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Client Profile
This is an important and confidential document. The information you have provided within this
document forms the basis of any advice given by your Financial Planner.
Prepared by
Glen Killen
Planners business address
22 The Mainsail, PORT MACQUARIE NSW 2444
Telephone number Mobile number
1300 201 087 0437 863 422
Facsimile number Email address
1300 848 718 glen@strategyfc.com.au
Location of interview
Page 1
Personal Details
Personal details Client 1 Client 2
Client Identifier
Surname
Given Names
Preferred name
Marital status
Date of birth
Residential Address
Business Address
Postcode Postcode
Postal address
Postcode Postcode
Business/Mobile no.
Facsimile no.
Email address
Employers name
Your occupation
Health issues: Are there any health issues that need to be considered in making an investment decision? .. Yes No
Page 2
Dependents
When would you expect
Name Date of birth Relationship dependency to cease?
/ /
/ /
/ /
/ /
English language
Do you need to consult any of the following in your decision making process? .. Yes No
Family member
Accountant/Tax agent
Banker
Solicitor
Other
Notes
Page 3
Lifestyle and Financial Goals
Tell us about
your family
needs e.g.
Childrens
education?
Tell us about
your
occupation?
Tell us about
your sports and
leisure,
entertainment
and holidays?
Tell us about
your monetary
needs both long
and short term?
If injury, illness, disability or death were to occur, what impact would this have on your goals and
commitments?
Planning/Protection
Considerations
Do you have an alternative source of income or capital in place if any of these events were to
happen to you and/or your partner? How confident are you that this is adequate for your needs?
Page 4
Family and Asset Protection Goals
In the event of death, illness, accident or disability, which of the following are important to you?
Page 5
Please provide the following: Client 1 Client 2
Poor Good Poor Good
Estate Planning
How important is Estate Planning to you? Low Medium High
Will
Do you have a Will? . Yes No Yes No
Is this Will current? ............................................................................................... Yes No Yes No
What is the date of your Will? / / / /
Does your Will include provision for a Testamentary Trust?................................. Yes No Yes No
Power of Attorney
Do you have a current Power of Attorney? . Yes No Yes No
If Yes, please state type: Enduring/Medical/Normal/General/Other ...................
Companies or Trusts
Will your company shares go where you want them to go? ... Yes No Yes No
Has Trustee succession been addressed? ... Yes No Yes No
Social Security
Is access to Social Security important to you?................................................. Yes No
Client 1 Client 2
Do you have any Centrelink concession cards (PCC, HCC or CSHC)?.............. Yes No Yes No
Page 6
Income / Expenditure Analysis
Income Select: Weekly Fortnightly Monthly Yearly
Client 1 Client 2 Joint
Value of salary package
Salary and wages (before tax)
Social security income
Investment income
Annuity/Pension income *
Distributions (eg trusts)
Net business income (eg sole trader, partnership)
Other taxable income
Other
TOTAL
Are your income and expenses likely to changer over the next few years?
Page 7
Personal Balance Sheet
1 Assets $ $ $ Date
Lifestyle: Client 1 Client 2 Joint Purchased Insured
Total A
Direct investments: (Totals only please provide details within Current Investments section)
Cash Bank accounts How much cash/liquidity do
Credit Unions you need for unforeseen
circumstances or
Other emergencies?
$
Fixed interest Term Deposits
Debentures
Bonds
Total C
Total all assets (A+B+C)
OVERALL TOTAL
2 Liabilities
Mthly Repayment
Type Bank/Lender Owner Loan Balance Rate % P&I or Int. only Start Date Term $
Mortgage / /
Investment loan / /
Credit cards / /
Personal loans / /
Business loans / /
Other / /
Net Value
Estimated funds available for investment
Current Investments
Page 8
Please list your bank accounts, debentures, bonds, other investments, or shares which you own at present.
If any are to be sold and reinvested as part of your planned investment arrangements, detail the investments
involved as Sell in the column provided. Accurate details of these investments are essential for full portfolio
and cash flow analysis.
Cash and Fixed Interest Owner Current Value Interest Rate Purchase Term Reinvest Hold/Sell
Investments % pa Date Income
$ % / / Y N
$ % / / Y N
$ % / / Y N
$ % / / Y N
$ % / / Y N
Direct Property Owner Current Value Rental Purchase Purchase Mortgaged Hold/Sell
Investments Income (net) Price Date
$ $ $ / / Y N
$ $ $ / / Y N
$ $ $ / / Y N
Shares and Managed Owner Current Value Asset Purchase Total Reinvest Hold/Sell
Funds Allocation Date Units/Shares Income
$ / / Y N
$ / / Y N
$ / / Y N
$ / / Y N
$ / / Y N
$ / / Y N
Super and Rollover Owner Current Value Asset Annual Type of Start Date Hold/ Super
Rollover Choice
Funds Allocation Contributions Contribution
$ $ / / Y
$ $ / / Y
$ $ / / Y
$ $ / / Y
$ $ / / Y
Pension/Annuity Details Owner Current Value Start Date Term RCV ETP Hold/
Rollover
$ / / Y N
$ / / Y N
$ / / Y N
$ / /
$ / /
$ / /
Page 9
Please list your income protection, personal and general insurance which you own at present.
Current Income Protection
Provider Owner Policy No. Monthly Benefit Annual Premium Waiting Period Benefit Payment
Period
$ $
$ $
$ $
$ $
$ $
Current Personal Insurance (Life cover Term, Total Permanent Disablement, Trauma, Whole of Life, Endowment)
Provider Type Life Insured Owner/ Cover Level Annual Premium Surrender Maturity
Beneficiary Value (if any) Value (if any)
$ $
$ $
$ $
$ $
$ $
What assets are to be realized upon death?
Asset Client 1 Client 2
$ $
$ $
$ $
$ $
$ $
Current General Insurance
Asset Insurer Sum Insured Market Value Annual Premium Renewal Date Notes
Family home
Home contents
Motor vehicle 1
Motor vehicle 2
Other
Notes
Page 10
Eligible Termination Payment
Have you, or will you receive an Eligible Termination Payment (ETP)? .. Yes No
Please provide any documentation relating to such payments.
Service Period Client 1 Client 2
Date of rollover/retirement / / / /
Eligible Service Start date / / / /
Composition of ETP
Tax Free Component
ie Concessional component
Pre 1983 component
Non-concessional contributions
Post June 1994 invalidity component
CGT exempt component
Taxable Component
Ie Post 1983 component
(taxed and untaxed)
TOTAL ETP
Compulsory preserved benefit
Date contributed / / / /
Amount contributed $ $
Date contributed / / / /
Amount contributed $ $
Notes
Page 11
Entity Details
Business Details Client 1 Client 2
Business name
Business address
Business structure
Contact person and position
Partnership, Company
Name of company or trust
Proportion of ownership/entitlement
Superannuation Fund
Name of fund
Name of trustees
Date established
Accumulation or pension?
Annual contributions
Page 12
Notes
Page 13
Determining your Investment Risk Profile
Important Information
Each individual has different preferences to levels of risk when profile is a good first step and can help determine an investment
investing. Risk is the chance that you may lose your money or plan to achieve your short and long-term investment goals.
that the returns on your investments will vary widely from year The profiling questions are designed to assist you in
to year. determining your investment profile and the type of investor you
Some investors may be prepared to accept higher risk are, based on your personal preferences and life situation. This
investments in search of higher returns while others may prefer information will be used in conjunction with your goals to
lower risk investments. It is important that you determine a level determine an appropriate financial strategy.
of risk you are comfortable with and balance that risk against For couples, each partner should complete this
the returns you are seeking on your investment. Understanding questionnaire separately.
your personal risk
Profiling questions
1. Which of the following best describes your investment experience?
A. I have no investment experience
B. Mainly bank accounts cash, term deposits and/or debentures
C. Cash and some shares (EG Telstra, Qantas) and/or investment property
D. A mix of cash, bonds, various shares, share funds and investment property Client 1 Client 2
E. Australian and international shares and/or share funds, property, venture capital and derivatives
3. What percentage of your money would you be prepared to invest in higher-risk investments?
(ie. investments which may fluctuate in value, even incurring short to medium term losses, but may
return higher gains over the longer term.)
A. 0%
B. 10%
C. 30%
Client 1 Client 2
D. 50%
E. 75%
4. How long before you would expect to require access to part or all of your investments?
A. Less than 1 year
B. Less than 3 years
C. Between 3 and 5 years Client 1 Client 2
D. Between 5 and 7 years
E. Greater than 7 years
Page 14
6. Assume that you inherit a reasonable share portfolio valued at $100,000 and you do not need the
money for any other purpose.
Would you:
A. Sell the entire portfolio immediately to avoid any loss in value?
B. Sell 75% and place the money in more conservative investments? Client 1 Client 2
C. Sell 50% and place the money in more conservative investments?
D. Sell 25% and place the money in more conservative investments?
E. Keep the entire share portfolio but move to more conservative, dividend paying shares?
7. Are you prepared to accept the possibility of a negative return at any time in exchange for
potentially higher long term returns? The more often you experience a negative return, the greater
the investment volatility.
A. Yes. One negative year in every 10 years
B. Yes. One negative year in every 7 years
Question 7 considered that all of your funds were at risk for
C. Yes. One negative year in every 5 years the entire period, what percentage (if any) would you be Client 1 Client 2
prepared to place into a single category or multiple
D. Yes. One negative year in every 3 years categories as per question 7.
E. I am not prepared to accept any negative returns A B C D E
% % % % %
8. Assume your long-term investments dropped in value by say 10% or more in one year, how would
you react?
A. You cannot accept any decline in the value of these investments
B. You consider selling and reinvesting elsewhere
Client 1 Client 2
C. You adopt a wait and see approach
D. You expect that your investment will recover in value at some time in the next 1 to 2 years
E. You consider purchasing more
Page 15
Explanation of Return/Volatility
Growth Shares
and MIS EG
Hedge funds etc
Defensive shares,
balanced MIS
Over the years, your capital and income are expected to rise and fall.
At times, this value may fall below the value of your initial investment.
Adviser Notes
Adviser notes of discussion about risk profiling, client(s)' investment time frame and objectives:
Page 16
Additional Information
High Growth is a portfolio of investments predominantly in Australian and international shares. Due to the
inherently high levels of volatility associated with these asset classes this portfolio is suited to
people with an investment horizon of at least 7 years. This type of portfolio is unsuitable for
clients requiring high levels of income from their investment
Growth is a diversified portfolio of investments in mainly the more aggressive asset classes of
Australian and international shares. The capacity for capital volatility in this portfolio makes it
more suitable for investors with a long term investment time frame of more than five years. It is
not suitable for investors requiring an income return from the portfolio.
Balanced is a balanced portfolio of investments with a moderate tilt towards the more aggressive asset
classes of Australian and international shares. The portfolio is designed with a long term time
horizon of five years or more. It will exhibit some volatility in the short term.
Conservative is a balanced portfolio of investments taking in all normal asset classes. This portfolio will aim
to achieve a satisfactory market related return over the longer term (at least five years) with
potential for moderate capital volatility in the shorter term.
Defensive is a portfolio containing core investments which have a bias towards security of capital.
Normally less than half the portfolio would be placed in property and Australian and overseas
share investments. These components give added capacity for capital growth over a period of
three to five years but will also entail some short term capital volatility.
Defensive (low Risk) is a portfolio of diversified investments with the emphasis on cash and fixed interest. Growth in
portfolio value can be mainly achieved by accumulating income. There is potential for low
capital volatility. A low exposure to shares of up to 25% of the portfolio can be considered.
Cash Only is a portfolio held exclusively in cash and cash equivalents such as short term deposits and / or
Government bonds that will provide security of capital and a regular stable income.
Capital growth in the portfolio may only be achieved by reinvesting income.
Please ensure the agreed risk profile is correctly transferred to the Authorisation page.
Volatility
Page 17
Authorisation
I/We have received a copy of the FSG at the first interview and have read and understood it, including the section titled
Respecting Your Privacy. I/We agree to Avalon collecting, using and disclosing my personal information in accordance with
the Privacy Policy.
I/We will inform any other individual, such as dependants, spouse, partner, that I/We have provided information about them
and make them aware of the information provided in the Privacy Policy.
I/We request that you provide financial advice based on the information disclosed and acknowledge that you will rely on the
information contained in this document.
Basis of Advice
Full Advice
Provide details if not full advice
Limited to Client Need
Limited to Product(s)
Limited Advice (incomplete information)
I/We declare that I/we am comfortable with the risk profile that I/we have been assigned and I/we understand that this will be
used to assist Avalon in determining an appropriate financial strategy for me/us.
I/We acknowledge that you will charge a fee of $ for the written advice.
/ /
/ /
/ /
Bank/Investment/Superannuation Statements
Insurance Policies
Tax Returns
Financial Statements
ETP Statements
Page 18
Client Authorisation for Additional Information
from other Institutions or Advisers
To whom it may concern
I/We
of
request that all information relating to my investments, insurances, superannuation, bank accounts or other
financial information be released to the AVALONfs Pty Ltd AFSL: xxxxxx on request.
Please forward the requested information to the representatives address as per the attached business card.
Yours faithfully
/ /
Page 19
Investment Replacement Checklist
Planner Date
Client Name
Page 20
Insurance Replacement Checklist
Planner Date
Client Name
Health loadings
Yes $ No
Loss of loyalty discount
Yes $ No
Loss of benefit
(eg suicide exclusion) Yes $ No
Loss of bonus (eg Whole of life or
Endowment policies) Yes $ No
Surrender Value (if there is an
investment value) Yes $ No
If replacing an existing Avalon policy, is
there an option to increase/decrease
the existing policy?
(Note: some older policies have more
favourable terms than the newer
policies)
Page 21
Superannuation Replacement Checklist
Planner Date
Client Name
Page 22
If Defined Benefit, has pension Provide details
option been explored?
Change in preservation status
Yes $ No
Page 23
Notes
ABN
ABN number
SFN
Client 1 Client 2
Page 24