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Partner Name: Date: / /
Client Name:
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 to 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 advice 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 a 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 personalised to our circumstances.
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This Personal Client Profile has been designed to assist you in the collection of the necessary financial and
personal data that is required by Financial Spectrum Pty Ltd. This is part of our process of enabling you to meet
you goals and objectives, as this questionnaire provides the basis for appropriate recommendations in regards to
your financial planning needs.
Whilst we appreciate this questionnaire will take some time to complete comprehensively, the information
contained is of fundamental importance to the facilitation of your ongoing financial management and planning
process.
This questionnaire contains blank spaces and tables to summarise your financial data.
In some instances it may be appropriate for you to attach photocopies of various documents such as insurance
policies, superannuation fund statements, tax returns etc
If you feel that a particular section or question is not applicable please indicate this by writing not applicable
on that question/section and initial that page in the bottom right-hand corner.
Financial Spectrum Pty Ltd must have a reasonable basis for making recommendations to you. We need to
have sufficient information about you, your goals, objectives and risk profile in order for us to ensure that our
advice is appropriate.
This Personal Client Profile is designed to be returned to your Financial Spectrum adviser in its entirety. Any
supporting documentation and/or summaries can accompany this document or be placed inside.
Please also complete, sign and return to us the following:
> the Declaration & Disclosure on page 23 of this document which states that the informationprovided is correct and will form the basis for our recommendations.
> the Letter of Authority that will enable us to gather any further information which may be requireddirectly from other sources (i.e. superannuation funds, accountants etc.)
> the Acknowledgement Receipt which confirms that you received a copy of our Financial ServicesGuide (FSG), Privacy Policy, and Adviser Profile
Personal Client Profile
September 2009V.1.2
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Inomao
Pso
Client #1lient #1lient #1 Client #2lient #2lient #2Current Health Poor / Good / Excellent Poor / Good / Excellent
Private Health Fund
Smoker Status Smoker / Non-Smoker Smoker / Non-Smoker
Medical History
Employment
Client #1lient #1lient #1 Client #2lient #2lient #2Tax File Number
Employment Status Employed / Self Employed / Retired / Part Time
Casual / Employer / Unemployed
Student / Home Duties / Other
Employed / Self Employed / Retired / Part Time
Casual / Employer / Unemployed
Student / Home Duties / Other
Industry
Job Title
Employer Name
Salary $ pa $ pa
Qualifications
Expected
Retirement Date
/ / / /
Expected
Retirement Age
Are you expecting anychange to your
employment?
Yes No
Yes No
Health
Client 1 Initials:
Client 2 Initials:
Please note that this information is used in our financial and insurance planning. Our advice is subject to underwriting assessments which are
outside our control.
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Suue
Ete&
Superannuation Details: Client 1
1 2 3 4Fund Name
Fund Type Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Member/Account #
Accumulated balance
Current contributions $ $ $ $
Eligible service date / / . / / . / / . / / .
Are you making
undeducted contributions?
$ $ $ $
Nominated beneficiaries
Binding nomination Yes
No
Yes
No
Yes
No
Yes
No
15 Feb 1990 balance Yes
No
$
Yes
No
$
Yes
No
$
Yes
No
$
ETP benefits
previously received
$ $ $ $
Comments
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Suue
Ete&
Superannuation Details: Client 2
1 2 3 4Fund Name
Fund Type Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Defined Benefit /DIY/
Accumulation
Member/Account #
Accumulated balance
Current contributions $ $ $ $
Eligible service date / / . / / . / / . / / .
Are you making
undeducted contributions?
$ $ $ $
Nominated beneficiaries
Binding nomination Yes
No
Yes
No
Yes
No
Yes
No
15 Feb 1990 balance Yes
No
$
Yes
No
$
Yes
No
$
Yes
No
$
ETP benefits received $ $ $ $
Comments
Client 1 Initials:
Client 2 Initials:
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Suue
Ete&
Client #1 Client #2
Client #1lient #1lient #1 Client #2lient #2lient #2Name
Purpose
Director/s
Beneficiaries
Ownership/
Shareholding
Client #1lient #1lient #1 Client #2lient #2lient #2Name
Purpose
Director/s
Beneficiaries
Client #1lient #1lient #1 Client #2lient #2lient #2Name
Purpose
Director/s
Beneficiaries
Self Managed Super Funds
Companies
Discretionary Trusts
Client #1lient #1lient #1 Client #2lient #2lient #2Benefit Name
Benefit Type
Amount Received $ $
Centrelink
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Suue
Ete&
Client #1lient #1lient #1 Client #2lient #2lient #2Will exists? Yes No Yes No
Date of will / / . / / .
Provision for
testamentary trust?
Yes No Yes No
Executors name
Relationship
Attorney type
Date / / . / / .
Attorneys name
Relationship
Location of will
Estate Planning
Accountants Details
Client #1lient #1lient #1 Client #2lient #2lient #2Name
Firm
Phone
Authority to contact Yes No Yes No
Solicitors Details
Client #1lient #1lient #1 Client #2lient #2lient #2Name
Firm
Phone
Authority to contact Yes No Yes No
Client 1 Initials:
Client 2 Initials:
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Epdtue
Inme&
Client #1 Client #2
Client #1lient #1lient #1 Client #2lient #2lient #2Your income before tax: $ pa $ pa
Your income after tax: $ pa $ pa
Pension/other benefit: $ pa $ pa
Family payment $ pa $ pa
Child support received $ pa $ pa
TOTAL INCOME $ pa $ pa
Investment inc. after tax: $ pa $ pa
Other regular inc. after tax: $ pa $ pa
Income
Expenses per annumxpenses per annumxpenses per annumHousing
- Rent $ pa
- Mortgage repayments $ pa
- Land rates $ pa
- Water rates $ pa
- House & contents insurance $ pa Total Housing Expenses
- Strata levies $ pa $ pa
Utilities
- Electricity $ pa
- Gas $ pa
- Water $ pa
- Mobile Phone $ pa
- Internet $ pa
- Cable TV $ pa Total Utilities Expenses
- Telephone $ pa $ pa
Expenditure
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Epdtue
Inme&
Client Partner
Attorney Type
Date
Attorneys Name
Relationship
Client 1 Initials:
Client 2 Initials:
Expenditure (continued)Transport
- Petrol $ pa
- Repairs & Maintenance $ pa
- Registration $ pa
- Fines $ pa
- Insurance $ pa
- Licence $ pa
- Fares $ pa Total Transport Expenses
- Parking $ pa $ pa
Food
- Groceries $ pa
- Meat $ pa
- Fruit/ Vegetables $ pa
- Lunches $ pa
- Pet Food $ pa Total Food Expenses
- Take away food/ Restaurants $ pa $ pa
Education
- School fees $ pa
- Uniforms $ pa
- Adult education $ pa
- School excursions $ pa
- Tutoring $ pa
- Books $ pa
- Sports/ Out of school activities $ pa Total Education Expenses
- Child-minding $ pa $ pa
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Epdtue
Inme&
Medical
- Health insurance $ pa
- Doctors bills $ pa
- Dentist $ pa
- Chemist $ pa
- Eye care/Optometrist $ pa
- Specialists/Alternative therapy $ pa Total Medical Expenses
- Pet and Vet $ pa $ pa
Loan Repayments
- Credit card repayments $ pa
- Personal loan repayments $ pa
- Car loans/hire purchase $ pa
- Store cards/accounts $ pa
- Finance companies $ pa
- Home loan repayments $ pa
- Investment loan repayments $ pa Total Loan Expenses
- Other debt repayments $ pa $ pa
Other
- Superannuation $ pa
- Life/term/income insurance $ pa
- Professional fees $ pa Total Other Expenses
- Other regular expenditure $ pa $ pa
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Epdtue
Inme&
Client 1 Initials:
Client 2 Initials:
Personal
- Maintenance (children) $ pa
- Clothing $ pa
- Hair $ pa
- Grooming/cosmetics $ pa
- Entertainment $ pa
- Sports $ pa
- Club fees $ pa
- Newspapers/magazines $ pa
- Holidays $ pa
- Gifts/donations $ pa
- DVDs/videos/movies $ pa
- Postage $ pa
- DVDs/videos/movies $ pa
- Postage $ pa
- Pocket money (children) $ pa
- Alcoholic drinks $ pa
- Cigarettes/tobacco $ pa
- Laundry/dry cleaning $ pa
- Gambling $ pa Total Other Expenses
- Other regular expense $ pa $ pa
TOTAL EXPENSES $ pa
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Ln
Bom
Partner Client Part-
nerWill exists?
Date of Will
Provision
testamentary trust
Will exists?
Date of Will
Provision for a
testamentary trust
Client Partner
Attorney Type
Date
Attorneys Name
Relationship
Your bottom line
Your combined after tax income $ pa
Minus your expenses $ pa
Equals $ pa
If your total is positive:Congratulations! This result means that your total income exceeds your total expenses, or that you are managing to save
the total amount on a yearly basis. Your Financial Spectrum adviser will be able to help you to maximise your savings
returns and investment potential
If your total is negative:
This result means that you are currently spending in excess of your total income. You should review in detail your
expenses and try to reduce any non-essential items such as entertainment expenses. Your Financial Spectrum adviser
will be able to help you with budgeting to improve your current position.
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Labte
A
s&
Will exists? Provision for a
testamentary trust
Client Partner
Attorney Type
PrincipalrincipalrincipalResidenceesidenceesidence
InvestmentnvestmentnvestmentProperty #1roperty #1roperty #1
InvestmentnvestmentnvestmentProperty #2roperty #2roperty #2
InvestmentnvestmentnvestmentProperty #3roperty #3roperty #3
Asset description Unit/House/Land Unit/House/Land Unit/House/Land Unit/House/Land
Location/Address
Owner Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/Joint/
Other
Client 1/ Client 2/
Joint/ Other
Year purchased
Purchase price $ $ $ $
Current value $ $ $ $
Income (pa) eg. Rent $ $ $ $
If mortgaged:
Lender
Original amountborrowed $ $ $ $
Date borrowed / / . / / . / / . / / .
Amount outstanding $ $ $ $
Original term
Loan type P&I /I only /LOC P&I /I only /LOC P&I /I only /LOC P&I /I only /LOC
Interest rate structure Variable/Fixed Variable/Fixed Variable/Fixed Variable/Fixed
Current interest rate % % % %
Property
Client 1 Initials:
Client 2 Initials:
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Labte
A
s&
Will exists? Provision for a
testamentary trust
Client Partner
Attorney Type
Date
Cashashash Cash #2ash #2ash #2 ManagedanagedanagedInvestmentnvestmentnvestment
ManagedanagedanagedInvestment #2nvestment #2nvestment #2
Company
Type
Owner Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/Joint/
Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/Joint/
Other
Date purchased / / / / / / / /
Fund Term deposit/At call Term deposit/At call Term deposit/At call Term deposit/At call
Initial Investment $ $ $ $
Current Value $ $ $ $
If geared:
Debt Outstanding $ $
Interest Rate % %
Loan Type P & I / I Only . P & I / I Only
Interest Rate Structure Fixed / Variable Fixed / Variable
Other Investments
Comments
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Will exists? Provision for a
testamentary trust
Client Partner
Attorney Type
Other Investments
Labte
A
s&
ManagedanagedanagedInvestment #3nvestment #3nvestment #3
ManagedanagedanagedInvestment #4nvestment #4nvestment #4
Direct Equitiesirect Equitiesirect Equities# 111
Direct Equitiesirect Equitiesirect Equities#222
Company
Type
Owner Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/Joint/
Other
Date purchased / / / / / / / /
Fund Term deposit/At call Term deposit/At call Term deposit/At call Term deposit/At call
Initial Investment $ $ $ $
Current Value $ $ $ $
If geared:
Debt Outstanding $ $ $ $
Interest Rate % % % %
Loan Type P & I / I Only . P & I / I Only . P & I / I Only . P & I / I Only .
Interest Rate Structure Fixed / Variable Fixed / Variable Fixed / Variable Fixed / Variable
Client 1 Initials:
Client 2 Initials:
Comments
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Other Investments
Will exists? Provision for a
testamentary trust
Client Partner
Labte
A
s&
Direct Equitiesirect Equitiesirect Equities#333
Direct Equitiesirect Equitiesirect Equities#444
Othertherther#111
Othertherther#222
Company
Type
Owner Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/
Joint/ Other
Client 1/ Client 2/Joint/
Other
Date purchased / / / / / / / /
Fund Term deposit/At call Term deposit/At call Term deposit/At call Term deposit/At call
Initial Investment $ $ $ $
Current Value $ $ $ $
If geared:
Debt Outstanding $ $ $ $
Interest Rate % % % %
Loan Type P & I / I Only . P & I / I Only . P & I / I Only . P & I / I Only .
Interest Rate Structure Fixed / Variable Fixed / Variable Fixed / Variable Fixed / Variable
Personal Use Assets
Ownerwnerwner Asset Valuesset Valuesset Value LiabilityiabilityiabilityMotor Vehicles Client 1/ Client 2/Joint/ Other $ $
Recreational Assets Client 1/ Client 2/Joint/ Other $ $
Contents/Personal
Property
Client 1/ Client 2/Joint/ Other $ $
Collectibles Client 1/ Client 2/Joint/ Other $ $
Other Client 1/ Client 2/Joint/ Other $ $
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Labte
A
s&
Will exists? Provision for a
testamentary trust
Client Partner
Attorney Type
Date
Attorneys Name
Relationship
Policy #1olicy #1olicy #1 Policy #2olicy #2olicy #2 Policy #3olicy #3olicy #3Insurer / Product
Policy Owner Client 1/ Client 2 / Other Client 1/ Client 2 /Other Client 1/ Client 2/Other
Life Insured Client 1/ Client 2 Client 1/ Client 2 Client 1/ Client 2
Cover Type Life / TPD / Trauma /
Income Protection
Life / TPD / Trauma /
Income Protection
Life / TPD / Trauma /
Income Protection
Cover Amount $ $ $
Premium $ $ $
Life Insurance
Client 1 Initials:
Client 2 Initials:
Policy #4olicy #4olicy #4 Policy #5olicy #5olicy #5 Policy #6olicy #6olicy #6Insurer / Product
Policy Owner Client 1/ Client 2 / Other Client 1/ Client 2 /Other Client 1/ Client 2/Other
Life Insured Client 1/ Client 2 Client 1/ Client 2 Client 1/ Client 2
Cover Type Life / TPD / Trauma /
Income Protection
Life / TPD / Trauma /
Income Protection
Life / TPD / Trauma /
Income Protection
Cover Amount $ $ $
Premium $ $ $
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Objectives1. I/we wish to retire at age
2. I/we wish to achieve a net income of $ per annum (in todays dollars) in
order to meet my normal living expenses
3. I/we wish to achieve a net income of $ per annum (in todays dollars) in
retirement in order to meet your normal living expenses
4. I/we wish to ensure I retain an ongoing cash reserve of at least $ to meet any larger or
emergency expenditures
I/we wish ensure that sufficient funds are retained to meet the following planned
expenditures
Will ex-
ists? Provision for a
testamentary trust
Scope of Advice
Full Adviceor
Limited Scope (tick areas for advice) Wealth Creation Retirement Planning Superannuation Consolidation Personal Protection Estate Planning Business Planning Other: please specify
Attorney Type
Date
Attorneys Name
Tgs
Obeve&
Item Date Value / / $
/ / $
/ / $
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Tgs
Obeve&
TargetsTick any that apply to you You require a review of your existing investing portfolio to ensure it is appropriate to your needs and is well
positioned to meet your objectives. You wish to minimise your ongoing income tax liability You wish to build your wealth within the superannuation environment for retirement
planning purposes You wish to reduce your level of non-deductible debt You wish to maximise your entitlement to Government income support You wish to focus entirely on defensive investments To focus extensively on income investments, but with a minor exposure to growth
investments To focus on a balance between income investments and growth investments, with an
emphasis on income investments To focus extensively on growth investments, but with a minor exposure to income
investments To focus entirely on growth investments You wish to ensure your investments are administered efficiently, taking advantage of the skills of
professional investment managers You wish to ensure you have appropriate risk management and insurance strategies in place to protect
your personal and general assets from unforeseen events You wish to ensure you have appropriate estate planning strategies in place, incorporating Wills and
Powers of Attorney
Will exists? Provision for a
testamentary trust
Client Partner
Attorney Type
Date
Attorneys Name
Relationship
Client 1 Initials:
Client 2 Initials:
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Dagams
Ne&
Notes & Diagrams
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Financial Services Guide (FSG)
By signing the declaration below, you acknowledge receipt of the Financial Services Guide (FSG) of FinancialSpectrum and the Adviser Profile of the Adviser/s to whom you have been assigned.
Privacy
Financial Spectrum is committed to ensuring the privacy and security of your personal information in
accordance with the principles of 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.
Tax File NumberBy 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.
DeclarationI/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/us, to prepare advice on my/our agreed needs and
objectives. I/We understand that any services or recommendations provided, on the basis of partial or
incomplete completion may be inappropriate to my/our needs. I/We appreciate that I/we may lose the right toseek 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.
..
Office use only
Dsoe
Daao&
FSG Provided Date: / / Version:
Signed Signed
Name Name
Date / / Date / /
Signed
Adviser Name
Date / /
Declaration & Disclosure
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Contacting Financial SpectrumYou can contact Financial Spectrum by:
Calling 02 8238 0888 9am6pm Monday to Friday;
Visiting our website at www.financialspectrum.com.au
Writing to us at:
Financial Spectrum Pty Ltd
GPO Box 4812
Sydney NSW 2001
Sending us an e-mail at [email protected]
Sending us a fax at 02 8238 0808