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If there are other people or organizations you think would benefit from this program, please provide their name(s), address or phone number on the back of this form.

The initial consultation provides an overview of financial planning concepts. You will not receive written analysis and/or recommendations.

*Consult with your tax advisor or attorney regarding specific tax issues.

© 2006 Ameriprise Financial, Inc. All rights reserved.

Ameriprise Financial Services, Inc., Member NASD and SIPC. For advisor use only. Not for inspection by, distribution or quotation to the general public. 4/06

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