Client Questionnaire - Business Account

Business Information

Business Legal Name(Required)

Business Phone

Business Street Address (No PO Boxes)(Required)

Business City(Required)

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Business ZIP / Postal Code(Required)

Business Email

Entity Tax Structure

Company Tax ID(Required)

Tax Year End

MM

DD

Participant Information

First Name(Required)

Middle Name

Last Name(Required)

Social Security Number(Required)

Date of Birth(Required)

Driver's License #

Driver's License State

Driver's License Issue Date

Driver's License Expiration Date

Mobile Number(Required)

Email Address (if different from company email)

Home/Legal Street Address (No PO Boxes)

Home City(Required)

Home State(Required)

Home ZIP / Postal Code(Required)

Mailing Address (if different from legal address)

Occupation

Name

This field is for validation purposes and should be left unchanged.

For additional questions, please call One Strategic Capital, Inc. at (206) 397-4890

or email insurance@oscfp.com.

If you would like to schedule an appointment, please go to: www.oscfp.com/whlt

Click on Appointment Type: WA Long Term Care Appointment

Select Date & Time

Enter your details

Click “Book”

249 WINSLOW WAY EAST

SUITE 100,

BAINBRIDGE ISLAND, WA

98110

f 206.397.4894

@onestrategiccapital

One Strategic Capital, Inc.

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2023 One Strategic Capital, Inc.

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2022 One Strategic Capital, Inc.

Powered by VSG Marketing

249 WINSLOW WAY EAST SUITE 100,

BAINBRIDGE ISLAND, WA 98110

f 206.397.4894

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2022 One Strategic Capital, Inc.

Powered by VSG Marketing