Investment Form - Investment Advice Solutions

Personal Information

Client 1

Client 2

Full Name

Email Address

Phone Number

Income Details (Annual)

Gross Employment Income

Client 1

Client 2

Salary / Wages (Excluding Super)

Bonus / Commission

Reportable Fringe Benefits

Net Operating Profit from Business

Sub Total

Investment Income

Interest

Rental income (net)

Dividends

Investment (unfranked)

Investment (franked)

Franking / Imputations credits

Sub-total

Income Stream Pensions

Annual Draw Down 1

Annual Draw Down 2

Centrelink Pensions / Allowances

Taxable

Non - Taxable

Sub-total

Total

Other Information

Is income subject to fluctuation ?

Is Occupation likely to change ?

How many weeks could you go without income (Disregard any leave entitlements) ?

Expenditure ( For each item you can input either weekly or annual amounts but not both )

Personal Items

Weekly

Annual

Groceries

Coffee

Clothing

Gym

Medical / Hospital Fund

Postage

Furnishings

Manchester

Sub Total

Housing

Gas

Water

Electricity

Phone

Internet

Rates & Taxes

Insurances

Repairs & Maintenance

Rent / Mortgage

Sub Total

Entertainment

Social Events

Dinner & Interests

Sports / Membership

Holidays

Sub Total

Transport

Public Transport

Registration / Green Slip

Insurance

Road Service

Petrol

Service & Maintenance

Tolls

Sub Total

General

Superannuation (RSP)

Life Insurance

Trauma / TPD Insurance

Credit / Store Cards

Gifts

Savings

Taxes

Sub Total

Tax Deductible Expenditure

Donations

Income Protection Ins

Memberships

Professional Texts

Sub Total

Dependents (Weekly / Annual)

Education

Child Care / Support

Pets / Vet Fees

Pocket Money

Sub Total

Total (Weekly / Annual)

Annual Total Expenditure

Net Cash Flow before Tax

Comments on Income or Expenditure

Existing Assets

Lifestyle Assets

Description	Current Value $	Purchase Amount	Purchase Date	Asset Tested	Centrelink Value	Owner	Security for Loan?	Retain	Sell on Death or Disability
Family Home
Contents
Motor Vehicle 1
Motor Vehicle 2
Holiday Home
Boat / Caravan

Cash / Fixed Interest

Description	Current Value $	Purchase Amount	Income ($ or %)	Maturity Date	Owner	Retain	Reinvest Income?

Direct Inv Property

Description	Current Value $	Purchase Amount	Purchase Date	Annual Rent	Annual Expenses	Owner	Security for Loan?	Retain	Sell on Death or Disability

Managed Funds / Shares

Description	Current Value $	Purchase Amount	Purchase Date	Income ($ or %)	Current Units	Owner	Security for Loan?	Retain	Reinvest Income	Sell On Death Or Disability

Existing Liabilities

Type	Lender	Current Debt	Interest Rate	Principle / Int or Int only	Monthly Repayments	Loan Term	Interest Tax Deductible?	Owner	Retain?	Original Amount / Limit	Date of Loan	Repay on Death or Disability
Home Mortgage
Investment Loan
Personal Loan
Credit Card 1
Credit Card 2
Credit Card 3
Lease / HP
Reverse Mortgage
Line of Credit
Home Equity Loan

Do you expect any changes in your future assets and liabilities? YesNo

If yes - provide comment

Superannuation and Bonds

Type of Investment	Institution	Amount $	Date Invested	Maturity Date	Return %	Owner
Superannuation
Superannuation
Superannuation
Superannuation
Rollover Funds
Rollover Funds
Insurance Bonds
Insurance Bonds
Friendly Soc Inv
Funeral Bonds

Retirement Income Streams

Income Stream	Description	Amount	Purchase date	Income	Return %
Allocated Pension
Allocated Pension
Annuity

Insurance Details

Insurance Type	Name Of Insurer	Amount Of Cover	Annual Premium
Building
Content
Vehicle(s)
Health / Medical
Life and Disability
Income Protection

Investment Objective

Please comment on your Investment objectives in the space below ( eg Growth ,Tax advantages, Income, rollover etc)

Other Information

Data Required	Client 1	Client 2	Data Required	Client 1	Client 2
Date of Birth			Do you have a current Will
Gender			Power of attorney in place
Employment status			Gifts given within 5 years?
Possible Inheritance			Sell home
Financial Dependents			Personal Super contribution
Smoker			Ever withdrawn from Super
Health Status			Marital Status
Previously Married			If Yes, Children?

By ticking this box I acknowledge that I have completed this form to the best of my ability and as accurately as possible.

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Personal Information

Income Details (Annual)

Gross Employment Income

Investment Income

Dividends

Income Stream Pensions

Centrelink Pensions / Allowances

Other Information

Expenditure ( For each item you can input either weekly or annual amounts but not both )

Personal Items

Weekly

Annual

Housing

Entertainment

Transport

General

Tax Deductible Expenditure

Dependents (Weekly / Annual)

Comments on Income or Expenditure

Existing Assets

Lifestyle Assets

Cash / Fixed Interest

Direct Inv Property

Managed Funds / Shares

Existing Liabilities

Superannuation and Bonds

Retirement Income Streams

Insurance Details

Investment Objective

Other Information

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Personal Information

Income Details (Annual)

Gross Employment Income

Investment Income

Dividends

Income Stream Pensions

Centrelink Pensions / Allowances

Other Information

Expenditure ( For each item you can input either weekly or annual amounts but not both )

Personal Items

Weekly

Annual

Housing

Entertainment

Transport

General

Tax Deductible Expenditure

Dependents (Weekly / Annual)

Comments on Income or Expenditure

Existing Assets

Lifestyle Assets

Cash / Fixed Interest

Direct Inv Property

Managed Funds / Shares

Existing Liabilities

Superannuation and Bonds

Retirement Income Streams

Insurance Details

Investment Objective

Other Information

Get notified about the latest News and Resources

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Get notified about the latest
News and Resources