client financial profile · page 1 of 14 client financial profile client 1 client 2/partner (if...

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ClientFinancialProfile

Client1 Client2/Partner(ifapplicable)

PersonalDetailsof:

Preparedby:

InterviewDate:

Thefollowingitems(ifapplicabletoyou)willassistincompletingthedataform,Pleaseprovideoriginalsorcopiesoftheapplicable

documentsforyourappointment:

€ Employment–recentpayslips

€ Tax–mostrecentATOnoticeofassessment

€ Investments–mostrecenttaxandendofyearstatements

€ Liabilities–Currentloanstatement/repaymentschedule

€ Superannuation–Mostrecentstatementfromfund/s

€ PersonalInsurance–Mostrecentcorrespondence(renewal/premiumnotice)

€ SocialSecurity–Centrelink/DVAAssessment

“HELPUSTOHELPYOU” byreadingtheinformationbelowbeforecompletingthisform

• Thisbookletisdesignedtoassistyourpersonaladvisertogatherinformationessentialforfuturerecommendations.

• Toensurethattherecommendationsareentirelyconsistentwithyourpersonalrequirements,itisabsolutelynecessary

foryoutoprovideaccurateandfullydetailedinformation.

• Ifyouareuncertainonhowtoansweraquestionpleaseconsultyouradviser.

• Theinformationyouprovidewillbetreatedwiththeutmostconfidentiality.

• Iftheinformationyouprovideisincompleteorinaccurate,youneedtobeawarethattherecommendationswemakeis

basedontheinformationyouprovide.

LicenseedetailsIndependentCapitalAdvisersPtyLtdABN95765269541POBox5667,CairnsQld4870T:0740314575F:0740345016E:admin@incapital.com.auAFSL:378693

Client Financial Profile

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Thisinformationwillprovideyouradviserwithaninsightintowhatyourgoalsandobjectivesare.

1.1 Whatisyourreasonforseekingadvice?

• Forexample,thescopeofadviceissuperannuationplanning(iewhatareareasweprovidingadviceon)

1.2 LongTermNeedsandShortTermObjectives

• Inrelationtoyourfuturelifestylewhatdoyouconsidertobeyourmaingoals/importantconsiderations?Forexample,needsandobjectivesmayincludepayoffmortgage,purchaseacar,holidayetc

NeedsandObjectives TimeFrameeg6mths/5yrs Cost Priority(High/Medium/Low)

• Haveyoubeensatisfiedwiththeprogressyouhavemadeinthepastfewyearstowardsachievingyourgoals?Y/N

• Ifno.,whathasbeenthemainbarriertoyourprogress?

AdviserNotes

SECTION1–PreDiscovery(Whatareyourgoals?)

Client Financial Profile

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ContactDetails

• Preferredtitleeg

Mr,Mrs,Ms

• Surname

• Givenname(s)

• Preferredname

• Dateofbirth

• Maritalstatus

• Australianresident

• Ifno,countryof

residence

ResidentialAddress

• StreetNumber

• Suburb/Town

• State

• Postcode

PostalAddress(Pleasetickifsameasabove) o

• StreetNumber

• Suburb/Town

• State

• Postcode

Phone,FaxandEmail

• Homephone

• Businessphone

• Businessfax

• Mobile

• Email

• Preferredcontact

method

• Personalinterests

SECTION2–PERSONALDETAILS

Client Financial Profile

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Childrenand/orOtherDependants|CurrentorExpected

FullName DateofBirth Gender Relationship DependantY/N

EmploymentDetails

• Occupation/Title

• Jobdescription/duties

• Qualifications

• Employername

• Employmentstartdate

• Doyouworkoverseas?

• Ifyes,listrelevant

country(ies)

• Availablepersonalleave

days

• TaxFileNumber(TFN)

• Employmentstatus

€ Full-time

€ Casual

€ Homeduties

€ Selfemployed

€ PartTime–Hrs?

€ Unemployed

€ Retired

€ Full-time

€ Casual

€ Homeduties

€ Selfemployed

€ PartTime–Hrs?

€ Unemployed

€ Retired

• Ifself-employed,what

structure?

€ Trust

€ Company

€ SoleTrader

€ Partnership

€ Trust

€ Company

€ SoleTrader

€ Partnership

• ProposedRetirementAge:

• DateofRetirement

AdviserNotes

Client Financial Profile

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InsertNETIncome–AnnualAmounts

Wages/Salary

Bonuses

Centrelink/DVA/Otherbenefits

Investment/RentalIncome

OtherIncome

TotalAnnualIncome

Outgoings–AnnualAmounts

Client1(orjoint) Client2/Partner(ifapplicable)

HomeMortgage/Rent

Rates

HouseRepairs/Maintenance

Electricity/Gas/Phone

HouseInsurance

CarMaintenance/Registration/Insurance

GeneralLiving–Food,clothingetc

InsurancePremiums

Health–Insurance,medicaletc

Education–Fees,books,uniforms

Holidays

Entertainment/Other

TotalAnnualOutgoings

Total

Total

AnnualSurplus/(Deficit)

Whatisthelikelypatternofyourexpensesoverthenext5years?: �Decrease�Same �Increase

• Whatisyourcurrentsavingsabilitypermonth?

• Whatannualincomewouldyouideallylikeinretirementtoallowyoutohaveacomfortablelife?

SECTION3–INCOMINGS&OUTGOINGS

$ $

$ $

$

$

Client Financial Profile

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AssetsandLiabilities–Thisinformationassistwithtaxeffectivenessandcapitalgainspurposes

Assets Owner(s) PurchasePrice$ CurrentValue$ Notes

• PrincipalResidence

• HolidayHome/Rental

Property

• BankAccounts

• Contents/Personal

Property

• MotorVehicles

• ManagedFunds

Totalassets $

Liabilities Owner(s) AmountOwing$InterestRateon

loan%

RepaymentsPrincipal

&InterestorInterest

Only

• HomeMortgage

• CarLoan

• PersonalLoan

• Contents/Personal

Property

• MotorVehicles

• InvestmentLoan

Totalliabilities $

Networth (TotalAssetslessTotalLiabilities) $

AdviserNotes

SECTION4–ASSETS&LIABILITIES

Client Financial Profile

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SuperannuationAssetsandIncomeStreams

FundName Owner(s) ValuePensionAmount

(ifapplic.)

Insurance

Type

Sum

InsuredPremium

SuperannuationContributions

Client1 Client2

Haveyoumadeanysupercontributionstoany

superannuationfundinthecurrentorprevioustwo

financialyears?

Y/N Y/N

Ifyes,pleaseprovidefulldetailsofamount(s) $ $

Beneficiaries

Name PercentageBenefit

AdviserNotes

SECTION5-SUPERANNUATION

Client Financial Profile

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Client1 Client2

• Doyouhaveawill?

• WhatdatewastheWilllastreviewed?

• IsthereaPowerofAttorney(PoA)inplace?

• Ifyes,whattype?Enduring/Other?

• NominatedAttorney

• Whatdatewasthe(PoA)lastreviewed?

• NameofSolicitor• ContactNumber

• NameofAccountant• ContactNumber

Detailsofanylegalobligations(ieGuarantor):

AdviserNotes

SECTION6–ESTATEPLANNING

Client Financial Profile

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Insuranceisanessentialpartoffinancialplanning.Itisimportantyouensurethatyouhaveadequatecoverforallaspects(personalandbusiness)

ofyourlife.Inhelpingyoutoassesstheadequacyofyourinsurances,pleaseanswerthefollowing:

InsuranceDetailsincludingLife,TPD,Trauma,IncomeProtection(IP)andBusinessExpenses

Pleaseprovidedetailsofexistinginsurancepoliciesorriderbenefits

Name of Insured

Person

Whoownsthepolicy?

egspouse/superfundTypeegLife/TPD Insurer SumInsured

Premium Amount &

howoften?

GeneralInsuranceDetails(IndependentCapitalAdvisersPtyLtdisnotlicensedtoprovidegeneralinsuranceadvice)

Provider SumInsured

Home

Contents

MotorVehicle

PrivateHealth

Other:

AdviserNotes

SECTION7–EXISTINGINSURANCES

Client Financial Profile

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• Provideandaftertaxincomeof:$__________

• Providecapitalgrowthof________________%,orinlinewithinflation(subjecttoinvestmentprofile)

• Maintainanemergencyfundof:$__________

• Forseeablefuturelargeexpenses(overseasholiday,homerenovations,etc):$__________

• Doyouknowofanyfurthercircumstancesthatmayaffectyourfinancialsituationinthenearfuture?Y/N

IfYes,whatarethey?

• Doyouhaveanyconcernsorlimitsinregardtoassetsplittingwithyourpartnertoreducetaxation?Y/N

• Wouldyouconsidertakingoutaloantofundyourinvestmentatanystage?Y/N

IfYes,whatisthelevelofgearingyouarepreparedtoaccept?_________%

Howimportanttoyouarethefollowing?Ahighernumberindicatesgreaterconcerns.Range1–5

1.Notconcerned2.SlightlyConcerned3.Concerned4.VeryConcerned5.ExtremelyConcerned

• Howconcernedareyouabouthavingyourportfoliokeeppacewithinflation?

• Howconcernedareyouabouttaxeffectiveinvestmentsandplacements?

• Towhatextentareyouconcernedaboutcapitalstabilityofyourinvestments?

• Howconcernedareyouthatcashbemadeavailabletomeetemergenciesorotherinvestmentopportunities?

• Howconcernedareyouaboutgeneratingmaximumincomeforyourportfolio?

• Towhatextentareyouconcernedaboutmaximisingthevalueofyourestate?

• Willyouworryifyourinvestmentsgodowninvalueintheshortterm,buthavethepotentialforlongtermgrowth?

Regardingyourincomeneeds,doyouwishto(PleaseSelectOneofTheFollowing):

• Liveoffincome,preservecapital: Yes No

• Liveoffincomeandcapital,noneedtopreserveassetsforestate: Yes No

• Liveoffincomeandcapital,butwouldliketohavesomeassetslefttoestate: Yes No

• Notliveoffincomeorcapital: Yes No

SECTION8–INVESTMENTOBJECTIVES

InvestmentProfile

IncomeNeeds

Client Financial Profile

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Client1 Client2/Partner(ifapplicable)

• Experience with financial products and in

particularmanagedinvestments

€ Good

€ Fair

€ Unfamiliar

€ Good

€ Fair

€ Unfamiliar

• Yourabilitytounderstandfinancialtermsand

toexpressyourpreference?

€ Good

€ Fair

€ Unfamiliar

€ Good

€ Fair

€ Unfamiliar

• Areyouoryourpartnerexpectingtoreceiveaninheritanceinthenearfuture?Y/N

Ifyes,detailsieAmount$andwhen

PleaseInitial

Conservative Longtermandsecureincomestream.Minimalgrowthoncapitalinvested.

Preservationofcapitalinvested.

ModeratelyConservative Stableincomestreams.Modestgrowthoncapitalinvested.

Lowtomoderatecapitalvolatility.

Balanced Moderategrowthoncapitalinvested.Moderateincomestream.

Moderatelevelofcapitalvolatility.

Assertive Highlevelofgrowthoncapitalinvested.Incomeisincidental.

Highlevelofcapitalvolatility.

Aggressive Veryhighlevelofgrowthoncapitalinvested.Veryhighlevelofcapital

volatility. Understandsandacceptsrisk.

• Completetheaboveforeachclient/partner •

KnowledgeofFinancialMatters

InvestorType

Client Financial Profile

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IncomeProtectionNeeds–Howwouldyoureplaceyourincomeintheeventoftemporaryorpermanentlossof

yourcurrentincome.

InsertName: InsertName:

• Doyouhaveanalternativesourceofincomein

theeventofseriousillnessordisability?Y/N Y/N

• Howmanydayscouldyougowithoutyour

regularincome?ie30/60/90

• Intheeventyouareunabletoworkforalong

periodoftimeduetoillnessoraccident,how

longwouldyoulikeyourincomeprotection

paymentstocontinuee.g.2,5years,uptoage

60,uptoage70?

• Whatminimumpercentageordollaramountof

yourcurrentgrossincomewouldyouneedto

maintainyourlifestyle(NBmaximum75%)?

• Replacesuperannuationcontributions? Y/N Y/N

9.2 LumpSumInsuranceNeeds

Death TPD Trauma

InsertName/s:

Indicatewho requires the cover In the event of death, TPD or amedical

event.

Ifso,whataretheamountsthatyouwouldrequire?

• Repaymortgage(s) $ $ $

• Repaypersonaldebt(s) $ $ $

• Providefundsforfuneralcosts $ $ $

• Providefundsforemergencye.g.cashinbank $ $ $

• Providealumpsumforhomeandlifestylealterationse.g.access

ramps$ $ $

• Providealumpsumformedicalcostse.g.majoroperations $ $ $

• Other: $ $ $

• Numberofyearsincomerequiredforchildren’seducation

• Amountrequiredeachyearforchildren’seducation $ $ $

• Numberofyearsincomerequiredforspouse/partner

• Amountrequiredeachyearforspouse/partner $ $ $

Sub-total $ $ $

Self-insurancee.g.saleofassets,existinginsurance $ $ $

Total $ $ $

SECTION9–PERSONALINSURANCENEEDSANALYSIS

Client Financial Profile

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AdviserNotes

DocumentationChecklist

TheinformationrecordedinthisClientDataFormwasprovidedduringadiscussionheldon

TheFSGandAdviserProfilewereprovidedtotheabovementionedclient(s)on

TheversionnumberoftheFSGprovidedwas

Theclient’sriskprofilequestionnairewascompletedon

AdviserSignatureandARNumber

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15.0 ClientDeclaration

Weherebydeclarethat:

• A Financial Services Guide (FSG) version Oct 2011 and Adviser Profile were provided to us and we have read and understood both

documents

• TheinformationprovidedinthisClientDataForm–FinancialPlanningisatruereflectionofmy/ourpersonalfinancialsituation,needsand

objectives.I/Weam/arenotawareofanyotherinformationthatwouldberelevanttothemakingofarecommendationbymy/ouradviser

• WeunderstandthatwherewehavenotcompletedsomeofthesectionswithinthisClientDataForm–FinancialPlanning,my/ouradviser

isobligedtowarnusthathis/heradvicemaybebasedonincompleteorinaccurateinformation

• WeconfirmthatwehavecompletedtheClientRiskProfileQuestionnaire.Wehavereadandunderstoodmy/ouragreedriskprofileand

additionally,weunderstandthatthisprofilewillbeconsideredintheadviceprocess

• Wegivepermissionformy/ourTaxFileNumber,asprovidedinsection2toberetainedonfilebymy/ouradviser

• Wegivepermissionforthisinformationtoberetainedandusedforthepreparationofmy/ourrelevantadvicedocumentandinrelationto

anyinvestmentwhichweholdormayholdandweunderstandthatanyadviceand/orfinancialplanningrecommendationswillbebased

ontheinformationsuppliedinthisClientFinancialProfile.Weacknowledge,inaccordancewiththeElectronicTransactionsAct(1999),thisClientFinancialProfilemaybeelectronicallystoredsecurelyforrecord-keepingpurposesbymy/ouradviser

• Weauthorisemy/ouradvisertocontactthefinancialproductprovidersthatcurrentlymanagethefinancialproductsthatweholdaslisted

in this Client Financial Profile, or as otherwise notified to my/our adviser, in order for my/our adviser to ascertain my/our financial

circumstances.

Client1

Signature

Fullname Date

Client2

Signature

Fullname Date

AdviserNotes