Pre-appointment Fact Find

Please take 5 minutes to complete this short background form.
Before your appointment, we need to gather some information so that we can best help your needs. All information is treated with the strictest of confidence, and will not be passed onto any third parties except with out your permission or as required by law.

Title
 Mr Mrs Ms Miss Dr. Other

First Name

Surname

Preferred name

Date of birth

Age

Marital status
 Single Married De facto Widow Divorced Engaged Other

Children or other financial Dependants(Name, Age, Date of birth)

Private health insurance details

Tax resident (Aus)
 Yes No

Contact details

Country of residence

Residential address

Postal address
 As above

Telephone and email

H

W

M

Email

Employment details

Occupation

Industry and Employer

Employment status
 Full time Part time Casual Contractor Self-employed Unemployed Retired Home

Do you currently salary package any items?
 Vehicle Computer Super Contributions Phone Other:

Current Annual leave/sick leave balance

Why have you sought advice?

Record your initial reasons for seeking advice and/or your financial objectives here:

Do you currently have a trust or company?
 Trust Company

INCOME

Salary

Expected Bonus/Overtime

Rental income

Interest

Dividends

Distributions

Centrelink income(incl. Family Tax Benefit)

EXPENSES(monthly)

Home Loan repayments

Investment Property Repayments

Share Loan Repayments

Credit Card/Pers Loan Repayments

Insurance – home

Insurance – car

Insurance – life

Where do you currently direct your surplus income?
 Mortgage Spending Other

Other:

ASSETS

Principal residence ($)

Investment Property ($)

Shares/Managed Funds ($)

Vehicle(s) ($)

Cash ($)

LIABILITIES

Home loan

Investment Property Loan

Personal loan

Car loan(s)

Credit card balance

HOME LOAN DETAILS

Lender

Balance
$

Interest%

Loan purpose
 Residence Investment

HOME LOAN DETAILS

Repayment frequency  Fortnightly Monthly Other
 Fixed Variable

Principal / interest

 P & I I/O

Term remaining

SUPERANNUATION AND RETIREMENT INCOME STREAMS

Super fund

Approximate Balance

Super fund

Approximate Balance

Super fund

Approximate Balance

Self Funded Pension/Income stream

Did you Salary Sacrifice into Super in the current tax year?

$

Did you make any Personal Super Contributions in the current tax year?

$

RETIREMENT GOALS

Expected retirement age:

Desired level of income in retirement:

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