SCHEDULE A CONSULTATION Name * First Name Last Name Email * Phone * (###) ### #### Have you spoken with a representative from Asset Preservation Tax & Retirement Services? Yes No If yes, whom did you speak with? Lou Guglielmetti - 18 1/2 & Van Dyke John Lopez - 17 & Van Dyke Subject * Any information you would like us to know before we schedule a meeting? * Preferred Date to Meet MM DD YYYY Thank you!