Financial Planning Questionnaire - Kelly Wealth Services · Financial Planning Questionnaire | 3...
Transcript of Financial Planning Questionnaire - Kelly Wealth Services · Financial Planning Questionnaire | 3...
2 | Financial Planning Questionnaire
Contents
Personal Details 3
Lifestyle and Financial Goals 5
Investment Preferences 7
Income and Expenses 8
Social Security 10
Assets and Liabilities 11
Superannuation and Income Streams 14
Insurance 16
Insurance Needs Analysis 17
Health and Estate Planning 19
Authorisation 20
Client authorisation for Additional Information from Other Institutions or Financial Advisers 22
Investment Replacement Checklist 24
Insurance Replacement Checklist 26
Superannuation/Pensions Replacement Checklist 29
Financial Planning Questionnaire | 3
Personal Details
Client 1 Client 2
Title (e.g. Mr, Mrs)
Surname
Given name
Preferred name
Gender Male Female Male Female
Marital status
Date of birth (DD/MM/YYYY) / / / /
Retirement age
Relationship betweenclients 1 & 2
Residential address
State Postcode State Postcode
Postal address (write ‘as above’ if same as residential address) State Postcode State Postcode
Home telephone
Business telephone
Mobile
Email address
Facsimile
Preferred contact method
Occupation
Employment status Full-time
Part-time
Self employed
Not working/Retired
Full-time
Part-time
Self employed
Not working/Retired
Hours worked per week
Employer’s name
Employer’s address
Employer’s phone number
Date employment commenced
/ / / /
Is salary packaging available? Yes No Yes No
If self-employed, what is the business structure?
Sole Trader Company
Partnership Split %
Sole Trader Company
Partnership Split %
4 | Financial Planning Questionnaire
Client 1 Client 2
Are you an Australian resident for taxation purposes?
Yes No Yes No
If no, which country?
Are you fluent in English? Yes No Yes No
Do you require the assistance of an interpreter?
Yes No Yes No
Dependants
Name Date of birth Relationship When would you expect dependency to cease?
/ /
/ /
/ /
/ /
Third Parties
Name Phone Address
Family member
Accountant/Tax agent
Banker
Solicitor
Doctor
Other
Do you need to consult any of the above in your decision making process?
Yes No If yes, who?
Notes
Financial Planning Questionnaire | 5
Lifestyle and Financial Goals
Details of Explicit Needs/Client Verbatim Amount/Instruction
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
6 | Financial Planning Questionnaire
Details of Explicit Needs/Client Verbatim Amount/Instruction
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
$
Address now
Ongoing goal
Address in ___ years
Not in scope
Financial Planning Questionnaire | 7
Investment Preferences
Please indicate the level of preference to the following options (where 1 is important, 2 is neutral and 3 is not important).
Client 1 Client 2
Flexibility and diversity in investment choice
Simpler administration
Automatic asset allocation/rebalance
Greater control and more active management
Cost effectiveness
Other
Do you have any environmental, social or ethical considerations that need to be taken into account?
Yes If yes, please give details:
No
Yes If yes, please give details:
No
Notes
8 | Financial Planning Questionnaire
Income and Expenses
Income
Select Frequency: Weekly Fortnightly Monthly Yearly
Source of income (before tax) Client 1 ($) Client 2 ($) Joint ($) Non-taxable ($)
Salary and/or wages (include SG contributions)
Bonus income
Social security income
Maintenance (e.g. child or spousal) income
Investment income
Pension/annuity income
Distribution income (e.g. trust)
Net rental income^
Net business income (e.g. sole trader, partnership)
Other taxable income (e.g. director’s fees)
Other
Other
Other
Subtotal Income
Total combined income (before tax)
Less: Estimated tax and/or other deductions (e.g. super, salary sacrifice, salary packaging)
Net combined income
* Where these payments attract superannuation contributions, you must consider these if making a superannuation contribution recommendation, with reference to the superannuation contribution limits.
^ Include where there is a long-term tenancy agreement in place of at least 12 months.
Notes
Financial Planning Questionnaire | 9
Expenses
Select Frequency: Weekly Fortnightly Monthly Yearly
Client 1 ($) Client 2 ($) Joint ($) Non-taxable ($)
Household (rates, utilities, food, etc.)
Car/boat/transport
Rent/ home mortgage
Credit cards
Other debt repayments
Personal (e.g. clothing)
Transport (e.g. car(s), fares)
Insurance premiums (general/life)
Medical/dental
Dependant(s)/maintenance payments
Entertainment
Education
Holidays
Superannuation contributions*
Business overheads
Regular savings plans
Donations (charity/foundation)
Other
Other
Other
Total combined expenses
Surplus/deficit (total net combined income less total combined expenses)
* Includes non-concessional or spouse superannuation contributions. Note, concessional or salary sacrifice contributions are recorded at ‘Income’ above.
Summary: Income, Expenses and Savings ($)
What are your living costs? (from above) p.a.
How much do you or your household save each year? p.a.
Do you expect any changes to your income and/or expenses? Yes No
If yes, please provide details
How much readily accessible money do you expect you might need to meet emergencies and your day-to-day expenditure?*
p.a.
How is your surplus used or deficit met?
* Cash, savings, liquid investments.
10 | Financial Planning Questionnaire
Social Security
Client 1 Client 2
Are you currently eligible for Centrelink/DVA benefits? Yes No Yes No
If yes, what benefit(s) are you eligible for?
Please provide details of the benefits received, such as frequency, reason, length of payment, etc.
Do you have any Centrelink/DVA concession cards (PCC, HCC or CSHC)? Yes No Yes No
Have you ‘gifted’ assets in the last 5 years? Yes No Yes No
If yes, how much and when? $
/ /
$
/ /
Notes
Financial Planning Questionnaire | 11
Asse
ts a
nd
Lia
bilit
ies
Ass
ets
Am
ount
($)
Ow
ner
Dat
e P
urch
ased
Insu
red
and
up
to
dat
e?In
sure
rS
um In
sure
d
($)
Pre
miu
m ($
)C
entr
elin
k Va
lue
($)
Prin
cipa
l res
iden
ce
/
/ Y
es
No
Hom
e co
nten
ts
/
/ Y
es
No
Mot
or v
ehic
le
/
/ Y
es
No
Car
avan
, boa
t, et
c.
/
/ Y
es
No
Col
lect
ible
s
/
/ Y
es
No
Hol
iday
hou
se
/
/ Y
es
No
Bus
ines
s go
odw
ill
/
/ Y
es
No
Bus
ines
s(p
lant
, equ
ipm
ent a
nd s
tock
)
/
/ Y
es
No
Oth
er
/
/ Y
es
No
Oth
er
/
/ Y
es
No
Oth
er
/
/ Y
es
No
12 | Financial Planning Questionnaire
Liab
ilitie
s
Lend
erO
wne
rFa
cilit
y/Li
mit
($)
Bal
ance
($)
Inte
rest
R
ate
(%)
P&
I or
Inte
rest
. on
ly
Sta
rt D
ate
Term
Mo
nthl
y R
epay
men
t ($
)
Sec
ured
ag
ains
tD
educ
tible
Mor
tgag
e
/
/N
/A
Cre
dit
card
s
/
/N
/AN
/A
Sto
reca
rds
/
/
N/A
Inve
stm
ent
/ mar
gin
loan
/
/
Yes
N
o
Per
sona
l lo
ans
/
/
Yes
N
o
Bus
ines
s lo
ans
/
/
Yes
N
o
Oth
er
/
/ Y
es
No
Oth
er
/
/ Y
es
No
Oth
er
/
/ Y
es
No
Doe
s an
yone
act
as
a lo
an g
uara
ntor
ove
r any
of t
hese
loan
obl
igat
ions
? Y
es
No
If ye
s, p
leas
e sp
ecify
the
nam
e of
gua
rant
or(s
) and
for
whi
ch lo
an(s
)
Not
es
Ext
ra in
form
atio
n re
gard
ing
repa
ymen
t opt
ions
– P
rinci
pal a
nd In
tere
st (P
&I)
or In
tere
st o
nly,
freq
uenc
y of
pay
men
t and
any
est
ablis
hmen
t, ex
it or
oth
er a
pp
licab
le fe
es p
ayab
le, e
tc.
Financial Planning Questionnaire | 13
Inve
stm
ents
and
sav
ings
Cas
h an
d fi
xed
inte
rest
in
vest
men
tsO
wne
rC
urre
nt v
alue
($)
Inte
rest
rate
(%
) pa
Pur
chas
e d
ate
Mat
urity
d
ate
Rei
nves
t inc
om
eA
mou
nt ($
or %
) to
re-a
lloca
te
/
/
/
/
Yes
N
o
/
/
/
/
Yes
N
o
/
/
/
/
Yes
N
o
/
/
/
/
Yes
N
o
/
/
/
/
Yes
N
o
Dire
ct p
rop
erty
inve
stm
ents
Ow
ner
Cur
rent
val
ue ($
)R
enta
l in
com
e ($
)P
urch
ase
pric
e ($
)P
urch
ase
dat
eM
ort
gag
edR
e-al
loca
te
(as
at _
__ /_
__ /_
__)
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
Sha
res
and
man
aged
fund
sO
wne
rC
urre
nt v
alue
($)
Tota
l uni
ts/
shar
esP
urch
ase
dat
eG
eare
dR
e-in
vest
in
com
eA
mou
nt ($
or %
) to
re-a
lloca
te(a
s at
___
/___
/___
)
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
/
/
Yes
N
o Y
es
No
Sav
ing
s p
lans
Ow
ner
Am
oun
t ($)
Sta
rt d
ate
Term
Freq
uenc
y
/
/
Yes
N
o
/
/
Yes
N
o
/
/
Yes
N
o
14 | Financial Planning Questionnaire
Superannuation and Income Streams
Superannuation Details
Superannuation &/or Rollover Funds*
Owner Current value ($) Start date Super Choice Amount ($ or %) to re-allocate
/ / Yes No
/ / Yes No
/ / Yes No
/ / Yes No
/ / Yes No
* Where the fund is a SMSF, please complete the SMSF Investment Strategy Workbook.
Previous Contribution Amounts
Superannuation contributions made in the current financial year and previous two (2) financial years
Client 1 Client 2
Current Financial Year
Year ending
Concessional amount
Non-concessional amount
30/06/ 30/06/
$ $
$ $
Previous two (2) Financial Years
Year ending
Concessional amount
Non-concessional amount
30/06/ 30/06/
$ $
$ $
Year ending
Concessional amount
Non-concessional amount
30/06/ 30/06/
$ $
$ $
Note: You must ensure that Income Bonus, Salary Sacrifice and/or employer Superannuation Guarantee payments are reflected in the above table.
Financial Planning Questionnaire | 15
Current Pension Annuity
1 2 3 4
Owner
Fund name
Pension/annuity type
Complying (Centrelink)
Date of purchase / / / / / / / /
Investment amount $ $ $ $
Current value $ $ $ $
Current units
Centrelink deductable amount
$ $ $ $
Tax free component $ $ $ $
Taxable component $ $ $ $
Income p.a. $ $ $ $
Indicate min/max/specified
Payment frequency
Term of pension/annuity
Indexed Yes No Yes No Yes No Yes No
Indexation rate % % % %
Residuary capital value
$ $ $ $
Reversionary Yes No Yes No Yes No Yes No
Death Benefit nomination
Yes No Yes No Yes No Yes No
Redundancy or early Retirement Payment
Have you, or will you expect to receive a Redundancy or Early Retirement Payment? Yes No
Please provide any documentation relating to such payments.
Service period Client 1 Client 2
Employment commencement date
Date employment to cease
Amount of redundancy/ early retirement payment
Payment for unused annual leave
Payment for unused long service leave
Will you have to exit the superannuation fund?
/ / / /
/ / / /
$ $
$ $
$ $
Yes No Yes No
16 | Financial Planning Questionnaire
Insu
ran
ce
Cur
rent
per
sona
l ins
uran
ce (t
erm
life
cov
er, t
otal
& p
erm
anen
t dis
abilit
y (T
PD
), tr
aum
a, w
hole
of l
ife o
r end
owm
ent)
Prov
ider
Type
Life
insu
red
Ow
ner/
bene
ficia
ryC
over
leve
l ($)
Ann
ual
prem
ium
($)
Surre
nder
valu
e (if
any)
($)
Mat
urity
valu
e (if
an
y) ($
)TP
D d
efin
ition
– ow
n/an
y/ho
me
dutie
s/ge
nera
l
Insid
e/ou
tsid
e Su
per
Ret
ain
Yes
N
o
Yes
N
o
Yes
N
o
Wha
t exi
stin
g as
sets
wou
ld b
e re
alis
ed (f
ully
and
/or p
artia
lly) i
n th
e ev
en o
f dea
th/T
PD
/tra
uma?
Ass
etA
mou
nt ($
)O
wne
rD
eath
TP
DTr
aum
a
Yes
N
o Y
es
No
Yes
N
o
Yes
N
o Y
es
No
Yes
N
o
Yes
N
o Y
es
No
Yes
N
o
Cur
rent
inco
me
prot
ectio
n or
sal
ary
cont
inua
nce
insu
ranc
e
Pro
vid
erO
wne
rA
gre
ed o
r in
dem
nity
val
ue ($
)M
onth
ly
ben
efit
($)
Ann
ual
pre
miu
m ($
)W
aitin
g p
erio
dR
etai
nIn
side
or
outs
ide
Sup
erB
enef
it pa
ymen
t pe
riod
Yes
N
o
Yes
N
o
Yes
N
o
Not
es
Financial Planning Questionnaire | 17
Insurance Needs Analysis
In the event of death Client 1 Client 2 Joint
Debts to extinguish $ $ $
Proportion of the income to replace % %
Income required To age _______ or for ______ years
To age _______ or for ______ years
Annual cost per child $ $
Expenses on death – e.g. funeral costs, legal costs, etc.
$ $
Other $ $
In the event of total & permanent disability (TPD)
Debts to extinguish $ $ $
Proportion of the income to replace % %
Income required To age _______ or for ______ years
To age _______ or for ______ years
Annual cost per child $ $
One off medical/lifestyle cost(s) $ $
Annual medical/lifestyle cost(s) $______ for ____ years $______ for ____ years
In the event of trauma
Debts to extinguish $ $ $
Proportion of the income to replace % %
Income required To age _______ or for ______ years
To age _______ or for ______ years
Annual cost per child $ $
One off medical/lifestyle cost(s) $ $
Annual medical/lifestyle cost(s) $______ for ____ years $______ for ____ years
In the event of illness or injury
Replace income % %
Replace portion of Superannuation Guarantee? Yes No Yes No
Do you have an alternative source of income? Yes No Yes No
How many months can you go without your income?
In the event of child trauma
Sum insured per child $
18 | Financial Planning Questionnaire
Insurance Features – desired
Client 1 Client 2
Death
Buy back
Extend expiry age on Life cover (e.g. until 99)
TPD
Buy back
Own occupation definition
Income Protection
Agreed value
Preferred waiting period
30 days
60 days
90 days
Note, for BT Protection Plans, the first payment is generally paid monthly in arrears after the waiting period is completed.
Trauma
Buy back
Re-instatement
Other
Stepped or level premiums
CPI automatic adjustment
Automatic upgrade in better features and benefits
Flexibility to adjust structure of premium to your needs
Child Benefits
Other
Notes
Financial Planning Questionnaire | 19
Health and Estate Planning
Health
Client 1 Client 2
What is the state of your health? Excellent
Good
Poor
Other (specify)
Excellent
Good
Poor
Other (specify)
Smoker Yes No Yes No
Are there any health issues that need to be considered in making an investment or insurance decisions?
Yes No Yes No
If yes, please provide details
Do you have private health insurance? Yes No Yes No
If yes, please outline the provider details
Accrued sick leave days
Accrued annual leave days
Accrued days long service leave
What are the main duties of your occupation?
Are you involved in any hazardous pursuits? Yes No Yes No
If yes, please provide details
Estate Planning
Client 1 Client 2
Power of Attorney
Do you have a current Power of Attorney?
If yes, please state type:
Yes No Yes No
Enduring
Medical
Normal
General
Other
Enduring
Medical
Normal
General
OtherWill
Do you have a Will? Yes No Yes No
What is the date of your Will? / / / /
Who is the executor?
Adequacy and EquityWill sufficient funds be available to your dependants between your death and the distribution of your Estate?
Yes No Yes No
Have you considered Capital Gains Tax on any assets you bequeath directly to beneficiaries?
Yes No Yes No
Superannuation AssetsHave you made binding nominations on death?
If yes, who? Yes No Yes No
20 | Financial Planning Questionnaire
Authorisation
Client acknowledgement
I/We have received a copy of the Magntiude Financial Services Guide and Credit Guide (FSG & CG) at the first interview and have read and understood it, including the section titled ‘Privacy Statement.’ I/We agree to Kelly Wealth Services collecting, using and disclosing my/our personal information in accordance with the Magnitude Privacy Policy.
I/We will inform any other individual, such as dependants, spouse and/or partner, that I/we have provided information about them and make them aware of the information provided in the Magnitude Privacy Policy.
Client 1 Name
Client Signature Date
| |
Client 2 Name
Client Signature Date
| |
Financial Adviser Name
Financial Adviser Signature Date
| |
Client authorisation I/We and confirm that:
I/We have received a copy of the Financial Services Guide Part 1 Version , dated
and Part 2 Version dated at (or prior to) the
first interview and have read and understood it, including the section titled ‘How we protect your privacy’.
My/our risk profile is:
Client 1
Client 2
As agreed in the ‘Determining your Investment Risk Profile’ booklet.
I/We authorise , an Authorised Representative of Magntiude, to (tick the relevant box/s):
Retain and store my Tax File Number for the period the Authorised Representative is acting on my/our behalf.
Quote my/our Tax File Number information to the Australian Taxation Office when necessary and investment bodies when making investments on my/our behalf.
Client 1 Tax File Number
Client 2 Tax File Number
Financial Planning Questionnaire | 21
Collect, use and disclose my personal information in accordance with the Magnitude Privacy Policy.
Provide financial advice based on the information disclosed in this booklet and acknowledge that my/our Adviser will rely on the information contained in this document. I/We will inform any other individuals, such as dependants, spouse, partner that I/We have provided information about them and make them aware of the information provided in the Magnitude Privacy Policy.
Retain my/our medical evidence on file.
To proceed with a Statement of Advice based upon the information contained in this booklet.
To charge a fee of $ for preparing a Statement of Advice and on completing the Statement of Advice to:
Debit my bank account — (Where fees are paid via direct debit please complete a direct debit authority form)
Bank the attached cheque — (Please make cheque payable to Kelly Wealth Services)
Other (please specify):
Client authorisation to proceed to adviceI/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: I/We have provided you with all relevant information, and have agreed to a full financial plan.
Limited Advice (tick only one option below):
Specific goals and objectives: I/We have provided you with all relevant information in relation to the limited advice that I/we have specifically requested. I/We have been offered full advice however at this time I/we have specifically asked you to limit the advice to:
Specific Product: I/We have provided you all relevant information in relation to the product I/we wish to receive advice on. I/We have been offered full advice however at this time I/we have specifically requested you to limit the advice to the following product(s):
I/We acknowledge that you will charge a fee of $______________ for the written advice.
Client 1 Name
Client Signature Date
| |
Client 2 Name
Client Signature Date
| |
22 | Financial Planning Questionnaire
Financial Adviser Name
Financial Adviser Signature Date
| |
The following documents have been supplied:
Bank/Investment/Superannuation statements Financial Statements (Audited Financial Statements only if self-employed from last 2 years only)
Tax Returns (last 2 years if self-employed only) ETP Statements
ATO Assessment Notices (last 2 years if self-employed only) Other
Client Authorisation for Additional Information from Other Institutions or Financial Advisers
To whom it may concern:
Client 1 Client 2
I/We
whose date(s) of birth is/are | | | |
of (client address)
Request that all information relating to my/our investments, insurances, superannuation, bank accounts and/or other financial information be released to Kelly Wealth Services on request.
Yours faithfully,
Client 1 Name
Client Signature Date
| |
Client 2 Name
Client Signature Date
| |
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
Financial Planning Questionnaire | 23
Financial Adviser contact details
Name
Address
Mobile
Telephone
Email address
Facsimilie
To whom it may concern:
Client 1 Client 2
I/We
whose date(s) of birth is/are | | | |
of (client address)
Request that all information relating to my/our investments, insurances, superannuation, bank accounts and/or other financial information be released to Kelly Wealth Services on request.
Yours faithfully,
Client 1 Name
Client Signature Date
| |
Client 2 Name
Client Signature Date
| |
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
Account/Policy# Account/Policy#
24 | Financial Planning Questionnaire
Client Authorisation for Additional Information from Other Institutions or Financial Advisers
Financial Adviser contact details
Name
Address
Mobile
Telephone
Email address
Facsimilie
Investment Replacement Checklist
Financial Adviser Date / /
Client Name
Investment Details Current Proposed
Investment Provider
Product name
Type of fund Cash
Unit Trust
Master trust
Wrap
Other
Cash
Unit Trust
Master trust
Wrap
Other
Commencement date / / / /
Current balance $
Units
$
Units
Fees ($ amount/% p.a.)
Entry
Exit
MER/ICR
Buy/Sell Spread
Administration/Account-Keeping
Switching Fee
Financial Adviser Fee
Other
Financial Planning Questionnaire | 25
Will the replacement result in:
Duplication of entry fees (p.a.) Yes $ No
Capital loss on initial investment Yes $ No
Capital gains tax liability Yes $ No
Loss of taxation benefit – break of 125% contribution rule (Insurance Bonds)
Yes $ No
Any other taxation implications Yes $ No
Adjustment to Centrelink benefits Yes $ No
Platform Fees
Type of Fee: Current Proposed
($) (%) ($) (%)
Entry
Exit
Buy/Sell Spread
Administration
Financial Adviser Fee
Switching Fee
Other
Underlying Investment Details
Current Underlying Investment name(s):
Balance ($) MER/ICR (Including Performance Fee)
($) (%)
Total (Balance and Weighted MER)
Proposed Underlying Investment name(s):
Balance ($) MER/ICR (Including Performance Fee)
($) (%)
Total (Balance and Weighted MER)
26 | Financial Planning Questionnaire
Insurance Replacement Checklist
Asset Allocation
Current Proposed
($) (%) ($) (%)
Cash
Fixed Interest
Australian Shares
International Shares
Property
Other
Is the proposed (or similar) asset allocation available on the client’s existing investment?
Yes No
If yes, what is your justification for recommending a new product?
Product Features and Benefits
Does the product have access to: Details
Direct shares Yes No
Term deposits Yes No
Income stream(s) Yes No
In-specie transfer Yes No
Asset Allocation Yes No Single sector Multi-manager Other
Outline the benefit(s) to the client of replacing existing investment(s):
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Financial Planning Questionnaire | 27
Financial Adviser Date / /
Client Name
Insurance Details Current Proposed
Insurance Provider
Product name
Type of cover Accidental death
Super
Ordinary (Life, TPD, Income Protection)
Accidental death
Super
Ordinary (Life, TPD, Income Protection)
Life Insured
Commencement date / / / /
Name of underwriter
Type & sum insured:
Death $ $
TPD (Any/Own/Home duties) $ $
Trauma $ $
Income Protection Agreed value $______ or ___%
Indemnity value
TPD option
Waiting period _________
Benefit period _________
Agreed value $______ or ___%
Indemnity value
TPD option
Waiting period _________
Benefit period _________
Premium structure Stepped Level Stepped Level
Premium payable (from quote) $ $
Indexation linked? Yes No Yes No
Policy Fee (p.a.) (from quote) $ $
Occupation Category (from quote)
Will the replacement result in:
Increased premium/policy fee (p.a.) Yes $ No
Health loadings Yes $ No
Loss of loyalty discount Yes $ No
Loss of benefit (e.g. suicide exclusion) Yes $ No
Loss of bonus (e.g. Whole of life or Endowment policies) Yes $ No
Surrender Value (if there is an investment value) Yes $ No
Is there an option to increase/decrease the existing policy? (Note: some older policies have more favourable terms than the newer policies)
28 | Financial Planning Questionnaire
Outline the benefit(s) to the client of replacing existing insurance(s):
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Financial Planning Questionnaire | 29
Superannuation / Pension Replacement Checklist
Financial Adviser Date / /
Client Name
Superannuation Details Current Proposed
Superannuation Provider
Product name
Type of fund Employer Personal Industry Other
Employer Personal Industry Other
If an employer fund, is it: Defined Benefit Accumulation Pension Annuity Other
Defined Benefit Accumulation Pension Annuity Other
Membership number and date joined Fund Number:
/ /
Number:
/ /
Current balance $
Units
$
Units
Surrender value $ $
Regular contribution received? Yes $________ No Yes $_______ NoType of contribution Concessional
Non-concessional Other
Concessional Non-concessional Other
Contribution received over previous 3 years?(If yes, please complete the table on page 14)
Yes $_________ No Yes $_________ No
Tax free component ( i.e. concessional, Pre 1983, Non-concessional, Post-June 1994, Invalidity, CGT Exempt)
$ $
Taxable Component
( i.e. post 1983)
Taxed $
Untaxed $
Taxed $
Untaxed $
Restricted Non-Preserved Amount $ $Preservation Status: Preserved
Restricted Non-Preserved
Unrestricted Non-Preserved
Preserved
Restricted Non-Preserved
Unrestricted Non-PreservedCompulsory preserved benefit:Beneficiaries Name
%
Name
%Type of nomination None
Binding Non-binding Non-lapsing Reversionary
None Binding Non-binding Non-lapsing Reversionary
Current death benefit $Premium $
Stepped Level
Policy Fee $Is there an existing insurance policy attached to the current superannuation fund? Yes NoIf yes, please complete the insurance replacement checklist.
30 | Financial Planning Questionnaire
Platform Fees
Type of Fee: Current Proposed
($) (%) ($) (%)
Entry
Exit
Buy/Sell Spread
Administration
Financial Adviser Fee
Switching Fee
Other
Underlying Investment Details
Current Underlying Investment name(s):
Balance ($) MER/ICR (Including Performance Fee)
($) (%)
Total (Balance and Weighted MER)
Proposed Underlying Investment name(s):
Balance ($) MER/ICR (Including Performance Fee)
($) (%)
Total (Balance and Weighted MER)
Asset Allocation
Current Proposed
($) (%) ($) (%)
Cash
Fixed Interest
Australian Shares
International Shares
Property
Other
Is the proposed (or similar) asset allocation available on the client’s existing investment?
Yes No
If yes, what is your justification for recommending a new product?
Financial Planning Questionnaire | 31
Product Features and Benefits
Does the product have access to: Details
Direct shares Yes No
Term deposits Yes No
Income stream(s) Yes No
In-specie transfer Yes No
Asset Allocation Yes No Single sector Multi-manager Other
Will the replacement result in:
Capital loss on initial investment Yes $ No
Duplication of entry fees Yes $ No
Loss of employer provided insurance e.g. Death/TPD and/or salary continuance
Yes $ No
If yes, please provide details.
Has a replacement been recommended?
Loss of ancillary benefits? Yes $ No
If Defined Benefit, has pension option been explored?
If yes, please provide details: Yes No
Change in preservation status Yes $ No
Any impact on Centrelink benefits
If yes, please provide details: Yes No
Change in preservation status
If yes, please provide details: Yes No
Outline the benefit(s) to the client of replacing existing superannuation/pension fund(s):
Unable to access all information (please include incomplete information warning).