To complete the online Pacific American Retirement and Financial Planning Analyzer, please read the Disclosure Statement and Terms of Agreement below, indicate your acceptance, and then click once on the Start button. You will be guided through a series of form pages that will request information related to your current financial status and your goals for education and retirement. You can use the navigation system located above to return to previously completed sections of the Analyzer for corrections and adjustments before final submission, but you will be required to enter the information requested in all fields before you can proceed to subsequent sections of the form.

DISCLOSURE STATEMENT AND TERMS OF AGREEMENT

The Pacific American Retirement and Financial Planning Analyzer collects information about you that is used by representatives of Pacific American Securities and Pacific American Advisors, both subsidiaries of Pacific American Services Group, as a source of facts that are used in the preparation of an individual Financial Plan. The calculations and assumptions, as well as the recommendations for certain courses of action included in the Financial Plan that you will receive are based primarily on the information that you provide in the Pacific American Retirement and Financial Planning Analyzer; and also on certain projections, estimates, variables and formulas that have been broadly established and are widely believed to represent sound economic theories. However, the calculations and assumptions, and the recommendations for certain courses of action, are purely forecasts and cannot be guaranteed. Past performance is not a guarantee of future results.

In utilizing the information provided in the Pacific American Retirement and Financial Planning Analyzer and in the preparation and providing of your individual Financial Plan, neither Pacific American Advisors, Pacific American Securities or Pacific American Services Group is acting as an investment advisor or as a fiduciary for purposes of the Employee Retirement Income Security Act of 1974 (ERISA).

Each Financial Plan is unique to the individual. It is developed based on the extent of planning desired and the amount of activity, investments and transactions in each case. Therefore, the fee for each Financial Plan will typically be between $1,200 to $3,000. Once we receive your completed Financial Analyzer we will send a letter of engagement to you that will stipulate the fee for your Financial Plan.

I acknowledge that I have completely read the Disclosure Statement and Terms of Agreement above, including the fee arrangement, and that I understand and agree to its contents and disclosures.