Pre-appointment Profile

Private and confidential
Important Notice to Clients
In order for us to provide financial planning advice to you, we need to have a reasonable basis for that advice. The information requested in this Pre-Appointment Profile is one of the tools we use to establish a basis for the advice we will provide. It is therefore important for you to complete this document as accurately and fully as possible. Failure to do so could result in advice being provided that is not appropriate to your individual needs, circumstances and objectives.
Your details
Client 1
Client 2
Name*
Prefix First Last
Name
Prefix First Last
Gender*
- Female
- Male
Gender
- Female
- Male
Marital Status*
Marital Status
Date of Birth*
DD slash MM slash YYYY
Date of Birth
DD slash MM slash YYYY
Health*
- Excellent
- Good
- Poor
Health
- Excellent
- Good
- Poor
Employment Status*
- Full time
- Part time
- Unemployed
- Self Employed
- Home maker
- Retired
- Casual
- Contractor
Employment Status
- Full time
- Part time
- Unemployed
- Self Employed
- Home maker
- Retired
- Casual
- Contractor
Occupation*
Occupation
Employer
Employer

Contact Details
Home Address*
Street Address Suburb State Postcode Country
Is your postal address the same as above?*
- Yes
- No
Postal Address
Street Address Suburb State Post Code Country
Client 1
Client 2
Home Phone
Home Phone
Work Phone
Work Phone
Mobile Phone*
Mobile Phone
Email Address*
Email Address
Preferred Method of Contact
- Mail
- Phone
- Email
Preferred Method of Contact
- Mail
- Phone
- Email

Children / Dependants
To add multiple children / dependents, please click the "+" button at the end of the row.
To add multiple children / dependents, please click the "+" button at the end of the row.
Name Relationship Related to Date of Birth Living at Home? (Yes/No) Financially Dependent Until? (Year)

How can we help you?
What key issues would you like to address in our meeting?*
When you think about your finances, what are your two or three biggest worries?*
Your major financial objectives
Short term (0 – 12 months)
Medium term (1 to 5 years)
Long term (5+ years)

Assets
Your lifestyle assets
Please list all of your assets (for example home, contents, vehicle/s etc). Each asset can be added within a new row by clicking the "+" button at the end of the row.
Asset Owner Value Is there an associated loan amount? (Y/N)
Your investment assets
Please list all of your assets (for example investment property, shares, funds etc). Each asset can be added within a new row by clicking on the plus symbol to add a new row.
Asset Owner Current value Is there an associated loan amount? (Y/N)
Further Information

Your super funds
Please list all of your super funds. Click on the "+" button to add a new row.
Fund Name Owner Account balance Employer contributions p.a. Salary sacrifice p.a. After-tax contributions p.a.
Your liabilities (e.g. home mortgages, investment loans, personal loans etc.)
Please list all of your liabilities. Click on the "+" button to add a new row.
Liability Owner Financial institution Current value Repayments (P&I or interest only) Current interest rate (%)
Further Information

Current Entities
Do you (or your partner) have a Self-Managed Super Fund?*
- Yes
- No
Do you (or your partner) have a Private Company?*
- Yes
- No
Do you (or your partner) have a Trust?*
- Yes
- No
Do you (or your partner) have a Partnership?*
- Yes
- No
If “yes” to any of the above, please provide further details

Your income and expenses
Client 1 (p.a.)
Client 2 (p.a.)
Annual income
Salary / Business income
Salary / Business income
Rental income
Rental income
Share / Investment income
Share / Investment income
Interest
Interest
Pension income
Pension income
Trust distributions
Trust distributions
Other
To add additional income sources please click on the "+" button at the end of the row.
Other
To add additional income sources please click on the "+" button at the end of the row.
Annual expenses
Please enter your estimated annual expenses for the entire household in whole dollars.
Total estimated household expenses (per annum)
Please list your major expense items (per annum)
To add additional expenses please click the "+" button at the end of the row.
Description Amount

Savings capability
Client 1 and Client 2
Are you able to save?
- Yes
- No
How much?*
How frequently?*
Further information

Personal insurance
Client 1
Total value of insurance
Please provide the details of the total value of any / all personal insurances you may hold.
Life ($) Total & permanent disablement ($) Critical illness / trauma ($) Income protection ($p/m) Income protection waiting period Income protection benefit period
Client 2
Total value of insurance
Please provide the details of the total value of any / all personal insurances you may hold.
Life ($) Total & permanent disablement ($) Critical illness / trauma ($) Income protection ($p/m) Income protection waiting period Income protection benefit period

Future changes
Are there any likely changes in your circumstances that may impact the ability to achieve your financial and lifestyle goals?*
- Yes
- No
Details
Other information
Is there any other relevant information we should be aware of?

Our Acknowledgments
Information in this form
The information provided in this form (Pre-Appointment Profile) is complete and accurate at the time of completion to the best of our knowledge (except where we have indicated that we have chosen not to provide the information).
We understand and acknowledge that before any advice can be given by the adviser, we will need to provide more information by completing a Client Profile.
Financial Services Guide
We have received the Financial Services Guide version dated prior to obtaining financial planning services and/or recommendations.
Information and Privacy Agreement
We agree that:
1. We are to receive financial planning services from the adviser named in this Client Profile [“adviser”] and understand that our personal information (including any sensitive information such as health information and membership of professional organisations [“sensitive information”]) is being collected primarily for that purpose.
2. We acknowledge the privacy notification in the Financial Services Guide, that we have access to the Privacy Policy and understand that our personal information will be used and disclosed as outlined in the Policy available from our adviser.
3. We also consent to the collection of our personal information for the purpose of our adviser providing the services stated above. This consent also relates to our sensitive information.
4. If we have provided personal information about an individual (such as a partner, dependant, employer or accountant) we have or will as soon as practicable, provide the individual with a copy of the Financial Service Guide which includes how you manage personal information and make them aware that this section applies to their personal information that has been collected for the purpose of our adviser providing us with the financial advice we have requested.
5. If we have provided information about someone else, we have or will obtain the consent of that person to that information being collected by our adviser and our adviser’s service providers. We have or will inform them that their information may be disclosed and we have authority to consent to this disclosure on their behalf.
6. We consent to the release of our personal information (including our sensitive information) to our spouse or partner.
Client Name 1*
Date*
DD slash MM slash YYYY
Signature 1*
Client Name 2
Date
DD slash MM slash YYYY
Signature 2

Name	Relationship	Related to	Date of Birth	Living at Home? (Yes/No)	Financially Dependent Until? (Year)

Asset	Owner	Value	Is there an associated loan amount? (Y/N)

Asset	Owner	Current value	Is there an associated loan amount? (Y/N)

Fund Name	Owner	Account balance	Employer contributions p.a.	Salary sacrifice p.a.	After-tax contributions p.a.

Private and confidential

Your details

Client 1

Client 2

Contact Details

Client 1

Client 2

Children / Dependants

How can we help you?

Your major financial objectives

Assets

Current Entities

Your income and expenses

Client 1 (p.a.)

Client 2 (p.a.)

Annual income

Annual expenses

Savings capability

Client 1 and Client 2

Personal insurance

Client 1

Client 2

Future changes

Other information

Our Acknowledgments

Information in this form

Financial Services Guide

Information and Privacy Agreement