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Consilium Client Fact Find – Comprehensive Version April 2019 Page | 1

CLIENT FACT FIND – COMPREHENSIVE

This Client Fact Find is issued by:

Consilium Advice Pty Ltd (‘Consilium’)

Australian Financial Services Licence No. 424974

Client Name/s

…………………………………………………………………………………………..

……………………………………………………………………………………………

Date

Consilium Authorised

Representative Name

Byron James Littlewood BA ADFS(FP) AFA, AR 255 833 of

B. J. Littlewood & Associates Pty Ltd trading as

Littlewood Financial Advisers ABN 14 003 560 950; CAR 255 455

Important Notice

Why do we ask you to complete the Data Collection Form?

The Client Fact Find Form relates to your personal and financial objectives, current financial situation, risk profile

and specific investment needs. The information we collect will ensure that we have sufficient understanding of

your current situation to provide you with financial advice that is appropriate to you. You have the right not to

provide us with this information, however, if you do not we may be unable to provide you with personal financial

advice.

Your Privacy Rights

Consilium’s commitment to protecting your privacy means that, amongst other things, in the process of

collection, storage, accuracy, use and disclosure of your personal information, your privacy is respected.

Consilium is bound by the National Privacy Principles under the Privacy Act. This policy explains how we treat

information that we hold about you. It sets out the types of information we collect, how we may use that

information and who we allow to access it. In addition to this policy, we will on occasions provide you with

specific notice about how we use particular information that we collect from you.


SCOPE OF THE INITIAL ADVICE

Please indicate with a tick the areas below in which you are seeking initial advice from Consilium

Advice Sought CLIENT 1 CLIENT 2

Wealth

Accumulation

Advice on the investment of my surplus income

Desirability of borrowing to invest

Providing for anticipated capital spending

Super

Advice on building my super assets

Consolidation of my individual super funds into a single fund

Desirability of the suitability of a Self-Managed Super Fund

Income

Advice on generating a retirement income stream

Obtain Centrelink benefits

Producing a required level of after tax income from your investments

Wealth

Protection

Analysis of my risk insurance needs

Review of your existing risk insurance policies

Investments

Construction of an investment portfolio using an available lump sum

Review of existing investments (managed funds/shares)

Improving

Cash Flow

Advice on salary packaging

Meeting my liquidity requirements

Analysis of my mortgage and investment loans

Impact of taxation on my financial position

Other

(please

specify)


PERSONAL DETAILS

Please provide your personal details below

CLIENT 1 CLIENT 2

Title

First Name

Middle Name

Surname

Preferred Name

Date of Birth / / / /

Health Status

(please circle)

Excellent Good

Fair Poor

Excellent Good

Fair Poor

Marital Status

(please circle)

Single Married De-facto

Widowed Divorced

Single Married De-facto

Widowed Divorced

Smoker? (please circle) Yes / No Yes / No

Home Phone ( )

Work Phone ( ) ( )

Mobile

Home Fax ( ) ( )

Work fax ( ) ( )

Home Email

Work Email

Residential Address

OTHER PROFESSIONAL ADVISERS

Please provide details of other professional advisers you currently use

Name Company Contact No Email

Accountant

Solicitor/Lawyer

Other


KEY GOALS AND OBJECTIVES

Please indicate your specific goals and objectives, including the estimated time when you

wish to meet these objectives

FINANCIAL GOALS

e.g. Retirement, borrow to invest

LIFESTYLE GOALS

e.g. Holidays, upgrade car

What goals and objectives do you wish to meet in the next 0 to 5 years?

What goals and objectives do you wish to meet in the next 6 to 10 years?

What goals and objectives do you wish to meet in the next 10 plus years?

What is your planned retirement age?

What is your desire level of income in retirement net of tax?

$ _ (Client 1)

$ _ (Client 2)

$ _ (Combined)

If our analysis indicates that you may not meet your retirement goals by the planned retirement date, would

you (please tick options you may consider):

Retire on the planned date and compromise on the level of retirement income

Consider deferring retirement to a later date

Increase the rate of capital drawdown

Consider strategies to build wealth, such as gearing (borrowing to invest)

Seek out ways of reducing expenses to allow you to save more


DEPENDANT DETAILS

Please complete details of your dependents below.

1 2 3 4

Name

Gender

Date of Birth

Relationship

Funding Requirements (pa) $ $ $ $

Number of years required?

EMPLOYMENT DETAILS

Please complete your employment details below, including your overall salary package

CLIENT 1 CLIENT 2

Occupation

Employer Name

Employment Status

(please circle)

Self-employed Full-time

Part-time Casual

Self-employed Full-time

Part-time Casual

Dated joined employer / / / /

If you are Self-Employed, please provide your business details below

Business Name

What is your principal trading activity?


INCOME AND EXPENSE DETAILS

Please complete your income and expenditure details in the following tables.

Income CLIENT 1 CLIENT 2

Gross salary (net of employer and salary

sacrifice contributions)

Estimated bonus

Investment income

Other income

Total Gross Income

Expenses

Housing & Utilities (mortgage repayments, rent, council rates, phone,

internet, electricity, gas, water) $

General Household (food, alcohol , groceries, clothing, entertainment, healthcare

& medical) $

Vehicles and Transport (lease/loan repayments, registration, fuel, servicing) $

Insurance (health insurance, home and contents, motor vehicle, life, TPD,

critical illness and income protection) $

Other expenses (children’s education, holidays/travel, tax deductible

donations, after tax super contributions) $

Total $

How much do you estimate you save each month? $

Where are you directing these savings?

(e.g. mortgage, bank account, managed fund)

Do you expect any future changes to your income/expenditure position?

Are you receiving any Government benefits?

If yes, which one? Please also specify amount.

Under some income protection policies, you can cover Superannuation Guarantee (SG)

and salary sacrifice contributions. Please enter your annual SG and salary sacrifice

contributions below.

SG contribution (pa) $ $

Salary sacrifice (pa) $ $


PERSONAL ASSETS AND LIABILITIES

Please list your assets and liabilities below. Please indicate those assets that you would be

comfortable selling in the event of permanent disability or death in the “Retain?” column.

Asset Name Description Owner Current

Value

Outstanding

liabilities

Retain?

(Y/N)

Family Home $ $

Holiday Home $ $

Home Contents $ $

Motor Vehicles $ $

Boats and caravan $ $

Other (please specify) $ $

Total $ $

Are you expecting any changes to your assets and liabilities? (e.g. sale of your

home, receiving an inheritance).

If yes, please provide details, including the expected dollar amount.

Yes No

$

Do you require cash funds to be kept liquid in case of emergency or

unexpected expenses? If yes, how much?

Yes No

$

Consilium Client Fact Find – Comprehensive Version April 2019 8

INVESTMENT ASSET AND LIABILITY DETAILS

Please include details of your existing investment assets below. If you own more than will fit in the spaces provided, please list the

total value below and provide a separate summary of your holding details

Asset Name Owner No. of units Purchase Date Purchase Cost Current Value Outstanding

Liability

Est.

Income

Retain

Yes/No

Cash A

ssets

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

Renta

l

pro

pert

y $ $ $ $

$ $ $ $

$ $ $ $

Managed F

unds $ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

Direct

Share

s $ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

Oth

er

$ $ $ $

$ $ $ $

$ $ $ $

Total $ $ $ $

Consilium Client Fact Find – Comprehensive Version April 2019 9

LIABILITY DETAILS

You can provide more detailed information on your liabilities below. This will assist us in reviewing and advising on your cash flow

situation

Liability Lender Borrower Amount

Outstanding

Interest

Rate

(%)

Payment Type

(P& I, Interest

only)

Payment

Amount

Payment

Frequency

Tax

Deductible

(Yes/No)

Mortgage (Family

Home) $ % $

Holiday Home $ % $

Motor Vehicle Finance $ % $

Investment Loan 1 $ % $



Margin Loan $ % $

Personal Loan $ % $

Credit Card 1 $ % $

Credit Card 2 $ % $

Other $ % $

Other $ % $

Total Liabilities $ $


SUPERANNUATION DETAILS

Please complete your superannuation details below, including annual contributions and

insurance cover

Fund 1 Fund 2 Fund 3 Fund 4

Member

Fund Name

Eligible Start Date

Is this a Defined Benefit Fund Yes No Yes No Yes No Yes No

Would you like this fund reviewed? Yes No Yes No Yes No Yes No

Current Value $ $ $ $

Taxable component $ $ $ $

Tax free component $ $ $ $

Non-preserved component $ $ $ $

Super Guarantee contributions (pa) $ $ $ $

Salary sacrifice contributions (pa) $ $ $ $

Personal deductible contributions

(pa) $ $ $ $

Non-Deductible contributions (pa) $ $ $ $

Life Insurance (sum insured) $ $ $ $

Total & Permanent Disability cover

(sum insured) $ $ $ $

Salary Continuance cover

(benefit per month)

$ for

years

$ for

years

$ for

years

$ for

years

Total Annual Premium $ $ $ $

Do you have a Binding Death

Nomination in place? Yes No Yes No Yes No Yes No

Please list the underlying investment options below:

Investment 1 $ $ $ $









SELF-MANAGED SUPER FUND DETAILS

Please complete the table for existing SMSF financials and member details

SMSF Name

Date SMSF was established

SMSF ABN

Who are the trustees of the SMSF?

Who administers the SMSF?

Member 1 Member 2 Member 3 Member 4

Member Name

Status (accumulation or pension)

Eligible Service Date

Investment strategy

Current member balance $ $ $ $

Tax free balance $ $ $ $

Annual contributions

- Amount

- Type

Insurance cover

Do you have a binding nomination?

Who have you specified to

receive benefits upon death?


PENSIONS AND ANNUITIES

Please complete details of any pensions/annuities you are receiving below

Fund 1 Fund 2 Fund 3 Fund 4

Owner

Pension Fund provider

Source (please circle) Super monies

Non super

Super monies

Non super

Super monies

Non super

Super monies

Non super

Type (please circle)

Account-based

pension

TTR pension

Complying

annuity

TAP

Account-based

pension

TTR pension

Complying

annuity

TAP

Account-based

pension

TTR pension

Complying

annuity

TAP

Account-based

pension

TTR pension

Complying

annuity

TAP

If annuity, what term has

been selected? (please

circle)

_ years

Lifetime

_ years

Lifetime

years

Lifetime

_ years

Lifetime

Date commenced

Purchase price $ $ $ $

Account balance $ $ $ $

Annual income $ $ $ $

Residual Capital Value $ $ $ $

Tax deductible amount (pa) $ $ $ $

Undeducted purchase price $ $ $ $

Past commutations/withdrawals $ $ $ $

Asset test exempt (please circle) Yes No Yes No Yes No Yes No

Reversionary Yes No Yes No Yes No Yes No

Who is the reversionary?

If you are currently receiving an overseas pension, or will receive one

in the future, please provide details (including amount)


EMPLOYER TERMINATION PAYMENTS

Please complete details of any employer termination payments you have received or are

expecting to receive below

CLIENT 1 CLIENT 2

Termination Date / / / /

Ex-gratia/golden handshake

amount $ $

Approved early retirement amount $ $

Long-service leave amount

(after tax) $ $

Annual leave amount (after tax) $ $

Sick leave amount (after tax) $ $

Other $ $

Are you receiving a redundancy?

If yes, please provide a copy of

the payment details as provided

by your employer

Yes No Yes No


EXISTING RISK INSURANCE

Please provide details of your existing risk insurance, including life, TPD, trauma and income

protection

Policy 1 Policy 2 Policy 3 Policy 4

Policy Type

(please circle)

Life

TPD

Trauma

Income Protection

Salary Continuance

Life

TPD

Trauma

Income Protection

Salary Continuance

Life

TPD

Trauma

Income Protection

Salary Continuance

Life

TPD

Trauma

Income Protection

Salary Continuance

Policy Owner

Life Insured

Insurer

Sum Insured $ $ $ $

Annual Premium $ $ $ $

Premium

Frequency

Renewal Date / / / / / / / /

Income protection

waiting period

Income protection

benefit period

Is this policy in

superannuation? Yes No Yes No Yes No Yes No

YOUR EXISTING GENERAL INSURANCE

Please provide details of your existing general insurance policies below

Policy 1 Policy 2 Policy 3 Policy 4

Type Health Insurance House Home Contents Motor Vehicle

Insurer

Policy Owner

Sum Insured $ $ $ $

Annual Premium $ $ $ $

Premium Frequency

Renewal Date


TRUST DETAILS

Please complete the table for existing Trust financial and beneficiary details

Trust Name

Type of Trust?

Fixed

Unit

Discretionary

Hybrid

Fixed Unit

Discretionary

Hybrid

Fixed

Unit

Discretionary

Hybrid

Fixed

Unit

Discretionary

Hybrid

Date Trust was established

ABN

Maximum term of the Trust

Appointer of the Trust

Trustee

Beneficiary 1 Beneficiary 2 Beneficiary 3 Beneficiary 4

Beneficiary Name

Beneficiary date of birth

Has a Trust election been made?

If yes, who is the

specified individual?

COMPANY DETAILS

Please complete the table for existing Company details

Company Name

ABN

Director(s)

Description of shares


ESTATE PLANNING

Please provide details of your current estate planning situation

Client 1 Client 2

Do you have a valid Will? Yes No Yes No

Date Will was drafted / / / /

Date Will was most recently reviewed / / / /

Power of Attorney Yes No Yes No

Enduring Power of Attorney Yes No Yes No

Enduring guardianship Yes No Yes No

Testamentary Trust Yes No Yes No

Do you have a funeral plan in place? Yes No Yes No

In which State was your estate planning documents prepared?


YOUR ATTITUDE TO RISK AND RETURN

Client 1 Client 2

Question 1

How confident are you with investment matters?

a. You are an experienced investor. You use research and other investment information to make investment decisions. You understand the various factors, which influence investment performance.

b. You understand that markets fluctuate and that different market sectors offer different income, growth and taxation characteristics.

c. You are confident about some investments. You don’t fully understand the share market.

d. You are not very confident when it comes to investments.

e. You are not confident with investments and feel uncomfortable with the complexity.

Question 2

What level of risk are you prepared to apply to your investment?

a. You would be willing to take substantial risk for substantial rewards.

b. Short-term losses are acceptable as long as the probability of a gain over the long-term is reasonable.

c. Moderate volatility is acceptable as long as medium term returns are positive.

d. You require low volatility with consistent positive returns.

e. Security of capital is paramount.

Question 3

What degree of investment risk have you taken in the past?

a. Large

b. Fair amount of calculated risk

c. Moderate degree of risk

d. Not much

e. Risk free only

Question 4

Investments such as cash offer highest security but have no capital growth and inflation can reduce the purchasing power. Considering this, which is more important for you?

a. More important to preserve purchasing power rather than security

b. Important to preserve purchasing power but also consider any risk

c. Look for a balance between security and preserving purchasing power

d. More important to have security than worry about inflation

e. Protecting the principle is the most important priority

Question 5

If you had to choose between a secure job with a reasonable salary and a high paid job with less security, which would you pick?

a. Definitely the highly paid job.

b. Probably the highly paid job with less security

c. Would have to consider other aspects

d. Probably the secure job with a reasonable salary

e. Definitely the secure job


Client 1 Client 2

Question 6

In light of current interest rates, what return do you reasonably expect to achieve from your investment?

a. Over 12%

b. Current inflation plus 8% p.a.

c. Current inflation rate plus 5% p.a.

d. Current inflation rate plus 2% p.a.

e. A reasonable return without losing any capital

Question 7

If you didn’t need your capital for more than 10 years, for how long would you be prepared to see your investment performing poorly before you cashed in?

a. Up to 2 years

b. Up to 1 year

c. Up to 6 months

d. Up to 3 months

e. You would cash in if there was any loss in value

Question 8

Your future income needs are such that a more aggressive investment strategy is recommended in order to achieve them. Which of the following best describes how you feel?

a. Happy with a more aggressive strategy – meeting your objectives is more important

b. Comfortable with an aggressive strategy however would watch closely to minimise any losses

c. Accept some extra risk in order to move towards the objective, but also prepared to reduce the objective slightly

d. A little extra risk is acceptable. Reduction of future objectives would be acceptable

e. A more aggressive strategy frightens you. You would rather reduce your future income needs significantly than take the risk

Question 9

The greatest tax savings are generally obtained from riskier investments, such as shares. Which balance do you feel most comfortable with?

a. Unstable, but potentially higher returns, maximising tax savings

b. Moderate variability in returns, reasonable tax savings

c. Some variability in returns, some tax savings

d. Stable, reliable returns, minimal tax savings

e. Preferably guaranteed returns, before tax savings

Question 10

What would your reaction be if 6 months after placing your investments, you discover that, in line with what is happening in the financial markets generally, your portfolio has decreased in value by 20%?

a. You would invest more funds to lower your average investment price, expecting future growth

b. This was a calculated risk and you would leave the investments in place, expecting performance to improve

c. You would be concerned, but would wait to see if the investments improve

d. You would cut your losses and transfer your funds into more secure investment sectors

e. Horror. Security of your capital is critical and you did not intend to take risks


Investor Risk Profile Score

Client Partner Client Partner

Number of A X 5

Number of B X 4

Number of C X 3

Number of D X 2

Number of E X 1

Total Investor Score

Please note that this questionnaire is aimed at establishing your Individual Risk Profile. It is not important

whether your score is high or low.

Please match your score with the investor profiles in the table below.

Score Investment Profile

Less than 12 Secure

Between 13 – 20 Conservative

Between 21 – 28 Moderately Conservative

Between 29 – 36 Balanced

Between 37 – 44 Growth

Greater than 45 High Growth

The asset allocation of each of the Investment Profiles is shown in the table below.

Investment Profile

Cash Australian

Fixed Interest

Int’l Fixed Interest

Australian Shares

Int’l Shares

Australian Property

Int’l Property

Other Time frame (Yrs)

Secure 55.2% 35.1% 9.7% 0.0% 0.0% 0.0% 0.0% 0.0% > 1

Conservative 36.2% 22.9% 21.1% 10.3% 9.4% 0.1% 0.0% 0.0% 1 – 3

Moderately Conservative

7.3% 27.0% 23.4% 19.4% 17.7% 5.2% 0.0% 0.0% 3 – 5

Balanced 7.0% 19.7% 15.5% 26.8% 22.8% 4.6% 3.6% 0.0% 5

Growth 9.0% 5.1% 5.6% 36.8% 33.8% 5.2% 4.5% 0.0% 7

High Growth 8.7% 1.1% 0.8% 40.2% 39.5% 5.2% 4.5% 0.0% 10

Notes:

a. The allocations recommended above do not add up to 100%

b. “Other” asset class represents alternative investments such as hedge funds

Now, please answer the following questions. We are attempting to ensure that the chosen risk profile is

matched to your investment time-frame and tolerance to risk.


Is your investment time-frame consistent with the suggested time-frame for your

chosen risk profile? Yes No

Are you comfortable with the risk level of the chosen risk profile? Yes No

Borrowing to invest can help certain investors increase their wealth over time. However, borrowing increases

investment risk. Borrowing to invest normally involves investing in growth assets such as Australian and

international shares and property. Please answer the following questions to help us understand whether

borrowing may be appropriate for you:

Borrowing to invest

Have you ever borrowed to invest before? (please circle) Yes No

Are you prepared to borrow to invest? (please circle) Yes, if professionally advised

No, I do not like debt

If yes, how much would you be prepared to borrow? $

What assets are you prepared to use as security? (please circle) Family home

Managed funds

Direct shares

Please read the profile descriptions above and if you feel there is a difference in the profile you feel most

comfortable with and profile indicated by the questionnaire score, please state your selected investor profile

and the reasons why you feel this way.

If you are not comfortable with the recommended profile (or you and your partner have different profiles) we

can start with the lower risk profile and review it over time, as you become more comfortable with investment

markets. But please be aware that risk and return and closely related, so by choosing a lower risk profile, you

are choosing to reduce your long term return expectations.

CLIENT 1 CLIENT 2

Agreed Profile

Please sign the following to confirm that you acknowledge the chosen risk profile

I/We confirm that the details recorded in this workbook are a true and accurate description of my/our feelings

towards the questions raised and I/We agree that the selected investor risk profile is accurate and can be

used as a basis for recommending an investment portfolio.

Please note that your selected investor risk profile and asset allocation are based on information provided by

you and on our knowledge of the various asset sectors and the existing investment environment. As it is not

possible to accurately predict the future corporate, legislative and economic factors, you should regard these

recommendations as a guide only.

No guarantee is expressed or implied to any projections or performance of any assets in the recommendations.

Signature:

Client 1 ____________________________ Date / /

Client 2 ____________________________ Date / /

Please sign the following to confirm that you acknowledge the information included in the

Client Fact Find Form


The information in this form accurately reflects my/our current financial situation.

I/We am/are not aware of any further information which would be relevant or assist Consilium

when providing advice and/or recommendations to me/us.

I/We understand that any advice or recommendation provided by Consilium will be based solely on

the information supplied in this Client Fact Find Form and any other personal information I/we

provide.

I/We am/are aware that a photocopy of the Client Fact Find Form is available upon request.

I/We confirm that that I/we was/were issued with the Financial Services Guide by Consilium before

I/we provided details of my/our personal circumstances set out in this form.

I/We understand that Consilium is not authorised to provide specific advice in relation to general

insurance, taxation, family law, drafting estate planning documents and trusts. Any advice on these

matters will be provided by qualified specialist advisers as appropriate. I/We also understand that

Consilium may receive a share of the commission payable and/or payments to refer me/us to other

specialist advisers. These payments will be disclosed to me/us at the time if referral.

I/We confirm that I/we was/were issued with a copy of the Consilium Privacy Policy contained in

the Financial Services Guide.

Signature:

Client 1 ____________________________

Date / /

Client 2 ____________________________

Date / /

Consilium Authorised Representative ___________________________

Byron James Littlewood

Date / /


NOTES

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