Client Questionnaire

Let's get started...

To be able to provide you with personal financial advice, we need to ask you about and record your financial situation and goals. This questionnaire is designed to record this information. If you are unsure about what to answer leave the section and we will discuss it in our meeting.

Our financial advice to you will be based on the information you provide.

Intro

Reason for seeking financial advice

Personal Details

Preferred Title
Please Choose...
  • Dr
  • Mr
  • Ms
  • Mrs
  • Miss
Given Names
Surname
Preferred Name
Marital Status
Please Choose...
  • Single
  • Married
  • Divorced
  • Separated
  • De Facto
  • Widowed
Gender
Please Choose...
  • Male
  • Female
  • Other
Date of Birth
Country of Birth
Tax Residency Country
Primary Citizenship
Children

Partner Details

Partner Preferred Title
Please Choose...
  • Dr
  • Mr
  • Ms
  • Mrs
  • Miss
Partner Given Names
Partner Surname
Partner Preferred Name
Partner Marital Status
Please Choose...
  • Single
  • Married
  • Divorced
  • Separated
  • De Facto
  • Widowed
Partner Gender
Please Choose...
  • Male
  • Female
  • Other
Partner Date of Birth
Partner Country of Birth
Partner Tax Residency Country
Partner Primary Citizenship
Partner Children

Contact Details

Preferred Email
Residential Address
Postal Address

Your Contacts & Occupation

Preferred method of contact
Please Choose...
  • Phone (Home)
  • Phone (Work)
  • Phone (Mobile)
  • Email
Phone (Home)
Phone (Work)
Phone (Mobile)
Retirement age (or expected)
Occupation

Partner Contacts & Occupation

Partner Preferred method of contact
Please Choose...
  • Phone (Home)
  • Phone (Work)
  • Phone (Mobile)
  • Email
Partner Phone (Home)
Partner Phone (Work)
Partner Phone (Mobile)
Partner Retirement age (or expected)
Partner Occupation

Your Income

Before tax salary/wage (p.a)
Other Income

Partner's Income

Partner Before tax salary/wage (p.a)
Partner Other Income

Living Expenses

Cashflow
Living Expenses
Frequency
Please Choose...
  • Weekly
  • Fortnightly
  • Monthly
  • Yearly

Assets

Family Home
Managed Funds
Bank Accounts
Term Deposits
Investment Properties
Personal Assets (e.g: Boat)
Direct Shares
Other - please explain

Your Superannuation

Fund #1 Name
Fund #1 Value
Fund #1 Type
Fund #2 Name
Fund #2 Value
Fund #2 Type

Partner Superannuation

Fund #1 Name
Fund #1 Value
Fund #1 Type
Fund #2 Name
Fund #2 Value
Fund #2 Type

Liabilities

Home Loan
Home Loan Rate
Home Loan Repayment Amount
Investment Loan
Investment Loan Rate
Investment Loan Repayment Amount
Personal Loan
Personal Loan Rate
Personal Loan Repayment Amount
Credit Card
Card Interest Rate
Repayment Amount

Personal Insurance

Would you like your personal insurances reviewed?

Wills & Estates

Do you have a current will?

Your Goals and Objectives

Goal #1
Goal #1 Timeframe
Goal #1 Amount
Goal #2
Goal #2 Timeframe
Goal #2 Amount
Goal #3
Goal #3 Timeframe
Goal #3 Amount
What areas of advice are you interested in?
Is there anything else that your advisor should know to provide you appropriate advice?

Referral

How did you find out about us
How?

Acknowledgement

By completing this form and ticking the following checkboxes, you confirm that
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