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					BEESON &
 COMPANY                                                                         PERSONAL FINANCIAL ADVISORS
John K. Beeson, CFP, MBA                                                                      Tel: 510.232.5339
Registered Investment Advisor                                                                 Fax: 510.232.5997
2530 Mira Vista Dr.                                                                           john@beesonandco.com
El Cerrito, CA 94530                                                                          www.beesonandco.com

                       Introduction for UCSF Non-Hospital Employees

Thank you for visiting our website. Included in the attached documents are a “Balance
Sheet, Data Form, and Cash Flow Statement”. Driving instructions are also included.

Please prepare a list of specific short and long-term goals, questions and concerns. Please
be as specific as possible with respect to your goals and questions.

Also, bring any financial documents (retirement statements, pay stubs, tax returns, etc.)
you feel are germane to our conversation. My hourly financial planning contract is
included for your review and consideration along with an Authorization to Release
Information that should be faxed to Jerry Neal in the benefits office (415.476.6153).

Please call or e-mail me if you have any questions.


John K. Beeson, CFP, MBA
Registered Investment Advisor
 COMPANY                                                                         PERSONAL FINANCIAL ADVISORS
John K. Beeson, CFP, MBA                                                                      Tel: 510.232.5339
Registered Investment Advisor                                                                 Fax: 510.232.5997
2530 Mira Vista Dr.                                                                           john@beesonandco.com
El Cerrito, CA 94530                                                                          www.beesonandco.com

                                         Privacy Statement
       Beeson & Company, an independent financial planning firm, is committed to
safeguarding the confidential information of its clients. We hold all personal information
provided to our firm in the strictest confidence. These records include all personal
information that we collect from you or receive from other firms in connection with any of
the financial services provided by Beeson & Company. We also require other firms with
whom we deal to restrict the use of your information.

      A complete privacy statement concerning our firm’s policy is available upon request.
You may obtain it in person, or through a written or electronically delivered request to John
K. Beeson, CFP, MBA at john@beesonandco.com or simply by calling us at 510.655.5339.
January 7, 2012

Jerry Neal
Benefits and Financial Planning Department
University of California, San Francisco
3333 California St., Suite 330, Box 0918
San Francisco, CA 94143-0918

Fax: 415-476-6153

RE: Authorization to Release Information

Dear Jerry:

I have engaged the services of John K. Beeson, CFP, MBA as my fee-only financial
planner. Please cooperate with any of his requests for information. This would include
full permission to answer questions, disclose information and send documents. I would
greatly appreciate your help in allowing him to gather this information as quickly as

Thank you in advance for your cooperation.


Type Your Name Here
                                  John K. Beeson, CFP, MBA
                                 Registered Investment Adviser

                                 Investment Advisory Agreement

The undersigned (the “Client”) retains John K. Beeson (the “Adviser) to provide financial planning
advice pursuant to the provisions of this Agreement and the Adviser accepts such engagement by
the Client.

1.    Adviser is a registered investment adviser, registered with the California Department of

2.    Based upon information furnished by the Client, the Adviser shall provide personal financial
      planning consultations, which may include:

      a. A detailed review of the client’s current financial position taking into account the stated
         financial goals and objectives of the Client, as requested by the Client.

      b. An evaluation and analysis of particular financial problem areas and topics that concern
         the Client. These topics include insurance review, investment advice, general estate
         planning, tax reduction strategies and college tuition planning.

      c. Specific recommendations that the Client purchase specific securities or take action with
         respect to estate planning or tax reduction.

3.    The Client will furnish the Adviser with any necessary data and such supporting documents
      as the Adviser may reasonably request, including financial information, investment
      experience and investment goals. The Client understands that the Adviser will provide
      services under this Agreement based upon information supplied to the Adviser by the Client
      concerning the Client’s financial circumstances and objectives. The Client represents and
      warrants that such information is and will at all times be substantially accurate and
      complete. The Client shall promptly inform the Adviser of any material change in the
      Client’s financial circumstance or objectives and shall respond promptly to reasonable
      requests by the Adviser for information on any such changes.

4.    The Adviser does not engage in the sale or offering for sale of securities or other financial
      products. The Adviser will not exercise any discretionary authority over any securities
      account of the Client. The Adviser is not a broker/dealer or a bank. As such, the Adviser
      does not undertake any obligation for the implementation of the financial planning
      recommendations made by the Adviser. The Client is under no obligation to place any
      investment, insurance or other transaction with any specific provider. It is the Client’s
      responsibility to consult with his or her own legal and tax counsel where such consultation is
      indicated. The Adviser will not monitor the performance of any investment made by the

5.    The Adviser will hold all information provided by the Client in confidence and will not
      voluntarily disclose information or any plan recommendations based on this information
      without the consent of the Client.
6.   The Client shall compensate the Adviser for all services furnished under this Agreement by
     payment of fees in accordance with the provisions of the section:

     a. The hourly rate is $250. Client will be charged only for the time involved in counseling
        and analysis. Payments are due and payable upon receipt. Interest, payable at the
        maximum rate allowed by law, will be charged on balances not paid within (30) days. In
        the event the Client fails to comply with the terms of the payment, the Adviser may, at
        his discretion and with prior written notice to the Client, discontinue service under this
        Agreement until the Client’s account is current.

     b. Fees charged by the Adviser are for financial planning services only and do not include
        any legal, accounting or other professional services, which may be required by the Client
        in the course of implementing the recommendations made by the Adviser.

     c. The Adviser will not be responsible for the acts of omissions or insolvency of any agents,
        broker or independent contractor selected to take any action or to negotiate or
        consummate any transaction for the Client’s account.

7.   Any dispute between Client and Adviser shall be resolved in an arbitration conducted
     pursuant to the rules of the American Arbitration Association. Any arbitration hearing shall
     be held in Santa Rosa, CA.

8.   Client acknowledges receipt of Part II of Adviser’s Form ADV.

9.   Miscellaneous Provisions

     a. The Laws of the State of California shall govern this Agreement.

     b. This Agreement may be terminated by either party with a 30-day written notice. At that
        time, a summary of hours accrued, year-to-date, will be provided to the Client. All
        charges in excess of the payments paid to date with regard to this Agreement will be the
        responsibility of the Client.

     c. This Agreement shall inure to the benefit of any successor of the Adviser and shall be
        binding upon the successors and assigns of the Client.

     d. This Agreement shall not become effective until acceptance by the Adviser, to be
        evidenced by the signature of an authorized representative entered in the place provided
        below. No modification amendment to this Agreement shall be effective unless made in
        writing and signed by the Client and by an authorized representative of the Adviser.
         e. No assignment of this contract shall be made by the Adviser without written consent of
            the Client.


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John K. Beeson, CFP, MBA
                          Beeson & Co. Client Data Sheet
                                CONFIDENTIAL INFORMATION
                                            PLEASE PRINT
Client Name:________________________________________________ Birthdate:_____/____/______
Address Client as:                                           S.S.#:_______-_____-______
Mr./Mrs./Ms./Dr.:_______________________                     Email: __________________
Spouse Name:_______________________________________________ Birthdate:_____/____/______
Address Spouse as:                                           S.S.#:_______-_____-_______
 Mr./Mrs./Ms./Dr.:_______________________                    Email:___________________

Home Address:_____________________________________              Home Phone: (_____) ______-______
City: _____________________________________________                      FAX: (_____) ______-______
Zip: _____________________________________________                Car Phone: (_____) ______-______


Client Employer:________________________________________ Work Phone: (____) _____-______
Position/Title:___________________________________________ Extension: _______
Work Address:__________________________________________
City:___________________________________________________       FAX: (____) _____-______

Spouse Employer:_______________________________________ Work Phone: (____) _____-______
Position/Title:___________________________________________ Extension: _______
Work Address:__________________________________________
City:___________________________________________________       FAX: (____) _____-______

Mailing Address to Send All Documents and Correspondence:
 Mr Mrs./Ms./Dr.: ____________________________________________________________________
 City/State/Zip: ______________________________________________________________________

Acct Exec:______________________________________________ Phone: (_____) ________-_______
 Address:______________________________________________ Fax: (_____) ________-_______
Attorney:_______________________________________________ Phone: (_____) ________-_______
 Address:______________________________________________ Fax: (_____) ________-_______
CPA:__________________________________________________ Phone: (_____) ________-_______
 Address:______________________________________________ Fax: (_____) ________-_______
Ins Broker:_____________________________________________ Phone: (_____) ________-_______
 Address:______________________________________________ Fax: (_____) ________-_______

                               Beeson & Co. Balance Sheet
                                  CONFIDENTIAL INFORMATION

1. Assets (current value)                   Client Name:

       A. Cash/cash equivalents

              1   Checking/cash                            $_________________

              2   Savings                                  $_________________

              3   Money Market                             $_________________
                    Total Cash Equivalents                 $_________________

       B. Investments

              1   Certificates of deposit                  $_________________

              2   Treasury Bills                           $_________________

              3   Taxable bonds                            $_________________

              4   Municipal bonds                          $_________________

              5   Municipal bond funds                     $_________________

              6   2nd Mortgages/Notes                      $_________________

              7   Stocks                                   $_________________

              8   Stock Funds                              $_________________

              9   Rental real estate                       $_________________

             10   Collectibles                             $_________________

             11   Business                                 $_________________

             12   Other                                    $_________________

                      Total investment assets              $________________

       C. Retirement Plans

              1   IRA’s                                    $_________________

              2   Keogh/IRA SEP                            $_________________

              3   401(k)/403(b)                            $_________________

         4    Profit Sharing                               $_________________
         5    Other                                        $_________________
                      Total retirement plan assets         $________________
                                       Balance Sheet (con’t)

      D. Personal use assets

        1    Personal residence                          $_________________

        2    Other real estate                           $_________________

        3    Household contents                          $_________________

        4    Automobiles                                 $_________________

        5    Other                                       $_________________
              Total personal use assets                  $_________________

                                                 TOTAL ASSETS       $________________

2. LIABILITIES (outstanding balances)
      A. Mortgages

        1    Mortgages-personal residence                $________________

        2    Home equity loan                            $________________

        3    Mortgage-2nd home                           $________________

        4    Mortgage-other real estate                  $________________

        5    Other                                       $________________
              Total mortgages                            $________________

      B. Other Loans

        1    Auto                                        $________________

        2    Education                                   $________________

        3    Life insurance                              $________________

        4    Credit cards                                $________________

        5    Personal loans                              $________________

        6    Other                                       $________________
                            Total other loans            $________________

                                   TOTAL LIABILITIES           $________________

3. NET WORTH (assets - liabilities)                               $________________

                                                Page 2
                     Beeson & Co. Cash Flow Statement
                                  CONFIDENTIAL INFORMATION


 1. Gross salary                $ ____________________
 2. Gross salary-spouse          ____________________
 3. Self-employed income         ____________________
 4. Child support                ____________________
 5. Alimony                      ____________________
 6. Dividends                    ____________________
 7. Interest                     ____________________
 8. Rental Income                ____________________
 9. Notes/mortgages benefits     ____________________
10. Trust income                 ____________________
11. Pension/retirement benefits  ____________________
12. Social security benefits     ____________________
13. Other __________________     ____________________
               TOTAL INCOME                                 $ _________________


1. Federal income tax     $ _____________________
2. State income tax         _____________________
3. Social security tax      _____________________
4. Property tax             _____________________
              TOTAL TAXES                                   $ _________________


1. Rent/1st mortgage-residence    $ _____________________
2. Home equity-residence            _____________________
3. Rent/mortgage-2nd home           _____________________
4. Home repair/maintenance          _____________________
5. Electricity/gas                 _____________________
6. Water/sewer                     _____________________
7. Trash removal                   _____________________
8. Telephone                       _____________________
9. Cable TV                        _____________________
10. Homeowner/renter insurance     _____________________
11. Auto insurance                 _____________________
12. Health insurance               _____________________
13. Life insurance                 _____________________
14. Disability insurance           _____________________
15. Auto loan/lease                _____________________
16. Auto/transportation expense   _____________________
                                 Cash Flow Statement (cont’d)


17. Vehicle license             $_____________________
18. Auto repair                   _____________________
19. Alimony                       _____________________
20. Child support                _____________________
21. Child/elder care              _____________________
22. Education                     _____________________
23. Domestic help                 _____________________
24. Doctors/dentists              _____________________
25. Medical-other                 _____________________
26. Charitable contributions      _____________________
27. Union dues                    _____________________
28. Financial/bank ser. charges _____________________
29. Employee business expenses _____________________
30. IRA/SEP/Keogh contribution _____________________
31. IRA/SEP/Keogh cont.-spouse _____________________
32. 403(b)/401(k) contribution    _____________________
33. 403(b)/401(k) cont.-spouse   _____________________
34. Rental property mortgage     _____________________
35. Rental property taxes         _____________________
36. Rental property insurance     _____________________
37. Rental property-other        _____________________
38. Savings/investments          _____________________
39. Education loans              _____________________
40. Charge card payments         _____________________
41. Other loans                   _____________________
42. Food-at home                  _____________________
43. Food-out                      _____________________
44. Clothing                      _____________________
45. Cleaning/laundry             _____________________
46. Personal care                _____________________
47. Pet care                     _____________________
48. Entertainment                _____________________
49. Vacations                    _____________________
50. Hobbies/recreation           _____________________
51. Books/subscriptions          _____________________
52. Appliances                   _____________________
53. Allowances                   _____________________
54. Other ________________       _____________________

      TOTAL EXPENSES                                      $__________________

                                            Page 2

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