Confidential Financial Questionnaire

If you would like us to telephone you, please complete the form below and click "Send - Please contact me"

 

Date:  

Client(s):  

Tel No Work:

 

Tel No Home:

 

Mobile:

 

Fax:

 

E-Mail:

 

Address:

 

PERSONAL DETAILS

Client 1:

 

Client 2:

 

Date Of Birth:

 

Date Of Birth:

 

Nationality:

 

Nationality:

 

Marital Status:

 

Marital Status:

 

Details of Children

Child's Name (1):

 

Age:

 

School Fees Cont:

 

Employers Cont:

 

Child's Name (2):

 

Age:

 

School Fees Cont:

 

Employers Cont:

 

Child's Name (3):

 

Age:

 

School Fees Cont:

 

Employers Cont:

 

EMPLOYMENT INFORMATION

Client 1 Job Title:

 

Client 2 Job Title:

 

Employer:

 

Employer:

 

Salary:

 

Salary:

 

Bonus:

 

Bonus:

 

Salary Increases:  

Estimated Monthly Salary Surplus:  

RESIDENCE PLANS

Residence Overseas To Date:

 

Resident In Present Country:

 

Possible Future Moves:- Where:

 

When:

 

Preferred/Planned Country of Retirement:  

PROPERTY

Property 1 Location:

 

Property 2 Location:

 

Value:

 

Value:

 

Mortgage Outstanding:

 

Mortgage Outstanding:

 

Repayments:

 

Repayments:

 

Income:

 

Income:

 

Planned Property Purchase:  

Rented Accommodation:

 

Cost:

 

Notes:

 

ACCUMULATED CAPITAL/INVESTMENTS
Cash Deposit (Please list assets together with amounts):

 

Unitised Investments, Mutual Funds, Equities (Please list assets together with amounts):

 

Other Investments (Please list assets together with amounts):

 

PENSION ARRANGEMENTS
Current/Company

Employers Retirement Age:

 

Early Retirement Charge:

 

Personal Contributions:

 

Employers Contributions:

 

Estimated Benefits at Normal Retirement Age:  

Preserved/Deferred Benefits

Scheme 1 (Current Value/Deferred Annual Pension):  

Scheme 2 (Current Value/Deferred Annual Pension):  

Scheme 3 (Current Value/Deferred Annual Pension):  

State Benefits:  

Desired Retirement Age:

 

Desired Income At Retirement:

 

Shortfall:  

Notes:

 

INSURANCE
Life Insurance - Personal

Life Assured (1):

 

Sum Assured (1):

 

Type (1):

 

Term (1):

 

Life Assured (2):

 

Sum Assured (2):

 

Type (2):

 

Term (2):

 

Life Assured (3):

 

Sum Assured (3):

 

Type (3):

 

Term (3):

 

Life Insurance - Employer

Life Assured (1):

 

Sum Assured (1):

 

Life Assured (2):

 

Sum Assured (2):

 

Critical Illness Cover

Life Assured (1):

 

Sum Assured (1):

 

Type (1):

 

Term (1):

 

Life Assured (2):

 

Sum Assured (2):

 

Type (2):

 

Term (2):

 

Income Replacement

Benefits (1):

 

Term (1):

 

Benefits (2):

 

Term (2):

 

Additional Information/Notes:

 

FINANCIAL OBJECTIVES & PRIORITY
What are your priorities? List from 1 - 7 in order of priority

Retirement Planning:

Capital Investment Planning:

Regular Savings Planning:

Education Fees Planning:

Life Assurance Planning:

Property Purchase:

Estate Planning/Wills:

Savings/Retirement/Investment Objective(s)
Time Frame

1:  

2:  

3:  

4:  

INVESTMENT RISK / REWARD RATIO
Please indicate your attitude to risk where 0=No Risk, 1=Cautious Risk, 2=Balanced Risk, 3=Market Risk, 4=Adventurous Risk, 5=Speculative Risk

Attitude To Risk:  

NB - Where a number of recommendations are made they may carry different risk ratings but overall they will aim to achieve an average level of risk as indicated above.
CURRENCY

Please Indicate Your Base Currency:  

If Other Please Specify: