1Profile & Contact
2GDC & Revenue
3Assets & Accounts
4Products & Partners
5Review & Submit
1

Financial Professional Profile

SECTION A
Basic Information
Required
Required
Contact Details
Valid email required
Current Affiliation
Team & Office Structure
Non-Compete / Non-Solicit
2

Fees, Commissions & GDC

SECTION B
Gross Dealer Concession Summary
Please provide proof of trailing 12 months GDC (commission statement, W-2, or 1099)
$
Required
$
$
T12M GDC by Product Type
$
$
$
$
$
$
$
$
$
$
$
ATP Advisory Profile
3

Assets Under Administration & Client Accounts

SECTION C
AUA by Product Type
Provide AUA totals by product and account type. Albridge or BD report preferred.
Product Type Brokerage ($) Direct / Sponsor ($) Advisory ($) Third-Party Managers ($)
Alternative Investments
General Securities
Fixed Insurance (Annuities & EIAs)
Mutual Funds
Variable Annuities
Variable Life Insurance
Money Market Funds
Cash Balances
% of Accounts < $50K
Customer Account Counts
Account Type Brokerage Direct / Sponsor Advisory Third-Party Managers
Retail / Non-Qualified Accounts
Qualified Accounts (IRA, 401k, etc.)
401(k) / Group Plans
4

Product Providers, Asset Managers & Context

SECTION D
Top 5 Mutual Fund Providers
1
2
3
4
5
Top 5 Variable Annuity Providers
1
2
3
4
5
Top Third-Party Asset Managers (Custodied Direct)
1
2
3
Additional Vendors & Portfolio Managers
Unique Practice Circumstances
ATP Strategic Assessment (Optional)
5

Review & Submit

SECTION E
Acknowledgement & Signature
By submitting this form you acknowledge that you understand any offer extended to you is based upon the information provided herein and is subject to verification. To the extent that Advisor Transition Partners is unable to verify or should the information change as a result of verification, any offer may be adjusted or withdrawn. This document and its contents are confidential and intended solely for ATP's internal use in connection with your engagement.