Financial Fact Find A confidential analysis of needs, goals and … · 2016. 10. 10. · Financial Fact Finder Personal Details Important Notice to Customers Your Financial Adviser

PO Box 288 Heidelberg VIC 3084 p: (03) 9497 2895 f: (03) 8648 6850 www.mccarthys.net.au

Financial Fact FindA confidential analysis of needs, goals and

your financial situation

Financial FactFinder

PersonalDetails

Important Notice to Customers Your Financial Adviser must have reasonable grounds for making an investment or insurance recommendation. Before making such a recommendation the Financial Adviser must ask you about your investment objectives, financial situation and your particular needs. The information requested in this form will be used strictly for that purpose.

Warning- The Financial Adviser could make inappropriate recommendations or give inappropriate advice if you fail to fully and accurately complete this form.

Office Use OnlyApplicationNo.: DateLodged://

Customer Spouse/Partner

Title

Surname

Given/PreferredName

HomeAddress

BusinessAddress

ContactPhone

DateofBirth

Sex

Smoker

ExpectedRetirementAge

Male Female Male Female

DependantsDateofBirth SexSchool OccupationName

Employment,Income&ExpenditureCustomer Spouse/Partner

Occupation

EmploymentStatus

BusinessStaus Sole Proprietor Partnership

Private Company Trust

Employee -FullTimePartTime Casual

Unemployed

Pensioner

Contractor

Other

Sole Proprietor Partnership

Private Company Trust

Employee -FullTimePartTime Casual

Unemployed

Pensioner

Contractor

Other

Note- Employment security is an integral part of the planning process and should be taken into consideration.

Employment,Income&ExpenditureAnyotherpersontobecontacted?E.g.Accountant,Solicitor,etc.

Name ContactNumber

P.O Box 288 Heidelberg Vic 3084 Phone: (03) 9497 2895 Fax: (03) 8648-6850Email: [email protected]

Phone:(03)94972895www.mccarthys.net.au

Yes No Yes No


IncomeandExpenditure



TotalIncome*

Includesalary,wages,rents,

investments,pensions,socialsecurityetc.

TotalHouseholdIncome(Combined)

MonthlyExpenses

e.g. rent, mortgage, food, clothing, utilities

Transport&Health

e.g. travel, car loans/registration, health funds

OtherExpenses

e.g. loans, credit card, superannuation,

insurances, education, entertainment

TotalExpenses

SuperannuationYourInvestmentPreferences

1.Inanyinvestmentplanning,arethere

anyinvestmentsyouwishtoaviod?

2.Inanyinvestmentplanning,arethere

anyinvestmentsyouwouldprefer?

DoyouhaveaWill?Ifso,whenwasyourWilllastreviewed?

Yes No


TotalHouseholdExpenses(combined)

Surplus/Shortfall(incomelessexpenditure)

ActualSavings

Doyouexpectanysignificantchangein

incomeorexpensesinthenextyear?Yes No Give Details



Assets&Liabilities

Assets



Value Description

Property(ies)-Residential

Property(ies)-Other

HouseholdGoods(eg.furniture,etc.)

PersonalItemsofValue

MotorVehicles

Investments(e.g.Stocks,etc.)

OtherAssets

TotalAssets

LiabilitiesValue Description

Mortgage-Residence

Mortgage-OtherProperties

Rent

HirePurchase/s

PersonalLoan(s)

CreditCard(s)

OtherLiabilities

TotalAssets


Financial FactFinderCurrentInvestments


Notes


Company Purchase Units Held/Fixed Rate Current Value Owner DebtInvestmentType

PersonalInsuranceMemberName

PolicyNo.

PolicyOwner

Insurer PolicyType

AnnualPremium

SumInsured

Superannuation Customer Spouse/Partner

FundName

DateJoinedFund

TypeofFund

Contribution(e.g.5%ofsalary)

CurrentRetirementValue

EstimatedRetirementValue

Isthereprovisionforyoutotopuporsalarysacrifice?

Accumulation Defined

Pension Lump Sum

Accumulation Defined

Pension Lump Sum

By Employer By Yourself By Employer By Yourself

Yes No Yes No

DoanyofthesepolicieshaveLoadingsorExclusions? Yes No

List


Financial FactFinderSavings

SavingsGoals



Amount Needed When

PersonalPrioritiesRankpersonalprioritiesinorderofimportance.e.g.1=highest

Protectincomeagainstsicknessoraccident

Protectfamilyand/orassetsintheeventofdeath

Provideagainstseriousillnessortrauma

Planforretirement

Saveforshortterm(depositforhome,overseasholiday)

Saveformediumterm(earlymortgagerepayment,children’s

Others(describe)

Rank Details

FutureNeedsInsuranceNeeds-Disability

Grossannualincome(beforetax)

Lessbusinessexpenses

Netannualincome(beforetax)

Maximumallowableannualbenefit(75%ofnetannualincome)

Divideannualbenefitby12(=monthlybenefit)

Lessexistinginsurance

Insuredmonthlybenefitshortfall(beforetax)


Gross income is the total of earned income ie before tax earnings derived from personal exertion, including salary, fees, commission, bonuses, fringe benefits or similar payments that would cease on disablement

BusinessExpensesareexpensesincurredbyyouintheprocessofearningincomefromyourprofession,businessorpartnership


Financial FactFinderInsuranceNeeds

Life&Retirement



Finalexpensesfund(debts,expenses,legals,medicals,emergencies,funeralfees)

MortgageDischarge

EducationAmounttopayeducationfeesforyourchildren

TraumaneedsFundtocoverout-of-pockethealthcarecosts,eg:excessoverhealthinsurance,medications,physiotherapyetc

Additionalexpensesofapermanentnature,wheelchairs,homealterationsetc:

Income1.Incomeforyourspouse/partner 2.Incomeforyourchildren

Retirementincome

Additionalincome:incomeprotectiononlycovers75%,wouldyouneedextra?

TotalFundsrequired

Lesscashavailableorassetsthatcanbereadilycashed

Shortfall/surplus


Additional Notes


Financial FactFinderAcknowledgementTheinformationprovidedinthisFinancialFactFinderiscompleteandaccuratetothebestofmyknowledge.I/Weunderstandthatmy/ourSOAwillbebasedsolelyontheinformationsuppliedandmy/ourscopeofadviceabove.I/weunderstandthatapolicypurchasedwithoutthecompletionofaFactFinder,orfollowingapartialorinaccuratecompletion,maynotbeappropriatetomy/ourneeds.

I/Weunderstandthatbyrestrictingtheadvicesought,I/weriskmakingafinancialcommitmenttoapolicythatmaynotbeappropriatetomy/ourneeds.

I/WeconfirmthatI/WehavereceivedacopyoftheFinancialServicesGuide(s)andMillennium3’sPrivacyState-ment(whererequested)andhavereadthesedocuments.I/weacceptthatmyadvisermaysendme/usinformationaboutitsservicesfromtimetotime.I/weunderstandthatI/wemaynotifyyouofmy/ourdecisionnottoreceivefurtherinformationbycontactingyoudirectly.

I/WeacknowledgethatinaccordancewiththeprovisionssetoutoftheAnti-MoneylaunderingandCounterTerror-ismFinancingAct,thatmyidentificationinformationwillberequiredbeforeanyfinancialservicesorproductsareap-pliedfor,andthatthisinformationwillbeprovidedtotheparticularproductissuer(s)andtotheDesignatedBusinessGrouptowhichMillennium3FinancialServicesPtyLtdisaparty.

I/WeacknowledgethattheinformationcontainedinthisFactFindmaybesenttoseveralInsurersforthepurposeofobtainingaPre-assessmentoflikelyunderwritingterms.

I/Wegivepermissionformy/ourtaxfilenumbertobestoredinasecureformatbymyadviserinaccordancewithlegislativerequirements;

I/wegivepermissionformy/ourtaxfilenumbertobeforwardedtofinancialinstitutionsasrequired.

Client(s)Signature(s)

Adviser’sName

Adviser’sSignature Date




Financial FactFinderLetterofAppointment

TOWHOMITMAYCONCERN

Effectivefromthebelowdate,I/WeherebyappointLaurenceMcCarthy,AuthorisedBrokerRepresentativeofMil-lennium3FinancialServicesPtyLtdasourInsuranceBroker/FinancialAdviser.Asourappointedadviser,LaurenceMcCarthyisauthorisedtoobtaininformationregardingpolicies,premiumsandclaimsandtomanagemyexistingandnewinsurancerequirementsasnecessary.Ihavereceived,readandacceptedtheFinancialServicesGuideprovided.Regards,

I/wegivepermissionformy/ourtaxfilenumbertobeforwardedtofinancialinstitutionsasrequired.

Client(s)Name(s)

Client’sSignature(s)

Date


Laurence McCarthy is a Corporate Authorised Representative ofMillennium3 Financial Services Pty Ltd ABN 61 094 529 987

Australian Financial Services LicenseeAustralian Financial Services Licence number 244252


LifeInsured PolicyNumber Insurer


Documents

Financial Fact Find A confidential analysis of needs, goals and … · 2016. 10. 10. · Financial Fact Finder Personal Details Important Notice to Customers Your Financial Adviser