Pre-Meeting Questionnaire

Pre-Meeting Questionnaire
Let us get to know you
Important Notice to Clients
Legislation and practice requires that an adviser making recommendations must have reasonable grounds for making those recommendations. This means that an adviser must conduct an appropriate investigation as the financial objectives, situation and particular needs of the client. The information requested in this form is necessary to enable recommendations to be made and will be used for that purpose. This document incorporates the requirements of the Corporations Law (as regulated by the Australian Securities and Investments Commission).
No liability is accepted for any advices given on the basis of inaccurate or incomplete information. This document contains personal information that is confidential. I/we acknowledge that any advice or information provided in the interview process is of general nature and may not be suitable for me/us. We acknowledge that it is not until we proceed with the completion of a Statement of Advice that the advice is personalized to our circumstances.
Personal Information
Title
Client 1 Client 2
Given Names
Client 1 Client 2
Surname
Client 1 Client 2
Preferred Name
Client 1 Client 2
Date of Birth
Client 1 Client 2
Country of Residence (tax purposes)
Client 1 Client 2
Marital Status
Client 1
- Single
- Married
- De facto
- Divorced
- Separated
- Widowed
Client 2
- Single
- Married
- De facto
- Divorced
- Separated
- Widowed
Contact Details
Residential Address
Client 1 Client 2
Time at Current Address
Client 1 Client 2
Current Residential Status
Client 2
- Own home
- Mortgage
- Renting
- Boarding
- Live with family
- Other
Client 2
- Own home
- Mortgage
- Renting
- Boarding
- Live with family
- Other
Postal Address
Client 1 Client 2
Postal Address
Same as residential address
Email
Client 1 Client 2
Mobile
Client 1 Client 2
Dependant Family Members (e.g. childres, parents)
Name Relationship Date of Birth Financial Dependant? (Yes/No)

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Lifestyle Goals and Objectives
Why have you come to see us?
Family, Community, Social, Personal Growth
What would you like to achieve? What would you like your future to look like? When (time-frame)
Employment, Volunteer, Work, Intellectual Engagement
What would you like to achieve? What would you like your future to look like? When (time-frame)
Leisure, Recreation, Home
What would you like to achieve? What would you like your future to look like? When (time-frame)
Desired Retirement Lifestyle, Income Needs and Wants
What would you like to achieve? What would you like your future to look like? When (time-frame)

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Money Beliefs
This exercise is designed to discover what you believe and identify unconscious assumptions about money. There are no right or wrong answers so just respond with the first think that comes to mind.
How did your parents manage money?
Client 1 Client 2
What money lessons did you learn from them?
Client 1 Client 2
What do you think are the best investments?
Client 1 Client 2
What emotions do you feel when you think about money?
Client 1 Client 2
In today's dollars, how much annual income do you think you will need to retire on?
Client 1 Client 2
Please write the first thing that comes to your mind when you think about:
Spending
Client 1 Client 2
Saving
Client 1 Client 2
Debt
Client 1 Client 2
Jobs
Client 1 Client 2
Receiving
Client 1 Client 2
Taxes
Client 1 Client 2
Government Payments
Client 1 Client 2

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Employment and entities
Employer
Client 1 Client 2
Occupation
Client 1 Client 2
Employment Status
Client 1
- Full Time
- Casual
- Home duties
- Retired
- Part Time
- Self Employed
- Not Employed
Client 2
- Full Time
- Casual
- Home duties
- Retired
- Part Time
- Self Employed
- Not Employed
Time in Current Employment
Client 1 Client 2
Gross Salary (excluding super)
Client 1 Client 2
Employer Super (%)
Client 1 Client 2
Tax File Number
Client 1 Client 2
Planned Retirement Age
Client 1 Client 2
Bonuses
Client 1 Client 2
Allowances
Client 1 Client 2
Centrelink
Client 1
Yes No Unsure
Are you entitled to any Centrelink Benefits?
Client 2
Yes No Unsure
Are you entitled to any Centrelink Benefits?
If yes, please specify:
If yes, please specify:
Entities
Client 1
Yes No
Do you have a private company?
Client 2
Yes No
Do you have a private company?
Provide additional information?
- Yes
- No
Name of Company
Client 1 Client 2
Client 1
Yes No
Do you have a Self Managed Super Fund?
Client 2
Yes No
Do you have a Self Managed Super Fund?
Client 1
Company Individuals
If so, is the Trustee of the SMSF a company or individuals?
Client 2
Company Individuals
If so, is the Trustee of the SMSF a company or individuals?
Name of Trustee
Client 1 Client 2
Client 1
Yes No
Do you have a trust?
Client 2
Yes No
Do you have a trust?
What is the trust name?
Client 1 Client 2
What is the trust structure and any further details
What is the trust structure and any further details
Advisers
Accountant
Company Name Contact Name Contact Details
Solicitor
Company Name Contact Name Contact Details
Mortgage Broker
Company Name Contact Name Contact Details

	Yes	No	Unsure
Are you entitled to any Centrelink Benefits?

	Yes	No	Unsure
Are you entitled to any Centrelink Benefits?

	Yes	No
Do you have a private company?

	Yes	No
Do you have a private company?

	Yes	No
Do you have a Self Managed Super Fund?

	Yes	No
Do you have a Self Managed Super Fund?

	Company	Individuals
If so, is the Trustee of the SMSF a company or individuals?

	Company	Individuals
If so, is the Trustee of the SMSF a company or individuals?

	Yes	No
Do you have a trust?

	Yes	No
Do you have a trust?

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Health
Client 1
Yes No
Are you a smoker?
Are there any health issues that could affect your future and/or this future?
Does your family history suggest long life?
Client 2
Yes No
Are you a smoker?
Are there any health issues that could affect your future and/or this future?
Does your family history suggest long life?
Client 1
Yes No
Do you have private hospital cover?
Client 2
Yes No
Do you have private hospital cover?
Client 1
Poor Average Good Excellent
What is that state of your health?
Client 2
Poor Average Good Excellent
What is that state of your health?
Height
Client 1 Client 2
Weight
Client 1 Client 2
Number of accrued sick leave days
Client 1 Client 2
Number of accrued leave days (e.g. annual, long service)
Client 1 Client 2

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Estate Planning
Client 1
Yes No
Do you have a valid Will?
Client 2
Yes No
Do you have a valid Will?
Date of Will
Client 1 Client 2
Client 1
Yes No
Is it up to date?
Client 2
Yes No
Is it up to date?
Will location
Client 1 Client 2
Client 1
Yes No
Does your Will have Testamentary Trust provisions?
Do you have a Power of Attorney?
Do you have an Enduring Guardianship?
Client 2
Yes No
Does your Will have Testamentary Trust provisions?
Do you have a Power of Attorney?
Do you have an Enduring Guardianship?

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Investment Assets
Cash and Fixed Interest
Account Current Value Owner
Investment Properties
Name/ Location Current Value Owner Rental Income (gross) Purchase Price Purchase Date Mortagaged (Yes/No)
Shares and Managed Funds
Account/ Company Current Value Owner Total Units/Shares Reinvest Income (Yes/No)
Superannuation and Pensions
Account Current Value Owner Fund Name
Other Investments
Investment Type/ Account Current Value Owner
Lifestyle Assets
Principal Residence
Current Value Owner
Home Contents
Current Value Owner
Motor Content
Current Value Owner
Caravan, Boat etc
Current Value Owner
Collectibles
Current Value Owner

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Liabilities
Home Loan
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
Investment Loan
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
Credit Cards
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
Personal Loans
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
Business Loans
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
Car Loan
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment
STSL (HEX / HELP / Student) Loan
Bank/ Lender Owner Loan Balance Rate % P&I or Interest Only Limit Start Date Term Monthly Payment

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Monthly Income and Expenses
Please visit our Budget Calculator and enter your monthly income and expenses data. You are also welcome to send us your own budget if you have one.
Income
From the budget calculator you have completed from our website or your own personal budget, what is your average monthly income?
Expenses
From the budget calculator you have completed from our website or your own personal budget, what is your average monthly expenses?
Savings
How much money do you have available after meeting your monthly expenses? Include any extra payments you make on your home loan.

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Insurance
Life insurance
Person Insured
Client 1 Client 2
Insurance Company
Client 1 Client 2
Policy Number
Client 1 Client 2
Income Protection
Person Insured
Client 1 Client 2
Insurance Company
Client 1 Client 2
Policy Number
Client 1 Client 2
Owner (self or super fund)
Client 1 Client 2
Current Monthly Benefits
Client 1 Client 2
Waiting Period (in days) until benefits starts
Client 1
- 30 days
- 60 days
- 90 days
- 720 days
- Other
Client 2
- 30 days
- 60 days
- 90 days
- 720 days
- Other
Benefit Period
Client 1 Client 2
Current Premium and Frequency
Client 1 Client 2
Total Permanent Disability (TPD) Insurance
Person Insured
Client 1 Client 2
Insurance Company
Client 1 Client 2
Policy Number
Client 1 Client 2
Trauma Insurance
Person Insured
Client 1 Client 2
Insurance Company
Client 1 Client 2
Policy Number
Client 1 Client 2

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Declaration and Disclosure
Financial Services Guides (FSG)
By signing the declaration below, you acknowledge receipt of the Financial Services Guide (FSG) of Financial Spectrum and the Adviser Profile of the Adviser/s to whom you have been signed
Privacy
Financial Spectrum is committed to ensuring the privacy Amendment (Private Sector) Act 2001 (Privacy Act). As required under the Privacy Act, we have provided you with a copy of our Privacy Statement which outlines our information management practices. If you have any questions, please ask your adviser. The information you have given us is confidential for use within Financial Spectrum and related companies. If you choose to work with one of our related companies, we will only disclose to them your personal information, where you have given us consent to do so.
Tax File Number
By signing the following declaration, you are authorising Financial Spectrum to use and disclose your Tax File Number/s only to fund managers, life insurance companies, and banking service providers as relevant for the purpose of the provision of financial services in accordance with legislative requirements.
Declaration
I/We acknowledge the information provided in this fact find is a true and accurate record and will be used, along with any applicable additional information provided by me/our needs. I/We appreciate that I/we may lose the right to seek compensation from the representative or the principal for any loss suffered by me/us as a consequence of incomplete or inaccurate information being provided. Where it is required, I/we give permission for our Tax File Number/s to be retained on our file. All information collected by Financial Spectrum will be kept private and confidential in accordance with our privacy policy
Date*
MM slash DD slash YYYY
Confirmation*
Please confirm you have read and accept the above declaration.*
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Step 1 of 11

Pre-Meeting Questionnaire

Let us get to know you

Personal Information

Lifestyle Goals and Objectives

Money Beliefs

Please write the first thing that comes to your mind when you think about:

Employment and entities

Centrelink

Entities

Advisers

Health

Estate Planning

Investment Assets

Lifestyle Assets

Liabilities

Monthly Income and Expenses

Income

Expenses

Savings

Insurance

Life insurance

Income Protection

Total Permanent Disability (TPD) Insurance

Trauma Insurance

Declaration and Disclosure

Financial Services Guides (FSG)

Privacy

Tax File Number

Declaration

Our Services

Quicklinks

Our Locations

Google Review

	Yes	No
Are you a smoker?
Are there any health issues that could affect your future and/or this future?
Does your family history suggest long life?

	Yes	No
Does your Will have Testamentary Trust provisions?
Do you have a Power of Attorney?
Do you have an Enduring Guardianship?

Name/ Location	Current Value	Owner	Rental Income (gross)	Purchase Price	Purchase Date	Mortagaged (Yes/No)

Account/ Company	Current Value	Owner	Total Units/Shares	Reinvest Income (Yes/No)

Name	Relationship	Date of Birth	Financial Dependant? (Yes/No)