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    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?

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