Financial Planning - New Client Information Form

Personal details

Yourself

Partner (if applicable)

Title

Surname

First Name

Date of Birth (DD/MM/YYYY)

Country of Birth

Gender

Marital Status

Do you have Private Health cover?

Contact details

Yourself

Partner (if applicable)

Email Address

Best Daytime Contact Number

Home Address (Residential)

Post Address (e.g. PO Box)

DEPENDENTS

Dependent 1

Full name

Date of birth

Sex

Support required to age

Dependent 2

Full name

Date of birth

Sex

Support required to age

Dependent 3

Full name

Date of birth

Sex

Support required to age

Dependent 4

Full name

Date of birth

Sex

Support required to age

Dependent 5

Full name

Date of birth

Sex

Support required to age

NAME OF COMPANY

(If any) (please include relevant ABN and TFN’s)

Company

Trust

Super Fund

How did you find out about our services?

Professional Adviser

Accountant

Name

Email Address

Telephone

Solicitor

Name

Email Address

Telephone

Financial Adviser

Name

Email Address

Telephone

Other (i.e. Bank Manager)

Name

Email Address

Telephone

Employment details

Yourself

Partner

Employment Status

Occupation

Employer Name

Do you feel your current Employment Security is secure?

Do you foresee any substantial change to your income in the next 2 to 5 years?

Lifestyle objectives

Yourself

Partner

At what age do you plan to retire?

After retirement do you intend to work again either on a full-time or part-time basis?

In the future will you be the Beneficiary of an Estate?

Do you have any planned significant expenditure, or lifestyle objectives now or in the future? (Do you want to purchase a new car, travel overseas, save for your children's education, reduce debt, retire early or reduce your working hours? Please indicate a level of priority for each.

Monthly income and expenditure

Please complete your income details and at minimum provide your total living expenses. Once we review your income against mortgage, food and bills, we can determine your surplus or deficit and develop a financial strategy accordingly.

Income

Gross Salary/Pension

Yourself ($)

Partner ($)

Joint ($)

Investment Income

Yourself ($)

Partner ($)

Joint ($)

Personal Income

Yourself ($)

Partner ($)

Joint ($)

Other Income (e.g. bonus or overseas income)

Yourself ($)

Partner ($)

Joint ($)

TOTAL INCOME

Yourself ($)

Partner ($)

Joint ($)

Expenditure

Rent/ Mortgage

Yourself ($)

Partner ($)

Joint ($)

Household Expenses (food, power, insurance rates etc.)

Yourself ($)

Partner ($)

Joint ($)

Motor Vehicle Expenses

Yourself ($)

Partner ($)

Joint ($)

Medical/ Education

Yourself ($)

Partner ($)

Joint ($)

Private Health Cover

Yourself ($)

Partner ($)

Joint ($)

Clothing/ Entertainment

Yourself ($)

Partner ($)

Joint ($)

Personal Insurance Premiums

Yourself ($)

Partner ($)

Joint ($)

Super/ Life Contributions

Yourself ($)

Partner ($)

Joint ($)

Business Expense

Yourself ($)

Partner ($)

Joint ($)

Personal Loans/ Credit Cards

Yourself ($)

Partner ($)

Joint ($)

TOTAL EXPENDITURE

Yourself ($)

Partner ($)

Joint ($)

Targets

Minimum income required?

Yourself ($)

Partner ($)

Joint ($)

Do you desire to minimise fees and costs?

Superannuation details

Yourself

Partner

Fund Name

Account Number

Current Value (estimate)

Insurance – Salary continuance, Life & TPD Cover (if applicable)

Fund Name

Account Number

Current Value (estimate)

Insurance – Salary continuance, Life & TPD Cover (if applicable)

Fund Name

Account Number

Current Value (estimate)

Insurance – Salary continuance, Life & TPD Cover (if applicable)

Assets & liabilities

Principle Residence

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Cash and bank Deposits

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Motor Vehicles

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Motor Vehicles

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Investment Property

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Investment Property

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Home Contents

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Business Interests

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Shares and Managed Funds

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Shares and Managed Funds

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Shares and Managed Funds

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Surrender value of traditional life insurance

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Superannuation (details on previous page)

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Superannuation (details on previous page)

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Holiday home

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Other Assets

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Other Assets

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Personal loans/ Overdrafts etc

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Credit Cards etc.

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Credit Cards etc.

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

Other liabilities

Assets ($)

Liabilities ($)

Ownership

Yourself Partner Joint

TOTAL NET ASSETS

(A)

(L)

Ownership

Yourself Partner Joint

(A) - (L) = $

Ownership

Yourself Partner Joint

Have you borrowed monies for any of the above investments?

Do you have any comments regarding your current investments or liabilities and preferences going forward?

Risk Insurance

Existing Risk Insurance Cover

Yourself

Partner

Company Name

Account Number

Type of Policy (life, TPD, Trauma or Income protection)

Amount Cover

Company Name

Account Number

Type of Policy (life, TPD, Trauma or Income protection)

Amount Cover

Company Name

Account Number

Type of Policy (life, TPD, Trauma or Income protection)

Amount Cover

*Please provide old statements of your insurance policies

Estate Planning

Yourself

Partner

Do you have a Will?

Last reviewed

Enduring Power of Attorney

Enduring Power of Guardianship

Funeral Plan

Testamentary trust Provisions

Details of Funeral plan

Estate Planning Objectives

Estate Planning Objectives (Please consider non-dependent children or children from another relationship)

Risk Insurance Background

Health Considerations

Client

Partner

Describe current health

Estate Planning Objectives (Please consider non-dependent children or children from another relationship)

Client

Partner

Do you intend to seek medical treatment for any health problems?

Have you recently had a treatment for any health problems?

Do you smoke (including social)?

If you answered YES to any of the above question, please provide details:

Lifestyle Pursuits

(e.g scuba diving, motor racing, football, abseiling etc.)

Details (e.g. diving depth, frequency of dives etc.)

Activity

Client

Partner

Consent Declaration

By submitting this form, I confirm that the information provided is true and correct and that I am providing it voluntarily with full and free consent to Permalink. I authorise Permalink to use and share this information with relevant third-party professionals where required to deliver services and meet compliance obligations, in accordance with applicable privacy laws.

Client Name

Partner Name

Signature

Date

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Financial Planning – New Client Information Form