Fact Find Sample - Multiple Entities

Fact Find - Private and Confidential
Fact Find
Client 1
Jon-Pierre John Smith
Client 2
Mary Smith
Adviser
Opex Advice
Date completed
16 Dec 2014
Private and confidential
ABC Financial Services Pty Ltd | ABN 111 222 333 AFSL 222333444
Page 1
Fact Find Private and Confidential
Personal information
Personal information
Client 1
Client 2
Title
Mr
Mrs
Given names
Jon-Pierre John
Mary
Surname
Smith
Smith
Preferred name
Jon-Pierre
Mary
Gender
Male
Female
Date of birth
12 Jun 1957
15 Dec 1960
Place of birth
Australian
American
Marital status
Married
Married
Date of marriage
25 Dec 2000
Resident status
Permanent Resident
Australian tax resident
Resident
Resident
Tax file number
Supplied
Not supplied
Contact details
Client 1
Client 2
Home address
555 Torrens Road

Eastside SA 5003
Business address
PO BOX 123
ADELAIDE SA 5000
Address for correspondence
222 Flower Ave

Paradise SA 5555
Home phone
08 8211 2233
Work phone
12234567
Contact information
Mobile
Fax
Email
jpsmith@bigpond.com.au
kelly@opexconsulting.com.au
bedwards@iress.com.au
0415 000 111
Other
Preferred method of contact
12234567
ABC Financial Services Pty Ltd | ABN 111 222 333 AFSL
222333444
Page 2
Children / dependants
Name
Relationship
Date of birth
Living at home?
Peter
Son
04 Jun 1990 (24)
Yes
No
Daughter
12 Mar 1992 (22)
No
Yes
Support to: 25
Geraldine
Financially dependant?
Additional information
(eg. special needs, education funding requirements, youth allowance or any other government benefit)
This is the dependants box.
Employment
Employment
Client 1
Client 2
Occupation
Chemical Engineer
Teacher
Position
Technical Manager
Industry
Laundries and Dry-Cleaners
Employment status
Full-time
Hours worked per week
40.00
Employer name
GPS Services Pty Ltd
Start date with employer
01 Jan 1997
Years in current occupation
12.00
Any change planned?

If yes, provide details below
No
Salary packaging available?
Yes
Leave details
(annual, sick, LSL)
Annual Leave: 2 weeks

LSL Leave: 12 weeks
Sick Leave: 7 weeks
Unknown
Business structure
(if self employed, record details WAHQ
later in fact find)
(eg. salary packaging details, any expected future changes in occupation, pending leave)
Employment additional details
Page 3
Health details
Client 1
Client 2
Health status
Good
Excellent
Health insurance?
Yes
No
Are their any health conditions

that may impact financial
decisions or investment
timeframes?
Health conditions
Nil
Family history
(eg health issues and
longevity of parents)
Family history
Nil
Description
Name/Company
Contact details
Lawyer
Margaret Johnston
Margaret Johnson Solicitors
444 Charles Road

Adelaide SA 5000
Home Phone Work Phone - (o8) 6666 6666
Name/Company
Contact details
Professional advisers
Referrer details
Description
Referred by
Page 4
Income
Income
Owner
Amount
Ordinary Wages / Jon-Pierre's salary
Jon-Pierre
$100,000.00
Ordinary Wages / Test
Jon-Pierre
$120,000.00
Bonuses
Jon-Pierre
$10,000.00
Pension Income / OnePath OA

Allocated Pension
Jon-Pierre
$33,000.00
Total income (per annum)
$263,000.00
Expenses
Expense
Owner
Amount
Mortgage Payments
Jon-Pierre
$3,000.00
Gas
Jon-Pierre
$400.00
Home / Lumley Home Plus 221133
Jon-Pierre
$750.00
Health / Bupa Hospital Extras Plus

998877
Jon-Pierre
$2,750.00
Term / Elevate Trauma Plus, Income

Premier, Life Insurance, TPD 889977
Jon-Pierre
$20,710.05
Term / Flexible Insurance 998877
Jon-Pierre
$1,000.00
Term / OneCare Life Cover & TPD &

Trauma Premier Maximiser 7654455
Jon-Pierre
$2,400.00
Other Expenditure / Living expenses
Jon-Pierre
$37,500.00
Term / Term Life Plus 445566
Jon-Pierre & Mary (Joint)
$1,407.36
Total expenses (per annum)
$69,917.41
Other cashflow details

Client 1
Client 2
Able to save?
Yes
No
If Yes, how much?
$2,000.00 per month
Use of savings over the last year
Debt reduction
None
Any capital gains from sale of

investments this year?
$7,500.00
$0.00
Any unused capital losses carried

forward from sale of investments?
$0.00
$0.00
(e.g. how expenses will change post retirement, any unusual expenses anticipated in the future)
Cashflow details
Page 5
Social Security benefits

Centrelink / DVA detail
Client 1
Client 2
Payment type
Age Pension
Reference No.
222333444
Centrelink assessed assets
250,000.00
Valuation date: 23 May 2013
Valuation date:
Centrelink assessed income
$2,350.00 per annum

Valuation date: 23 May 2013
$
Valuation date:
Are you renting?
No
Gifts in last 5 years
No
PBS registered?
Yes
(Date: 01 Jul 2008
CSHC registered?
Yes
Annual entitlement
$12,500.00
$0.00
Gifted $5,000 to son Peter on 1 May 2010.
Aged Care
Aged care
Client 1
Client 2
- Daily care fee
- Income tested fee
Facility type
Date of entry
Fees
- Entry fee
Status of former home

Total annual fees
Page 6
Assets
Assets lifestyle
Owner
Amount
Life Style / Antiques Antique furniture
Jon-Pierre
Peter Adams
$75,000
Business Assets / Goodwill Jim's

Mowing
Jon-Pierre
Liquid Assets / Current Savings Bank

West Cash Saver
Mary
Costa Filippou
Real Estate / Primary Residence Home
Joint
$750,000
Life Style / Household Contents

Contents
Joint
$50,000
$100,000
$27,500
Total assets
$1,002,500
Assets - investment
Amount
Jon-Pierre
Default Account
Art Work
$100,000.00
Art Work 2
$10,000.00
CBACCA
$1,000.00
GDI Property Group
$860.00
S&P/ASX 200 A-REIT
$1,324.10
Subtotal
$113,184.10
Jon-Pierre's Wrap Account

BT Classic Investment Funds - BT Core Australian Share Fund
$120,480.05
Hunter Hall Australian Value Trust
$114,766.16
Subtotal
$235,246.21
Colonial First State FirstChoice Personal Super 8599

CFS FirstChoice Personal Super - Aberdeen Australian Fixed Income
$70,718.25
CFS FirstChoice Personal Super - Acadian Defensive Income
$67,822.71
CFS FirstChoice Personal Super - Acadian Global Equity
$78,019.91
Subtotal
$216,560.87
Findon Home
Adelaide Home
$400,000.00
Findon Home
$450,000.00
Subtotal
$850,000.00
Macquarie Wrap Pension Manager 6859

AMP Capital Australian Equity Opportunities Fund Class A
$139,884.77
Macquarie Global Infrastructure Trust II - A Class
$143,471.17
Macquarie Master Property Securities Fund
$168,751.28
Subtotal
$452,107.22
Jon-Pierre's Super Fund

Commonwealth Bank of Australia
$137,274.48
Page 7

Assets - investment
Amount
Perpetual WealthFocus Super Plan - Perpetual Smaller Companies
$128,217.72
Perpetual's Cash Management Fund
$100,000.00
Platinum International Fund
$127,255.07
Telstra Corporation Limited
$132,000.00
Testing the name
$144,110.21
Wesfarmers Limited
$115,421.76
Subtotal
Total
$884,279.24
$2,751,377.64
Mary
Default Account
BHP Billiton Limited
$15,995.00
$3,300.00
Subtotal
Total
$19,295.00
$19,295.00
JPS Company
Default Account
OnePath OA PS - OptiMix Balanced EF/Sel
$1,816.30
$660.00
Woolworths Limited
$32,790.00
Subtotal
Total
$35,266.30
$35,266.30
Smith Family Super Fund

Default Account
Platinum International Fund
$150,993.02
Subtotal
Total
$150,993.02
$150,993.02
Costaki Superfund
Default Account
BHP Billiton Limited
$63,980.00
OnePath OA IP - OptiMix Australian Fixed Interest Trust NEF
$1,543.80
$6,600.00
Subtotal
Total
Total assets
$72,123.80
$72,123.80
$4,630,704.10
Asset details
Page 8
Liabilities
Liabilities
Owner
Outstanding Balance
Loan Limit
Credit Card
Jon-Pierre
Fred Turk
$3,000
$5,000.00
Investment Property Mortgage
Mary
Mazza Turk
$23,750
Primary Residence Mortgage / ANZ

Bank / ANZ Bank
Joint
Total liabilities
$500,000
$526,750
(eg. What are the clients attitudes to managing debt? When does the client want all debt to be paid off?
Liability details
Page 9
Superannuation fund details

Superannuation
Jon-Pierre
Fund name:
Type
Total fund balance as at 19 Feb 2013:
Policy number
Employer contributions (pa)
Salary Sacrifice contributions (pa)
Personal deductible contributions (pa)
Non-Deductible contributions (pa)
Tax-free component:
Taxable component (taxed):
Taxable component (untaxed):
Eligible start date:
Unrestricted non-preserved:
Death cover
TPD cover
Salary continuance
Beneficiary/Type
Access eWrap Super

Accumulation
$625,000
1122334455
$18,000.00
$0.00
$0.00
$0.00
$55,000
$450,000
$120,000
01 Jul 1997
$25,000
$150,000.00
$150,000.00
$150,000.00
Beneficiary name: Mary Smith
* binding: yes
* binding end date: Inception
* relationship to owner: Spouse
* percentage: 100%
Fund name:
Type
Total fund balance as at 12 Aug 2014:
Policy number
Tax-free component:
Death cover
TPD cover
Salary continuance
Beneficiary/Type
Advance Retirement Savings Account

Accumulation
$200,000
666666
$0.00
$0.00
$0.00
$0.00
$0
$200,000
$0
Fund name:
Type
Total fund balance as at 14 Jan 2014:
Policy number
Colonial First State FirstChoice Personal Super

Accumulation
$200,000
$0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Page 10

Superannuation
Tax-free component:
Death cover
TPD cover
Salary continuance
Beneficiary/Type
Mary
Fund name:
Type
Total fund balance as at :
Policy number
Tax-free component:
Death cover
TPD cover
Salary continuance
Beneficiary/Type
$0.00
$0
$150,000
$50,000
$0
$0.00
$0.00
$0.00
BT SuperWrap Super (Standard)

Accumulation
$0
$0.00
$0.00
$0.00
$0.00
$0
$0
$0
$0
$0.00
$0.00
$0.00
Superannuation details
Page 11
Employment termination payments (ETP)

Termination payment details
Client 1
Client 2
Employment start date

Expected termination date
Tax-free redundancy amount
ETP amount
Unused annual leave
Unused long service leave
Other:
Super and ETP payment history

Jon-Pierre
Payee
Source
Date of payment
Total
Smiths Crisps Pty Ltd

Employer ETP
23 May 2008
$48,000
Page 12
Pension and Annuity details

Pension / annuities
Jon-Pierre
Provider name/Product name
Account number
Type
TTR?
Current value
Purchase price
Purchase date
Term at purchase
Tax free %
Reversionary
Gross Income
Tax deductible %
Centrelink deductible amount
Beneficiary
OnePath OA Allocated Pension

55228866
Account Based Pension TTR
Yes
$257,890.00
$200,000.00
01 Feb 2010
0 year(s)
45.00%
Yes
$2,750.00 / Monthly
25.00%
$10,000.00
Mary Smith (Non-Lapsing Binding)
Pension details
Page 13
Existing Personal Insurances

Insurer/Product
Owner/
Life Insured
Macquarie Life
OneCare Life Cover & TPD
& Trauma Premier
Maximiser
7654455
Jon-Pierre Smith
Jon-Pierre
AMP
Term Life Plus
445566
AMP
Elevate Trauma Plus,
Income Premier, Life
Insurance, TPD
889977
Waiting
period
Benefit period
Accident
Sickness
Premium
$200.00
$12,750
Monthly
IP
30 Days
Age 65
Age 65
$234.56
Death
$500,000
Jon-Pierre Smith
$1,000.00
Status
Monthly
Inforce
Stepped
Inforce
Monthly
Inforce
Stepped
Inforce
Yearly
Inforce
Mary
Death
$500,000
Stepped
Inforce
Mary
TPD
$250,000
Stepped
Cancelled
Jon-Pierre Smith
Mary
AMP
AMP Life Cover
AC12345
Level
of cover
Jon-Pierre Smith
Smith and Jones
Partnership
Jon-Pierre
AMP
Flexible Insurance
998877
Type
of cover
$20,710.05
Key Body Sys

Additional Life
Yearly
Inforce
$250,000
$75,000
Stepped
Inforce
Jon-Pierre
Death
$1,224,918
Stepped
Inforce
Jon-Pierre
TPD
$500,000
Stepped
Inforce
Jon-Pierre
Trauma
$162,500
Stepped
Inforce
Jon-Pierre
Child Cover
$100,000
$2,750.00
Death
$250,000
Jon-Pierre
IP
$5,897
Monthly
Jon-Pierre
TPD
$250,000
Notes box
Back exclusion
100% loading for stress related illness
Any Occupation
Any Occupation
Inforce
Smith Family Super

Fund
Jon-Pierre
Notes/Beneficiaries
60 Days
Age 65
Monthly
Inforce
Beneficiaries:
Smith, Mary (100.00%)
Level
Inforce
Renewal date: 4 Sep
Stepped
Inforce
Inforce
Page 14
Any Occupation
Renewal date: 4 Sep

Allianz
Test
1546
JPS Company
Jon-Pierre
AMP
Term Life Plus
445566
Death
$500,000
Jon-Pierre Smith
Smith and Jones
Partnership
Jon-Pierre
AC&L
Term and Disability Cover
AC99999
$1,500.00
$234.56
Death
$500,000
Smith and Jones

Partnership
Costa Filippou
Costa
$4,578.99
TPD
$250,000
Inforce
Hybrid
Inforce
Monthly
Inforce
Stepped
Inforce
Yearly
Inforce
Level
Insurance details
Monthly
Page 15
Inforce
Notes box
Back exclusion
100% loading for stress related illness
Any Occupation
Notes box
Neck exclusion
Knee 100% loading
General and Health insurance

General Insurer
Type
Lumley General
Insurance (NZ)
Limited
Buildings and
Contents
Residential
Health Insurer/Product
Bupa Hospital Extras Plus
Details
Owner
Sum insured
Premium
Jon-Pierre Smith
$750,000.00
$125.00
111 Big Tree Lane
$650,000.00
Type
Owner
Insured
Family
Jon-Pierre Smith
Mary Smith
Jon-Pierre Smith
Mary Smith
Premium
$5500.00 (AUD)
General Insurance details
Page 16
Estate planning
Estate planning
Client 1
Client 2
Existing Will?
Yes
Yes
Date of original Will
01 Jul 2001
01 Jul 2001
Date last reviewed
03 Apr 2008
03 Apr 2008
Name of appointed guardian
Peter Adams
Peter Adams
Location of Will
JP Accounting
Have circumstances changed

since last review?
See Additional Information below
Testamentary trust?
If yes, who are the beneficiaries?
Powers of attorney?
Yes
Yes
No
If yes, what types/who?
Enduring
Enduring power of guardianship
Funeral plan?
Not in place
State in which documents

prepared?
SA
Any previous relationships that

may impact on estate planning
arrangements?
Yes. Married for 10 years to Jezzabelle

Witch (2 children both devils).
Any bequests?
Any other special estate

planning issues? (e.g. likelihood of
receiving an inheritance, de-facto

relationship, children from previous
relationships)
Any potential beneficiaries in a

vulnerable situation? (e.g.
financial trouble, relationship
problems, disabilities)
Executors (Client 1)
Notes
Peter Adams
Peter is the family accountant and close friend.
Mary Smith
Executors (Client 2)
Notes
Beneficiaries (Client 1)
Age of entitlement
Andrew Smith
25
Mary Smith
Immediate
Notes
Page 17

Beneficiaries (Client 2)
Notes
Powers of Attorney (Client 1)
Type
Peter Adams
Enduring
Powers of Attorney (Client 2)
Type
Notes
Notes
(eg. For business owners, are buy/sell agreements and relevant insurance policies in place? Complete the separate Business Fact Find
where appropriate. )
Estate Planning details
Page 18
Structures
Associated structures
Name
Type
Ownership
Purpose
Gillard SMSF
SMSF
Julia and Tony
Family fun
Other information
Company Name
Directors
Shareholders
TFN
ABN
SMSF Name
Trustees
Members
TFN
ABN
SFN
JPS Company
Hugo Walters
James Google
- 50 shares
- 50 shares
Supplied
77665544
Smith Family Super Fund
Jon-Pierre Smith
Mary Smith
Jon-Pierre Smith
Mary Smith
Not supplied
111222333
SMSF Name
Trustees
Members
TFN
ABN
SFN
Costaki Superfund
Partnership Name
Smith and Jones Partnership

Pedro Jones (50.00%)
Jon-Pierre Smith (50.00%)
Supplied
222333444
Partners
TFN
ABN
Not supplied
Additional information (eg. entity diagram)
Page 19
Scope of advice
Initial reason for seeking advice
Record the initial reason why the client is seeking your advice. For example, there may be specific event (eg. house or business purchase,
marriage, birth of child, receipt of an inheritance, redundancy, moved to an aged care facility) or the client may want advice on specific
objectives (eg. retirement planning, estate planning, income protection, business succession insurance).
Initial scope of advice

1. Inheritence
2. Birth of a child
3. Marriage
4. Divorce
Agreed scope of advice

Once you have completed further investigations and discussions with your client, record the agreed scope of advice. Include a clear
explanation of the reasons for any changes from the initial to agreed scope of advice. Has the advice been scaled? If so, include details
that support your judgement to scale your advice. Please note that once the scope of advice has been agreed, you may need to make
further enquiries to be in a position to provide appropriate advice (record any additional information in the relevant section of the Fact
Find).
Agreed scope of advice
Analysis of your personal risk insurance needs.

Advice on insurance products for specific types and amount of cover you nominate.
Advice limitations
Advice limitations
Has the client limited the advice or given directions as to the scope of advice? Yes
Provide details *:
During our discussions, you requested that we limit our advice to the scope of advice and the needs and objectives as
outlined in this Statement of Advice. Because of this request, it is important that you are aware that we have not provided
advice on the following: [insert excluded advice areas excluded and where applicable give the reason for exclusion]
e.g. Trauma insurance because you have indicated you do not currently have the cashflow to afford the
additional premiums.
e.g. Your direct share portfolio as you have this managed by your stockbroker, [name], and you want to continue
with that arrangement.
Due to the reduced scope of our advice, [insert implications] e.g. this SOA may not address all of your issues and
needs/the types and levels of insurance cover may not be appropriate to your needs.
[Insert recommended actions (if any)] e.g. We recommend you review your insurance requirements at your next annual
review meeting or earlier if your circumstances change.
Clearly outline the aspects that the client has taken out of scope. Examples: (i) you may identify an issue with the clients cashflow/debt/retirement or
estate planning position but the client declines advice in those advice areas, (ii) within a particular advice area like Insurance, the client may decline a type
of cover, or they may select the actual amount of cover, or limit the total premium, (iii) the client may wish to retain/purchase/sell a component within
their investment or insurance portfolio without your advice).
Page 20
Incomplete or inaccurate information

Information limitations
Has the client provided all the information you require and requested?
Yes
Provide details :
We note that you were unable to provide some of the information we requested. In particular, we have not been given
details about abc. You are aware that this limits our ability to provide advice based on a full consideration of your
complete situation. As a result, the recommendations may not be appropriate to your particular financial situation.
Therefore, you should carefully assess the appropriateness of the recommendations in light of your overall financial
situation. Of course, we will endeavour to provide appropriate advice based on the information you have provided.
Steps taken to obtain information box.
*
Clearly outline what information is incomplete and/or inaccurate and the steps you have taken to obtain the information you require.
Adviser expertise
Adviser expertise
Do you have the necessary expertise to give the advice?
No
Do you have the relevant proper authority to give the advice?

If No, provide relevant information and actions taken (eg decline to give advice, referral to other parties):
Adviser expertise box.
Page 21
Needs and objectives

Use the tables below to record the needs and objectives you and the client have agreed will be addressed. Aim to be specific when stating
the clients objectives (eg. include a purpose, amount and timeframe where appropriate). You may wish to prioritise each need/objective
and include details about how the client wishes them to be funded (e.g. savings, sale of assets, pension etc).
Description
You have reduced your work hours and wish to access your super to top up your reduced work income with
pension income. You want to increase your take home pay by $12,000 per annum to $70,000 per annum.
To protect your family/dependants in the event of death.
To review your Estate Planning arrangements to ensure that your wishes will be followed in relation to your
financial and personal matters in the event of your death. Also, you want to ensure that your affairs are taken
care of in the event you are incapacitated.
Planning priorities and preferences*

Jon-Pierre and Mary have asked us to review their portfolios to ensure they are well placed for the future and will meet
their needs and objectives. When designing out advice solustions they would like us to take into account their
preferences:
they are comfortable with their current 'balanced' investor profile
a well diversified portfolio that is actively managed so that it works hard for them
the ability to incorporate direct shares and term deposits in their portfolio as well as the 'usual' sector specialist
managed funds
an administration system that provides 24/7 access to their portfolio status and the ability to obtain good online
portfolio reports
regular access to our services so they can 'keep on top of' everthing that's going in their portfolio.
Include any client concerns and preferences that the client wants you to consider when formulating your advice. For example, access to funds, security of
capital or income, desire for tax efficiency, portfolio style (active/passive/control) and make-up (direct v managed, access to cash/TDs/shares), desired
features of superannuation platform (e.g. auto-rebalancing, daily unit pricing, ability to select and maintain exact amount of cover, allows TTR pensions and
binding nominations, view account balances online, make contributions by BPay, contribution splitting, overseas pension transfers), particular financial
products the client wants you to consider, attitudes to managing debt (is repaying debt a priority? at what age does the client want all debts repaid)
Page 22
Personal risk needs analysis

Jon-Pierre Smith
Requirements - Jon-Pierre
Calculation Mode
Analysis Mode
Hide Null Rows
Assumptions
Present Value
Detailed
Yes
Income
Protection
pa
Business
Expenses
pa
$56,250
$0
Life
TPD
Trauma
$250,000
$731,106
$250,000
$0
$62,500
$0
$0
$0
$0
$0
$250,000
$100,000
$0
$0
$0
$0
$0
$30,000
$0
$0
$0
Total Capital Required

Total Upfront Needs
$981,106
$250,000
$530,000
$530,000
$162,500
$162,500
Capital Provisions
Disposable Assets
Continuing Income (PV)
$0
$438,664
$0
$438,664
$0
$0
Total Capital Available
$438,664
$438,664
$0
Insurance Needs
Total Cover Required
Existing Cover
$542,443
$0
$500,000
$0
$162,500
$0
$56,250
$0
$0
$0
-$542,443
-$500,000
-$162,500
-$56,250
$0
Partner Life Exp.
Partner Life Exp.
30 years *
30 years *
Partner Life Exp.

Upfront Costs Only
*
Capital Requirements
Liabilities to clear
Future Expenditure Required
Future Education Expenses
(PV)
Medical costs/Recovery
income
Provision for Tax
Other Provisions
Other
Surplus/Shortfall
Projection/Funding Period
Actual Funding Period
* Based on cashflow
projection
Page 23

Mary Smith
Requirements - Mary
Calculation Mode
Analysis Mode
Hide Null Rows
Assumptions
Present Value
Detailed
Yes
Income
Protection
pa
Business
Expenses
pa
$0
$0
Life
TPD
Trauma
Capital Requirements
Liabilities to clear
Future Expenditure Required
Future Education Expenses (PV)
Medical costs/Recovery income
Provision for Tax
Other Provisions
Other
$250,000
$169,088
$0
$0
$0
$0
$0
$250,000
$169,088
$0
$0
$0
$0
$0
$0
$169,088
$0
$0
$0
$0
$0
Total Capital Required

Total Upfront Needs
$419,088
$250,000
$419,088
$250,000
$169,088
$0
$0
$0
$0
$0
$0
$0
$419,088
$0
$419,088
$0
$169,088
$0
$0
$0
$0
$0
-$419,088
-$419,088
-$169,088
$0
$0
Client Life Exp.

23 years *
Client Life Exp.

23 years *
Client Life Exp.

23 years *
Capital Provisions
Disposable Assets
Continuing Income (PV)
Insurance Needs
Total Cover Required
Existing Cover
Surplus/Shortfall
Projection/Funding Period
Actual Funding Period
* Based on cashflow projection
Page 24
Additional underwriting details

Underwriting details
Client 1
Client 2
Height
183 cm
155 cm
Weight
80 kg
55 kg
Smoker?
If No, when ceased?
If Yes, number/day
Yes
No
15
Key duties of occupation

(include details of heights/
underground work etc)
duties for client
Administrative %
100.00%
75.00%
Manual %
0.00%
0.00%
Supervisory %
0.00%
25.00%
Travel %
0.00%
0.00%
Taking or been on any

prescribed medication?
Yes
No
Previous insurance claims?
No
No
Previous insurance declined,

loaded or exclusions applied?
No
No
Hazardous pursuits
Client 1
Client 2
Any special interests (eg

abseiling, car racing, scuba
diving)?
Sky diving
Nil
Provide additional details on the information in the above needs analysis and underwriting tables. Explain the reasons why the Agreed
cover is less than the Cover required (if applicable).
Underwriting details
Risk planning priorities and preferences*

Additional info
Include any client concerns and preferences that the client wants you to consider when formulating your advice. For example - Ownership
(super/self/other); Beneficiaries (type/person); Preferences re features of recommended policies (eg. linked or standalone TPD/Trauma cover, TPD
definition, basic or comprehensive IP cover, IP features that provide immediate cover during the waiting period, needlestick benefits, preferred WP/BP),
particular financial products the client wants you to consider
Page 25
Investment experience and attitude to risk

Please use your Licensees approved Risk Profile Questionnaire and attach a copy to the fact find (if applicable). Outline your discussions
with your client about their investment knowledge, education and experience, their motivation for investing and their attitude to risk.
Have they used other advisers previously? Is the agreed risk profile consistent with the outcome of the questionnaire? Is the profile
appropriate? Would another adviser recommend the same profile? If not, explain why.
Agreed profile
Client 1
Client 2
Moderately aggressive
Moderate
Additionsl Info Risk Profiling.
Page 26
Adviser notes
Adviser notes
Adviser notes
Page 27
Fee details
Details
Advice fee (preparation of SOA)
$2,750.00
Payment method
I/We have agreed to pay this fee [enter alternative form of payment].
Communication preferences
Communications
Details
Preferred means of communication of advice

documents, PDS, FSG etc
email
If email, confirm preferred email address
Privacy/FDS/FSG details
FSG details
Details
Privacy discussed?
Yes
Fee Disclosure Statement (FDS) Date
31 Oct 2014
FSG version number
Date FSG provided
03 Oct 2012
Separate fact find worksheets

Client 1
Client 2
Investor risk profile questionnaire
Yes No
Yes No
Investment schedule
Yes No
Yes No
Superannuation contribution history
Yes No
Yes No
Business expenses
Yes No
Yes No
Business insurance
Yes No
Yes No
SMSF information
Yes No
Yes No
Budget
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Opex Advice
____________________________________
______________
Signature
Date
Page 28

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Fact Find - Private and Confidential

Jon-Pierre John Smith

Private and confidential

Fact Find Private and Confidential

Australian tax resident

Tax file number

555 Torrens Road

Address for correspondence

222 Flower Ave

Fact Find - Private and Confidential

04 Jun 1990 (24)

12 Mar 1992 (22)

This is the dependants box.

Laundries and Dry-Cleaners

Hours worked per week

GPS Services Pty Ltd

Start date with employer

Years in current occupation

Any change planned?

Salary packaging available?

Annual Leave: 2 weeks

Employment additional details

Fact Find - Private and Confidential

Are their any health conditions

444 Charles Road

Fact Find - Private and Confidential

Ordinary Wages / Jon-Pierre's salary

Ordinary Wages / Test

Pension Income / OnePath OA

Total income (per annum)

Home / Lumley Home Plus 221133

Health / Bupa Hospital Extras Plus

Term / Elevate Trauma Plus, Income

Term / Flexible Insurance 998877

Term / OneCare Life Cover & TPD &

Other Expenditure / Living expenses

Term / Term Life Plus 445566

Jon-Pierre & Mary (Joint)

Total expenses (per annum)

Other cashflow details

If Yes, how much?

$2,000.00 per month

Use of savings over the last year

Any capital gains from sale of

Any unused capital losses carried

Fact Find - Private and Confidential

Social Security benefits

Centrelink assessed assets

Centrelink assessed income

$2,350.00 per annum

Are you renting?

Gifts in last 5 years

- Daily care fee

- Income tested fee

Status of former home

Fact Find - Private and Confidential

Life Style / Antiques Antique furniture

Business Assets / Goodwill Jim's

Liquid Assets / Current Savings Bank

Real Estate / Primary Residence Home

Life Style / Household Contents

GDI Property Group

S&P/ASX 200 A-REIT