2B Questionnaire GVA’s online 2B questionnaire helps us securely gather the appropriate information we will need to create your ADV 2B. The data is transmitted through a secure connection on our website, using the strongest encryption available. You may view the authenticity of the connection by selecting the green lock icon at the top next to the address bar. If you have any questions regarding this form, please contact Michelle Duff, mduff@greatvalleyadvisors.com. Advisor Information Questionnaire: 2B Questionnaire Financial Advisor: Date of Birth: (00/11/2222) Primary SSN: (111-22-3333) LPL Email (If applicable): (jane.doe@lpl.com) CRD #: (Brokercheck link) Branch Office Information DBA Name: DBA Phone: DBA Fax: DBA Address: DBA Email: DBA Website: Educational Background Primary Education Institution: Degree Attained: Graduation Year: Secondary Education Institution: Degree Attained: Graduation Year: Business Experience (Past 5 Years) Company 1 Employer Name: Title: Dates Worked (MM/YYYY - MM/YYYY): Company 2 Employer Name: Title: Dates Worked (MM/YYYY - MM/YYYY): Company 3 Employer Name: Title: Dates Worked (MM/YYYY - MM/YYYY): Licensing Series 6: Series 63: Series 65: Series 7: Series 24: Series 66: Other Licenses: Designations - Certified Financial Planner (CFP) - Certified Financial Analyst (CFA) - Certified Public Account (CPA) - Accredited Investment Fiduciary (AIF) - Retirement Income Certified Professional (RICP) - Chartered Financial Consultant (ChFC) - Chartered Life Underwriter (CLU) Insurance - Life - Accident - Health - Variable Annuities Total time spent on insurance (%): Disciplinary History Disciplinary History: No Yes If yes, please explain: Additional Compensation Additional Compensation: No Yes If yes, please explain Berwyn, PA 920 Cassatt Rd, Suite 202 Berwyn, PA 19312 (610) 296-7630 Wilmington, DE 1200 Pennsylvania Ave, Suite 202 Wilmington, DE 19806 (302) 483-7200 Braintree, MA 30 Braintree Hill Office Park, Suite 202 Braintree, MA 02184 (610) 296-7630 Boca Raton, FL 3837 NW Boca Raton Blvd, Suite 100 Boca Raton, FL 33431 (610) 296-7630