Please read this carefully before proceeding Strictly Private and Confidential By virtue of the nature of their role, advisers will have access to their client’s personal and financial information. In addition to the legislated privacy requirements that apply to such information, the obligation of confidentiality also forms part of the ethical requirements an adviser must observe as part of their general business practises. An adviser must not reveal any client information to a third party unless instructed to do so, in writing, by the client, or where required by law. The written authority of all clients will be required to release information that is held in a joint file. In the absence of such authority, only information relating to the particular client may be disclosed. These obligations extend to any employees or contractors working for the adviser. It is the adviser’s responsibility to ensure that this obligation is fully explained and understood by staff. Client files must be stored securely and should not be accessible to unauthorised persons. Special requirements apply to the retention and security of client’s tax file numbers. Failure to adhere to these key principles will be regarded as a serious business risk and may result in adviser suspension or termination. Important Notice to Clients In order for an adviser to make an investment and insurance recommendation they must have reasonable grounds for making that recommendation. This means that the adviser must conduct an appropriate investigation as to the financial situation and particular needs of the individual(s) concerned. The information requested in this fact finder is necessary to enable a recommendation to be made on a reasonable basis. Failing to provide information requested by your adviser may result in your commitment to a product or strategy that may not be appropriate to your individual needs and circumstances. The following document is quite detailed and will take some time to complete but it is an investment in your future as any recommendations we may make will be based on the information contained in this document. We ask you to have it fully completed for your initial interview with our adviser. By law any recommendation we may make to you has to be based on full and complete disclosure of all possible facts that you have supplied in this document. In preparation for the interview we require you to also have all existing and past superannuation documentation and current risk or insurance policies attached. . All details will remain confidential at all times. If you have any queries then please ring us on 02 4276 2557 for assistance. PLEASE COMPLETE IN BLACK OR BLUE PEN
Client Client Employment Employed Self-employed Employed Self-employed Employment type Full time Part time Casual Full time Part time Casual Employer: occupation/title: Date commenced employment Number of hours worked per week: Current Income (Before Tax) Client Client Gross salary/wages $ $ How often do you get paid? Weekly Fortnightly Monthly Weekly Fortnightly Monthly Income from other employment/work $ $ Fringe benefits Benefit $ $ allowance/cash: $ $ Commissions/ bonus/profit share: $ $ Centrelink/Department of Veteran Affairs benefits Benefit:_____________________________ Benefit:_____________________________ Amount: $________________ per fortnight Amount: $________________ per fortnight Gifts in the last 5 years? Centrelink Reference Number (CRN) Private hospital cover Yes No Yes No Is this income expected to change over the next 12 months – when? Yes / / No Yes / / No Expected/increased income $ $ Leave details (hours/days) Sick Leave: Annual Leave: LSL: Other: Sick Leave: Annual LSL: Other: Do you have any capital gains from sale of investments this financial year? Any unused capital losses carried forward from sale of investments? Household Day to Day Expenses - Show as an annual amount
What sources of income do you expect to rely on in retirement? Are you on Yes No Unsure If yes how have you measured this? Assets (Non-Financial) Principal Residence Owner Asset value Date purchased / / For the purpose of your advice do you authorise a valuation of the properties if it is at no cost to you? Yes No Date of last valuation? / / FIRESALE VALUES Contents Non income producing real estate (e.g. holiday home, land) vehicles Boat/ marine Owner Asset value Date purchased Details Date of last valuation? / / / / FIRESALE VALUES Caravan Collectables/ Art/ other Business pension assessable assets (inc. gifts > $10K) Owner Asset value Date purchased
Owner Units (if applicable) Current value $ $ $ $ Purchase price $ $ $ $ Date purchased / / / / / / / / Income reinvested Yes No Yes No Yes No Yes No Regular contributions Yes No Yes No Yes No Yes No Regular Contributions Amount $ $ $ $ Frequency F/M/Y Do you wish to retain? Yes No Yes No Yes No Yes No Investment Property 1 2 3 4 Address Owner Ownership % % % % % % % % Date purchased / / / / / / / / Cost base $ $ $ $ Current value $ $ $ $ Would you consider selling? Yes No Yes No Yes No Yes No Rental income $ pa $ pa $ pa $ pa Rates $ pa $ pa $ pa $ pa Maintenance $ pa $ pa $ pa $ pa Agent fees $ pa $ pa $ pa $ pa Insurance $ pa $ pa $ pa $ pa
$ $ $ $ per General Insurance Insurer Sum Insured Home Yes No $ Contents: Yes No $ Vehicle(s): Yes No $ or Market Value Private health insurance: Yes No Provider: Personal effects: Yes No $ (e.g. professional indemnity, business, investment property) Yes No $ Do you wish to be referred to a third party to have your general insurances reviewed? Yes No Account Pensions, Allocated Pensions and Annuities Client Client Do you have a superannuation income stream Yes No Yes No Pension/annuity type: (account based pension, allocated pension, annuity) What is the name of your fund? What is your account number? What is the current account balance? $ $ Have you provided your last statement? Yes No Yes No Frequency of payment: Wk Fn Mth Wk Fn Mth Income amount: $ $
Client Client Other than your home, do you intend on leaving an inheritance to your dependants or other family members? Yes No Yes No If Yes, Details: and Power of Attorney Client Client Do you have a Will? Yes No Yes No Date of Will / / / / Date last reviewed / / / / Do you have a Power of Attorney In Place? Yes No Yes No What types of Power of Attorney do you have? General Medical Enduring Guardianship General Medical Enduring Guardianship Who is your of Attorney? Who is your Power of Guardianship? Which state or territory of Australia does it relate to? Notes:
Would you want the flexibility for your spouse to cease work for a period? (if applicable) Yes No Yes No Permanent Disability In the of serious illness or accident resulting in permanent disablement, where between 0% and 100% would you ideally want your income to be replaced? _______% _______% Would you want to provide a provision for medical costs and care? Yes No Yes No Would you want the flexibility for your spouse/family member to cease work, reduce their hours to provide ongoing care or would you seek external carer support? (if applicable) Yes No Yes No Would you want to be mortgage (non-deductible debt) free? Yes No Yes No Unexpected Death In the event that you or your spouse were to die unexpectedly, what standard of living would you like to leave for your family? As well off Slightly better off Worse off As well off Slightly better off Worse off In the event of premature death, where between 0% and 100% would you ideally want your income to be replaced? _______% _______% Would you want these funds paid to your family via a tax effective income stream if possible? Yes No Yes No Would you want to provide a provision for terminal illness care so that this does not reduce death provisions for income? Yes No Yes No you want to ensure your family is mortgage free? Yes No Yes No you want the flexibility for your spouse to cease or reduce work for a period? (if applicable) Yes No Yes No Protection for Children Is it important to have appropriate protection for your children in the event they suffered from a severe illness? Yes No
To Whom It May Concern I DOB: / / of request that all relevant information of my / our investments, insurance, superannuation, bank accounts, income and expenses or other financial, accounting or legal information be released to Finance Control Mortgage Solutions Pty Ltd. Finance Control Mortgage Solutions Pty Ltd, ABN 59 449 532 097 Lighthouse Lane, 145-149 King Street, Warrawong NSW 2502 is a credit representative of Pty Ltd ACN 117 651 760 (“BLSSA”) Australian Credit Licence Number: 391237 Please provide this information by letter, phone or fax: Carly Smith, Jodie-Lee Pyke and Paul Rawson Finance Control Mortgage Solutions Pty Ltd Box 256 Warrawong NSW 2502 Phone: (02) 4276 2557 Fax: (02) 4276 2558 Email: info@financecontrolms.com.au Please also accept a photocopy or facsimile of this letter as authority as the original will stay on file at Finance Control Mortgage Solutions Pty Ltd This authority remains in force indefinitely until revoked by myself in writing. Yours faithfully, Signature: Name: Date: / / The broker certifies that this information will be used for the preparation of lending recommendations. Option to Quote Tax File Number Why investment and superannuation bodies ask for your TFN You are not required to provide us or any other body with your TFN and it is not an offence if you choose not to do so.