Financial Planning Questionnaire

Financial Services and Markets Act 2000

Independent Financial Advisers are required to have proper regard for a client’s best interests in any advice given. They must therefore do their utmost to ensure that they are aware of your personal and financial circumstances so that their advice is the most suitable for your needs. The questions here have been specifically designed to help your adviser provide advice that meets your needs. If, for any reason, you decline to answer any or all of the questions or if you fail to provide true and accurate information to the best of your knowledge, the advice given subsequently may not be best advice, as it can only be based on the information provided.

PNM Financial Management is a trading name of P N Morris Financial Management who are authorised and regulated by the Financial Conduct Authority

Name of client

Date:

Completed by:

1

Customer Agenda

Your service preferences as follows:

Review of your full current financial situation with an overview to other areas

Repaying your Mortgage / Raising Finance with an overview to other areas

Protecting your Income to ensure that you have enough money to meet your monthly requirements should you be unable to work due to accident or illness for a prolonged period of time.

with an overview to other areas

Protecting your Family to ensure that in the event of you or your partner’s death or the diagnosis of a critical illness, your family has enough money to provide for their on-going financial needs.

with an overview to other areas

Retirement Lifestyle to ensure that you (and your partner) have sufficient income in retirement to afford the lifestyle that you want.

with an overview to other areas

Regular Savings ensuring that you have a cash emergency fund to cater for the short-term, planning regular savings aims to allow you to make structured plans for savings in general or to provide a vehicle to allow you to save towards a specific future event in the medium to long-term.

with an overview to other areas

Capital Investment giving the opportunity to optimise the returns from your investments whether their aim be tax-efficiency, maximising income or planning for growth.

with an overview to other areas

Private Medical Insurance to provide independent care either in the UK or abroad should medical treatment be required.

with an overview to other areas

Long Term Care to provide for care in your old age is a way of helping to ensure that you can afford the help you may need. For example, care can be provided in your own home or in a suitable Nursing Home should you become disabled or unable to perform some of the tasks that allow you to be independent.

with an overview to other areas

Inheritance Tax Planning to plan how to reduce any liability to inheritance tax therefore maximising the value of your estate, which can be passed to their heirs.

with an overview to other areas

Comments:

2

IMPORTANT NOTICE - Data Protection Act 1998

Information supplied may be stored on computer records and may be used for marketing and statistical purposes by members of the group of companies. Details may be passed to our regulatory authorities for the purpose of compliance.

Do you consent to this: Yes No

We would also like to keep you informed of products which may be of interest to you.

Do you wish to receive such information: Yes No

Personal Details Client Partner

Surname

First names

Title

Marital status

Date of birth

Home address

Postcode

Tel No (home)

Tel No (work)

Mobile

Email (home)

Email (work)

National Ins. No.

State of health

Smoker Yes No Yes No

Smoker Details

Units of Alcohol per week

Dependants Name Date of birth Age Relationship

1.

2.

3.

4.

Client Partner

Have you made a will? Yes No Yes No

When was it updated?

Main provisions

Executors names/address

3

Occupation Details Client Partner

Occupation

Employment status

Employer’s / Company name

Address

Postcode

Tel No.

Commencement date

Income/Expenditure Client Partner Joint

Gross annual income £ £ £

Net monthly income £ £ £

Expenditure (monthly) £ £ £

Disposable income (monthly £ £ £

Liabilities/Outgoings Client / Partner/Joint

Lender Purpose Amount End Date

Repayment pm

Mortgages/Rent

Bank overdraft

Personal loans

Hire purchase

Credit cards

Others (please specify)

Monthly outgoings e.g. food, bills, council tax, clothes, holiday etc

£

Estimated future outgoings £

Are the loans protected Yes No Total unprotected liabilities £

Client Partner Joint

Net monthly income £ £ £

Less monthly expenditure £ £ £

Net disposable income £ £ £

Notes:

4

Assets

Client Partner Joint

Home (primary residence)

Other properties

Contents & Personal Effects

Vehicles

Current accounts

Building society and deposits

National savings

TESSA/TESSA ISA

PEPs / ISAs

Investment Bonds

Unit / Investment Trusts

Stock-market shares

Loan Stocks and Gilts

Other assets

Total Assets

Notes:

5

Retirement Planning

Planning for retirement aims to ensure that you have sufficient income in retirement to afford the lifestyle that you want.

(Refer monthly expenditure sheet) Client Partner

What age would you like to retire (realistically)?

On what income (in today’s money)? £ £

Would you be interested in reviewing your pension arrangements to improve your benefits?

Yes No Yes No

Existing arrangements

Does your employer offer a pension scheme?

Yes No Yes No

Are you eligible to join a company sponsored pension scheme?

Yes No Yes No

If so, please provide details

Details of existing arrangements Client Partner

Insurance company/provider/scheme

Policy number

Commencement date

Type (money purchase/final salary/FSAVC/AVC/GPP/PPP)

Selected/Scheme retirement age

Contributions: Personal (pm/pa)

(increasing/level/waiver/contracting out)

Contributions: Employer (pm/pa)

(increasing/level/waiver/contracting out)

Pensionable salary

Fund value

Fund choice

Basis of benefits

(pension n/60ths/80ths)

Pension payable in today’s terms

Has this been written in Trust

Current or preserved

Notes:

Single person’s basic state pension £107.45 pwk / £5,587.40 pa. (2012 / 2013)

Married couple’s basic state pension £171.85 pwk / £8,936.20 pa. (2012 / 2013)

6

Mortgage Details

Lender & Address Single Joint Tenants in common

Type of loan

Repayment

Interest Only

Endowment

ISA

Other ________________ Current repayment £

Interest

Rate %

Original loan £ Original term

Balance outstanding £ Term outstanding

Redemption penalties

Are you planning to move within next 12 months? Yes No

Are you happy with your current mortgage? Yes No

Would you consider changing providers if you could improve your mortgage rate/terms?

Yes No

Do you think your mortgage protection is adequate? Yes No

Do you have critical illness cover? If not, would you be interested in adding cover to protect your loan?

Yes No

If your mortgage is to be repaid by an ISA/ endowment etc is it on course to repay your loan?

Yes No

Mortgage Protection

Do you have mortgage protection (e.g. life cover) or

a repayment vehicle Yes No

Client/Partner/Joint

Type (endowment, term ass, MPP)

Provider

Policy number

Sum assured

Life cover

Critical illness cover

Premium

Start date

Expiry date

Summary

Total mortgage cover required

Total cover provided

Shortfall

Notes:

7

Family Protection

Family protection aims to ensure that in the event of your or your partner’s death or earlier critical illness, your family has enough finances to provide for their ongoing needs.

(refer to monthly expenditure sheet)

Client Partner

In the event of your death or earlier critical illness how much income would your dependants need?

£ £

What cover, if any, do you have to provide this income?

None List below None List below

For how long? (children finish school / university / retirement etc)

What income could this provide? £ £

Shortfall £ £

Do you have any unprotected liabilities we need to take into account? If so, how much?

£

Term

£

Term

Details of Existing Arrangements

Client/Partner/Joint

Type

Life/CI/Life & CI

Provider

Policy number

Date started

Maturity/Expiry date

Premium

Premium owner

Sum assured

In trust

Beneficiary (ies)

Purpose

Notes:

Widowed parents allowance £105.95 pwk / £5,509.40 pa (2012 / 2013) maximum basic allowance.

8

Income Protection

Income protection aims to ensure that you have enough money to meet your monthly requirements should you be unable to work due to accident or illness for a prolonged period of time.

Client Partner

If you were unable to work due to sickness or accident how much income would you require to maintain your standard of living?

£ £

To what age?

What provision do you have to provide this income?

Details of Existing Arrangements

Type (PHI/ASU)

Provider

Policy number

Date started

Term/Age

Deferment period

Premium

Benefit

Period (weeks)

You

Employer

State

Total

Actual shortfall

9

Notes: Employment and Support Allowance Rates (2012 / 2013)

Weekly rate during the assessment phase The assessment phase rate is paid for the first 13 weeks of a claim while a decision is made on the capability for work through the Work Capability Assessment.

Age of claimant Weekly amount

A single person aged under 25 up to £56.25

A single person aged 25 and over up to £71.00

Weekly rate during the main phase The main phase starts from week 14 of a claim, if the Work Capability Assessment shows that the illness or disability does limit the ability to work.

Type of group Weekly amount

A single person in the Work Related Activity Group up to £99.15

A single person in the Support Group up to £105.05

10

Private Medical Insurance

The provision of medical cover for you and your family independently of the NHS.

Client Partner

Are you happy to rely on the NHS for your medical needs?

Yes No Yes No

Do you have or would you consider private medical insurance?

Yes No Yes No

Are you happy with your existing cover/provider?

Yes No Yes No

Would you be interested in looking at private medical insurance?

Yes No Yes No

Type required (single, married, family)

Cover required

Core Core plus Comprehensive

(Cover provided where NHS waiting list for treatment exceeds 6 weeks)

(All in-patient treatment using the NHS for out-patient treatment)

(Full cover, in and out-patient treatment, access to alternative consultations)

Type (single, married, family)

Provider / Insurer

Start Date

Expiry Date

Premium £ £

Notes:

11

Regular Savings

This is to ensure that you have a cash emergency fund to meet unexpected short-term expenses and for specific reasons over the medium to long term.

Client Partner

Do you save on a regular basis? Yes No Yes No

Would you like to review or increase your savings?

Yes No Yes No

What reasons might you have for saving for the future (e.g. education fees, house purchase, home improvement, holidays, weddings etc)

Over what period? months years months years

Do you think you have sufficient savings as an emergency fund?

Yes No Yes No

What amount would you require as an emergency fund?

£ £

Existing Provision

Owner

Provider

Policy number

Type

Premium

Sum assured

Current value

Start date

End date

Fund/sector

In trust?

Notes:

12

Capital Investment

Investment planning gives people the opportunity to optimise the returns from their investments whether their aim be tax-efficiency, maximising income or for growth.

Client Partner

Do you have any investments in place (PEP/ISA, stocks/shares, corporate bonds, Nat Savings etc)

Yes No Yes No

What were your reasons for these investments? (income, long-term saving, tax-efficiency, for family etc)

Would you be interested in looking at alternative investment opportunities?

Yes No Yes No

Are you considering further investments?

Yes No Yes No

Existing Plans

Owner

Provider

Policy number

Start date

Maturity date

Type/Account name

Initial investment

Current value

Purpose (income/growth)

Fund/sector

In trust

Notes

13

Long Term Care

Planning to provide care in your old age is a way of helping to ensure that you can afford the help you may need. For example, care can be provided in your own home or in a suitable Nursing Home should you become disabled or unable to perform some of the tasks that allow you to be independent.

Client Partner

Are you aware how much it costs to provide care in your area?

Yes No Yes No

How would you manage if you or a member of your family needed long-term care?

Current annual cost of private nursing care in your area.

£ £

Income Available Client Partner

State provision attendance allowance

£ £

Other allowances £ £

Pension income £ £

Net basic state pension £ £

Other net income bank/building society/investments

£ £

Total income £ £

Less cost of continued living £ £

Cost of care shortfall £ £

Details of Existing Arrangements

Self/Partner

Type

Provider

Date started

Premium

Policy owner

Sum assured

Notes:

NHS nursing care £108.70 pwk / £5652.40 pa (Standard Rate - 2012 / 2013)

Attendance allowance

Lower £51.85 pwk / £2,696.20 pa (2012 / 2013)

Higher £77.45 pwk / £4,027.40 pa (2012 / 2013)

14

Inheritance Tax (IHT)

Inheritance tax planning could ensure that your loved ones as your beneficiaries receive all or as much of your wealth and possessions after your death.

Client Partner

Are you aware of IHT? Yes No Yes No

How far is it of concern to you?

(none, some, great)

What is the current value of your estate (approx total value of all assets inc debts payable to you)

£

Are you expecting any future legacies/bequests?

Yes No

£

Yes No

£

Have you made gifts or placed assets into trust? If yes, please specify below.

Yes No Yes No

Would your executors / beneficiaries be able to pay any IHT liability?

Yes No Yes No

Summary of Total Estate

Item Client Partner Joint Total

Home (s) £ £ £ £

Contents £ £ £ £

Vehicles £ £ £ £

Collections £ £ £ £

Investments £ £ £ £

Life Assurance (not in trust) £ £ £ £

Business Assets £ £ £ £

Others £ £ £ £

Total £ £ £ £

Less borrowings e.g. mortgage £ £ £ £

Less nil rate band £325,000 £ £ £ £

Balance subject to tax @ %

£ £ £ £

Tax payable £ £ £ £

Do you have any arrangements in place to meet any IHT? E.g. discretionary will trust, whole of life policy etc.

Yes No Yes No

Existing Provision

Owner (client/partner/joint)

Provider

Policy number

Type

Premium

Sum assured

Current value

15

Start date

End date

In trust

Attitude to Risk

When addressing the solutions to fulfil your current priorities, which one of the following statements best describes your feelings towards the future:-

Risk Averse – You are a very cautious investor and are not willing to take any stock market risk. You are prepared to take the inflationary risk this implies. Examples of this type of investment would be deposit accounts.

Low – Although a cautious investor, you are prepared to accept low levels of risk for the prospect of slightly higher returns. You are not likely to want to invest in equities. Examples of this type of investment would be fixed interest securities.

Low/Medium – You will accept below average risk to achieve more attractive potential returns and would expect to invest in a balanced portfolio of assets such as equities, property and fixed interest.

Medium – You prefer a balanced approach to investment and are willing to accept average risk in the hope of higher returns. Examples of this type of investment would be Managed funds.

Medium/High – You will accept above average risk for the prospect of high returns. You are not concerned with short-term volatility. You would expect the majority of your funds to be invested in equities and may invest in funds within a specific geographical area.

High – This category is reserved for those investors who are prepared to take very high risks in order to obtain the potential for very substantial returns, although substantial falls in value may be equally as likely. Investment vehicles that fall within this category are likely to be available only through specialist investment houses and will normally require a considerable financial commitment from the investor. Examples of this type of investment would be an Emerging Markets funds.

Investment Experience

When it comes to investing, how would you describe yourself?

No understanding / knowledge

Very little understanding / knowledge

About as much understanding / knowledge as the next person

A fair degree of understanding / knowledge

A high level of understanding / knowledge

Do you have strong views on where your money is invested?

Yes No Yes No

Notes:

16

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Attitude to Risk (continued)

Client Priority Advisor Priority Attitude to Risk

Client Partner Client Partner Client Partner

Repaying your mortgage

Protecting your income in the event of illness.

Protecting your family in the event of your death.

Requirement lifestyle pensions

Regular savings

Capital investment

Investment income

Retirement lifestyle long term care

Private medical insurance

Inheritance tax planning

Of your net disposable income, how much are you prepared to commit to meet your priorities?

NOTE: Challenge inconsistencies / discuss clients appetite for loss of capital value.

Cash Gilts Bonds Property Equity

Income

Equity

Growth

Overseas

Equities

r i sk

17

Investment Timeframe:- When do you intend to use the invested money?

Short term (0-5 years)

Medium term (5-10 years)

Long term (10+ years)

No fixed term

Capacity for Loss:- How much of this investment could you stand to lose without having a significant impact on your standard of living?

None or very limited losses (0-5%)

Small/medium losses could be tolerated

Large losses would have a low impact on me

Investment Liquidity:- If you needed sudden access to a lump sum, how likely is it that you would need to encash this investment?

There are other savings and investments which can be used.

Access to the investment may be required

Access to the investment will definitely be required

Notes:

18

DECLARATION

I/we understand that the recommendations will be based solely on the information given by me/us in this review.

I/we confirm that we were provided with a Retail Client Agreement, Key Documents and Business Card.

I/we authorise PNM Financial Management to disclose personal data to relevant third parties to secure any investment, protection, pension or mortgage business on my/our behalf.

I/we consent to the processing and storage of personal information on computer and/or paper files and understand this information will be treated in accordance with the Data Protection Act.

We like to take care to keep our clients informed of products that may be of interest to them. If you do not wish

to receive this information in future please tick:

Customer 1 – Name Customer 2 – Name

Signature Signature

Date / / Date / /

Adviser Paul N Morris

Signature

Date / /