NEW CLIENT INFO INTAKE

INTERNAL USE ONLY

IMPORTANT: DO NOT, send this page to a prospect or client.

Use the form below to submit new client information into the JB Wealth CRM

CLIENT INTAKE SURVEY

INTERNAL FORM

IMPORTANT: Copy & Paste the following contact information from an existing CRM contact record to ensure data matching with an existing contact record. Note: If a new email and phone is used, a new contact record will be created.

First Name *

Last Name *

Note: Phone & Email fields below will determine contact record matching

Mobile Phone *

Phone Field Instruction: Copy & Paste Phone Number from existing Jucebox CRM Contact Record to insure intake info is matched to existing record. e.g. 222-867-5309

Email *

Email Field Instruction: Copy & Paste email address from existing Jucebox CRM Contact Record to insure intake info is matched to existing record

Date of birth

Address

City

State

US Citizen

Yes

No

Action Item: Request and Add Client Social Security Number (SSN) to Client's Secure ID Info Sheet. (Prequisite: Create Clients Secure ID Info Sheet, in respective client folder in Google Shared Drive)

(ADMIN) Add Secure ID Info URL

Client Info

Client Status

Investment Adviser (IAR) [Client]

Custodian [Client]

Fidelity Account Type [Client] (if applicable)

Standard

BrokerageLink

Investment Model Selection (Initial)

Field Instruction: Select all models that apply

Client Rating

Client Intake Notes

Funding Info (GEN)

REMINDER: Submit to Save This form does NOT autosave. You must submit the form to save the information you've entered to the respective contact record

Funding Methods [All Accounts]

TRANSFER Only (i.e. Transfer of existing Investment Account(s) Like to Like Accounts))

CASH Only (i.e. Check, Cash, or similar)

MULTIPLE (i.e. Both Transfers and Cash will be used for funding)

ROLLOVER (i.e Not Alike accounts)

Other

Field Instruction: i.e. How will you be funding your investment accounts with JB Wealth Advisors and our preferred Custodian Fidelity?

Funding Details, Other [All Accounts]

Funding Info (Cash)

REMINDER: Submit to Save This form does NOT autosave. You must submit the form to save the information you've entered to the respective contact record

Account Info #1 [A1C]

Funding via CASH (i.e. Check, Cash, or similar)

Funding Type [A1C]

Account Type [A1C]

Account Value [A1C]

$

Account Info #2 [A2C]

Funding via CASH (i.e. Check, Cash, or similar)

Funding Type [A2C]

Account Type [A2C]

Account Value [A2C]

$

Account Info #3 [A3C]

Funding via CASH (i.e. Check, Cash, or similar)

Funding Type [A3C]

Account Type [A3C]

Account Value [A3C]

$

Funding Info (Transfer)

REMINDER: Submit to Save This form does NOT autosave. You must submit the form to save the information you've entered to the respective contact record

Account Info #1 [A1T]

Funding via Transfer

Custodian [A1T]

Account Type [A1T]

Account Number, Current [A1T]

Account Value [A1T]

$

Account Statements Status [A1T]

Secure File Upload: If Client needs to submit statements, provide the following Secure File Upload link for submission: https://clients.jbwealthadvisors.com/file

Account Info #2 [A2T]

Funding via Transfer

Custodian [A2T]

Account Type [A2T]

Account Number, Current [A2T]

Account Value [A2T]

$

Account Statements Status [A2T]

Secure File Upload: If Client needs to submit statements, provide the following Secure File Upload link for submission: https://clients.jbwealthadvisors.com/file

Account Info #3 [A3T]

Funding via Transfer

Custodian [A3T]

Account Type [A3T]

Account Number, Current [A3T]

Account Value [A3T]

$

Account Statements Status [A3T]

Secure File Upload: If Client needs to submit statements, provide the following Secure File Upload link for submission: https://clients.jbwealthadvisors.com/file

NEW CLIENT INFO INTAKE

INTERNAL USE ONLY

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