print and fax or send to us's Account Transfer Questionnaire.


Annual Income (From all sources including investments)

Approximate Value of Primary Residence

Approximate Total Value of Liquid Assets (Cash, stocks, etc.)

Approximate Value of All Other Assets (businesses, real estate, etc)

Total Mortgage (Primary Residence) Debt

Total NON-Mortgage Debt

What did you pay in income taxes last year?What did you pay in income taxes two years ago?

Total Monthly Debt Payment

(Including mortgage)



Are you adequately insured?


Do you have disability insurance? (Most people have disability through their employer.)
Do you have life insurance?
What is the total face value of your life insurance?$.00
Are you and your family covered under a comprehensive health insurance plan?


Section IV - Goals


Please list any financial goals you may have in the space provided. A financial goal is defined as any goal that requires you to save money to achieve it. Some examples include investment in business opportunities, first or second homes, recreational items (boat, vacation, etc.), college education, your retirement or any other currently known future need for substantial cash. Please estimate the amount needed (in today’s dollars) to achieve each financial goal and the year that you want to fund the goal by.


Section V - Risk Assessment


This risk tolerance assessment is designed to assist in the recommendation of an optimal portfolio based on your investment time horizon, risk tolerance, investment objectives and liquidity needs. The information you enter into this worksheet and your reactions to certain investment scenarios provided in the assessment are instrumental in determining a recommended portfolio. Below are several types of questions used to measure your reactions to various investment scenarios. These include risk/return trade-off, upside potential and downside risk, volatility aversion and impact of inflation.


Indicate which of the following statements summarize your attitudes or beliefs using a scale of 1-5 (1 being most true and 5 being least true)

I am more concerned about protecting my assets than about growth
I am comfortable with investments that promise slow, long term appreciation for growth
I feel comfortable with aggressive growth investments
I don’t like surprises
I am optimistic about my financial future
My immediate concern is for income rather than growth of my capital
I am a risk taker
I like predictability and routine in my daily life
I prefer predictable, steady return on my investments, even if the return is low
I believe that real estate (being a landlord) is a superior investment to stocks

1.  This graph shows the potential range of gains or losses of a $100,000 investment in each of four hypothetical portfolios at the end of a 1-year period. The number above each bar shows the best potential gain for that portfolio, while the number below each bar shows the worst potential loss. Given that this is the only information that you have on these four hypothetical portfolios, which one would you choose to invest in?

Portfolio A
Portfolio B
Portfolio C
Portfolio D

4.  Assume you have a substantial portion of your investment portfolio in stocks.  If the stock market were to gradually decline at an average of 2 percent per month, eventually losing 22% of its value over a year, which of the following would you do?


Invest more now because stocks are selling for approximately 20% less than they were 12 months ago. You believe that stocks will regain their value or possibly appreciate even higher over the long-run.

 Sell the stocks in your portfolio and realize the 22% loss. You wish to avoid the risk of further loss.

Sell half of the stocks in your portfolio. You are not willing to leave all of your investment at risk for further loss.

Do nothing. You are comfortable waiting for the stocks to regain their previous value to or to increase in value.

6.  For each of the two investment decisions below, check the option with which you are comfortable.  Please consider both decisions 1 and 2 together before answering either and before moving on to decision 3.



Decision 1 – Choose between

A sure gain of $23,000

A 25% chance of winning $100,000 and a 75% chance of winning nothing



 Decision 2 – Choose between

A sure loss of $77,000

A 75% chance of losing $100,000 and a 25% chance of losing nothing




Decision 3 – Choose between

A 25% chance of winning $23,000 and a 75% chance of losing $77,000

A 25% chance of winning $25,000 and a 75% chance of losing $75,000


Section VI - Agreements


Investment Management Agreement

(Printable PDF version of IM Agreement and Trading Authorization)


Trading Authorization


My online signature represents that:


I have read and accept the terms of the Investment Management Agreement and the Trading Authority Agreement, thus hereby elect Brick Financial Management, LLC as my Investment Adviser. (Please print and retain a copy of both agreements for your records.)

I elect the Standard Fee Arrangement as set forth in the Investment Management Agreement, Item "F".


I elect the Performance Fee Arrangement as set forth in the Investment Management Agreement Item "G" and the Performance Fee Rider. By doing so, I certify that one of the following apply: I am an individual with a net worth in excess of $1.5 million, or have earned at least a $200,000 (or $300,000 with spouse) income that past two years, or I am an organization with at least $5,000,000 in assets, or that I have placed at least $750,000 under Brick Financial Management, LLC's supervision.

I have read and accept the terms and conditions of Foliofn's Customer Agreement or Group Customer Agreement. (Please print and retain a copy the agreement for your records.)


 Client One*Client Two
Type your full name to represent your online signature.* 

Insert today's date





** By submitting your information, you agree to be bound by Brick Financial's terms and conditions regarding information it provides. Any information provided in return, by Brick Financial, is not, under any circumstances, to be viewed as investment advice. The information is to be seen as feedback the company might provide to a client in a similar circumstance, and it is intended to be seen as a part of a proposal to form a client relationship with Brick Financial, at which time the advice may be implemented by Brick Financial. It is not intended for implementation by any other party, including the individual seeking the analysis. Brick Financial, will not, under any circumstances, accept payment in any form for the information it provides, or the effort going into the analysis.