Personal Client Profile

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Partner Name: Date: / /

Client Name:

Important Notice to Clients

Legislation and practice requires that an adviser making recommendations must have reasonable grounds for

making those recommendations. This means that an adviser must conduct an appropriate investigation as to the

financial objectives, situation and particular needs of the client. The information requested in this form is necessary

to enable recommendations to be made and will be used for that purpose. This document incorporates the

requirements of the Corporations Law (as regulated by the Australian Securities and Investments Commission).

No liability is accepted for any advice given on the basis of inaccurate or incomplete information. This document

contains personal information that is confidential. I/we acknowledge that any advice or information provided in the

interview process is of a general nature and may not be suitable for me/us. We acknowledge that it is not until we

proceed with the completion of a Statement of Advice that the advice is personalised to our circumstances.

Personal Client Profile


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This Personal Client Profile has been designed to assist you in the collection of the necessary financial and

personal data that is required by Financial Spectrum Pty Ltd. This is part of our process of enabling you to meet

you goals and objectives, as this questionnaire provides the basis for appropriate recommendations in regards to

your financial planning needs.

Whilst we appreciate this questionnaire will take some time to complete comprehensively, the information

contained is of fundamental importance to the facilitation of your ongoing financial management and planning

process.

This questionnaire contains blank spaces and tables to summarise your financial data.

In some instances it may be appropriate for you to attach photocopies of various documents such as insurance

policies, superannuation fund statements, tax returns etc

If you feel that a particular section or question is not applicable please indicate this by writing not applicable

on that question/section and initial that page in the bottom right-hand corner.

Financial Spectrum Pty Ltd must have a reasonable basis for making recommendations to you. We need to

have sufficient information about you, your goals, objectives and risk profile in order for us to ensure that our

advice is appropriate.

This Personal Client Profile is designed to be returned to your Financial Spectrum adviser in its entirety. Any

supporting documentation and/or summaries can accompany this document or be placed inside.

Please also complete, sign and return to us the following:

> the Declaration & Disclosure on page 23 of this document which states that the informationprovided is correct and will form the basis for our recommendations.

> the Letter of Authority that will enable us to gather any further information which may be requireddirectly from other sources (i.e. superannuation funds, accountants etc.)

> the Acknowledgement Receipt which confirms that you received a copy of our Financial ServicesGuide (FSG), Privacy Policy, and Adviser Profile

Personal Client Profile

September 2009V.1.2


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Inomao

Pso

Client #1lient #1lient #1 Client #2lient #2lient #2Current Health Poor / Good / Excellent Poor / Good / Excellent

Private Health Fund

Smoker Status Smoker / Non-Smoker Smoker / Non-Smoker

Medical History

Employment

Client #1lient #1lient #1 Client #2lient #2lient #2Tax File Number

Employment Status Employed / Self Employed / Retired / Part Time

Casual / Employer / Unemployed

Student / Home Duties / Other

Employed / Self Employed / Retired / Part Time

Casual / Employer / Unemployed

Student / Home Duties / Other

Industry

Job Title

Employer Name

Salary $ pa $ pa

Qualifications

Expected

Retirement Date

/ / / /

Expected

Retirement Age

Are you expecting anychange to your

employment?

Yes No

Yes No

Health

Client 1 Initials:

Client 2 Initials:

Please note that this information is used in our financial and insurance planning. Our advice is subject to underwriting assessments which are

outside our control.


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Superannuation Details: Client 1

1 2 3 4Fund Name

Fund Type Defined Benefit /DIY/

Accumulation

Defined Benefit /DIY/

Accumulation


Accumulation


Accumulation

Member/Account #

Accumulated balance

Current contributions $ $ $ $

Eligible service date / / . / / . / / . / / .

Are you making

undeducted contributions?

$ $ $ $

Nominated beneficiaries

Binding nomination Yes

No

Yes

No

Yes

No

Yes

No

15 Feb 1990 balance Yes

No

$

Yes

No

$

Yes

No

$

Yes

No

$

ETP benefits

previously received

$ $ $ $

Comments


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Superannuation Details: Client 2

1 2 3 4Fund Name

Fund Type Defined Benefit /DIY/

Accumulation


Accumulation


Accumulation


Accumulation

Member/Account #

Accumulated balance

Current contributions $ $ $ $

Eligible service date / / . / / . / / . / / .

Are you making

undeducted contributions?

$ $ $ $

Nominated beneficiaries

Binding nomination Yes

No

Yes

No

Yes

No

Yes

No

15 Feb 1990 balance Yes

No

$

Yes

No

$

Yes

No

$

Yes

No

$

ETP benefits received $ $ $ $

Comments

Client 1 Initials:

Client 2 Initials:


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Client #1 Client #2

Client #1lient #1lient #1 Client #2lient #2lient #2Name

Purpose

Director/s

Beneficiaries

Ownership/

Shareholding


Purpose

Director/s

Beneficiaries


Purpose

Director/s

Beneficiaries

Self Managed Super Funds

Companies

Discretionary Trusts

Client #1lient #1lient #1 Client #2lient #2lient #2Benefit Name

Benefit Type

Amount Received $ $

Centrelink


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Client #1lient #1lient #1 Client #2lient #2lient #2Will exists? Yes No Yes No

Date of will / / . / / .

Provision for

testamentary trust?

Yes No Yes No

Executors name

Relationship

Attorney type

Date / / . / / .

Attorneys name

Relationship

Location of will

Estate Planning

Accountants Details


Firm

Phone

Authority to contact Yes No Yes No

Solicitors Details


Firm

Phone

Authority to contact Yes No Yes No

Client 1 Initials:

Client 2 Initials:


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Epdtue

Inme&

Client #1 Client #2

Client #1lient #1lient #1 Client #2lient #2lient #2Your income before tax: $ pa $ pa

Your income after tax: $ pa $ pa

Pension/other benefit: $ pa $ pa

Family payment $ pa $ pa

Child support received $ pa $ pa

TOTAL INCOME $ pa $ pa

Investment inc. after tax: $ pa $ pa

Other regular inc. after tax: $ pa $ pa

Income

Expenses per annumxpenses per annumxpenses per annumHousing

- Rent $ pa

- Mortgage repayments $ pa

- Land rates $ pa

- Water rates $ pa

- House & contents insurance $ pa Total Housing Expenses

- Strata levies $ pa $ pa

Utilities

- Electricity $ pa

- Gas $ pa

- Water $ pa

- Mobile Phone $ pa

- Internet $ pa

- Cable TV $ pa Total Utilities Expenses

- Telephone $ pa $ pa

Expenditure


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Epdtue

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Client Partner

Attorney Type

Date

Attorneys Name

Relationship

Client 1 Initials:

Client 2 Initials:

Expenditure (continued)Transport

- Petrol $ pa

- Repairs & Maintenance $ pa

- Registration $ pa

- Fines $ pa

- Insurance $ pa

- Licence $ pa

- Fares $ pa Total Transport Expenses

- Parking $ pa $ pa

Food

- Groceries $ pa

- Meat $ pa

- Fruit/ Vegetables $ pa

- Lunches $ pa

- Pet Food $ pa Total Food Expenses

- Take away food/ Restaurants $ pa $ pa

Education

- School fees $ pa

- Uniforms $ pa

- Adult education $ pa

- School excursions $ pa

- Tutoring $ pa

- Books $ pa

- Sports/ Out of school activities $ pa Total Education Expenses

- Child-minding $ pa $ pa


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Epdtue

Inme&

Medical

- Health insurance $ pa

- Doctors bills $ pa

- Dentist $ pa

- Chemist $ pa

- Eye care/Optometrist $ pa

- Specialists/Alternative therapy $ pa Total Medical Expenses

- Pet and Vet $ pa $ pa

Loan Repayments

- Credit card repayments $ pa

- Personal loan repayments $ pa

- Car loans/hire purchase $ pa

- Store cards/accounts $ pa

- Finance companies $ pa

- Home loan repayments $ pa

- Investment loan repayments $ pa Total Loan Expenses

- Other debt repayments $ pa $ pa

Other

- Superannuation $ pa

- Life/term/income insurance $ pa

- Professional fees $ pa Total Other Expenses

- Other regular expenditure $ pa $ pa


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Epdtue

Inme&

Client 1 Initials:

Client 2 Initials:

Personal

- Maintenance (children) $ pa

- Clothing $ pa

- Hair $ pa

- Grooming/cosmetics $ pa

- Entertainment $ pa

- Sports $ pa

- Club fees $ pa

- Newspapers/magazines $ pa

- Holidays $ pa

- Gifts/donations $ pa

- DVDs/videos/movies $ pa

- Postage $ pa

- DVDs/videos/movies $ pa

- Postage $ pa

- Pocket money (children) $ pa

- Alcoholic drinks $ pa

- Cigarettes/tobacco $ pa

- Laundry/dry cleaning $ pa

- Gambling $ pa Total Other Expenses

- Other regular expense $ pa $ pa

TOTAL EXPENSES $ pa


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Ln

Bom

Partner Client Part-

nerWill exists?

Date of Will

Provision

testamentary trust

Will exists?

Date of Will

Provision for a

testamentary trust

Client Partner

Attorney Type

Date

Attorneys Name

Relationship

Your bottom line

Your combined after tax income $ pa

Minus your expenses $ pa

Equals $ pa

If your total is positive:Congratulations! This result means that your total income exceeds your total expenses, or that you are managing to save

the total amount on a yearly basis. Your Financial Spectrum adviser will be able to help you to maximise your savings

returns and investment potential

If your total is negative:

This result means that you are currently spending in excess of your total income. You should review in detail your

expenses and try to reduce any non-essential items such as entertainment expenses. Your Financial Spectrum adviser

will be able to help you with budgeting to improve your current position.


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Will exists? Provision for a

testamentary trust

Client Partner

Attorney Type

PrincipalrincipalrincipalResidenceesidenceesidence

InvestmentnvestmentnvestmentProperty #1roperty #1roperty #1



Asset description Unit/House/Land Unit/House/Land Unit/House/Land Unit/House/Land

Location/Address

Owner Client 1/ Client 2/

Joint/ Other

Client 1/ Client 2/

Joint/ Other

Client 1/ Client 2/Joint/

Other

Client 1/ Client 2/

Joint/ Other

Year purchased

Purchase price $ $ $ $

Current value $ $ $ $

Income (pa) eg. Rent $ $ $ $

If mortgaged:

Lender

Original amountborrowed $ $ $ $

Date borrowed / / . / / . / / . / / .

Amount outstanding $ $ $ $

Original term

Loan type P&I /I only /LOC P&I /I only /LOC P&I /I only /LOC P&I /I only /LOC

Interest rate structure Variable/Fixed Variable/Fixed Variable/Fixed Variable/Fixed

Current interest rate % % % %

Property

Client 1 Initials:

Client 2 Initials:


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testamentary trust

Client Partner

Attorney Type

Date

Cashashash Cash #2ash #2ash #2 ManagedanagedanagedInvestmentnvestmentnvestment

ManagedanagedanagedInvestment #2nvestment #2nvestment #2

Company

Type


Joint/ Other


Other

Client 1/ Client 2/

Joint/ Other


Other

Date purchased / / / / / / / /

Fund Term deposit/At call Term deposit/At call Term deposit/At call Term deposit/At call

Initial Investment $ $ $ $

Current Value $ $ $ $

If geared:

Debt Outstanding $ $

Interest Rate % %

Loan Type P & I / I Only . P & I / I Only

Interest Rate Structure Fixed / Variable Fixed / Variable

Other Investments

Comments


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testamentary trust

Client Partner

Attorney Type

Other Investments

Labte

A

s&



Direct Equitiesirect Equitiesirect Equities# 111

Direct Equitiesirect Equitiesirect Equities#222

Company

Type


Joint/ Other

Client 1/ Client 2/

Joint/ Other

Client 1/ Client 2/

Joint/ Other


Other





If geared:

Debt Outstanding $ $ $ $

Interest Rate % % % %

Loan Type P & I / I Only . P & I / I Only . P & I / I Only . P & I / I Only .

Interest Rate Structure Fixed / Variable Fixed / Variable Fixed / Variable Fixed / Variable

Client 1 Initials:

Client 2 Initials:

Comments


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Other Investments


testamentary trust

Client Partner

Labte

A

s&



Othertherther#111

Othertherther#222

Company

Type


Joint/ Other

Client 1/ Client 2/

Joint/ Other

Client 1/ Client 2/

Joint/ Other


Other





If geared:

Debt Outstanding $ $ $ $

Interest Rate % % % %

Loan Type P & I / I Only . P & I / I Only . P & I / I Only . P & I / I Only .

Interest Rate Structure Fixed / Variable Fixed / Variable Fixed / Variable Fixed / Variable

Personal Use Assets

Ownerwnerwner Asset Valuesset Valuesset Value LiabilityiabilityiabilityMotor Vehicles Client 1/ Client 2/Joint/ Other $ $

Recreational Assets Client 1/ Client 2/Joint/ Other $ $

Contents/Personal

Property

Client 1/ Client 2/Joint/ Other $ $

Collectibles Client 1/ Client 2/Joint/ Other $ $

Other Client 1/ Client 2/Joint/ Other $ $


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testamentary trust

Client Partner

Attorney Type

Date

Attorneys Name

Relationship

Policy #1olicy #1olicy #1 Policy #2olicy #2olicy #2 Policy #3olicy #3olicy #3Insurer / Product

Policy Owner Client 1/ Client 2 / Other Client 1/ Client 2 /Other Client 1/ Client 2/Other

Life Insured Client 1/ Client 2 Client 1/ Client 2 Client 1/ Client 2

Cover Type Life / TPD / Trauma /

Income Protection

Life / TPD / Trauma /

Income Protection


Income Protection

Cover Amount $ $ $

Premium $ $ $

Life Insurance

Client 1 Initials:

Client 2 Initials:

Policy #4olicy #4olicy #4 Policy #5olicy #5olicy #5 Policy #6olicy #6olicy #6Insurer / Product

Policy Owner Client 1/ Client 2 / Other Client 1/ Client 2 /Other Client 1/ Client 2/Other

Life Insured Client 1/ Client 2 Client 1/ Client 2 Client 1/ Client 2

Cover Type Life / TPD / Trauma /

Income Protection


Income Protection


Income Protection

Cover Amount $ $ $

Premium $ $ $


20/2420

Objectives1. I/we wish to retire at age

2. I/we wish to achieve a net income of $ per annum (in todays dollars) in

order to meet my normal living expenses

3. I/we wish to achieve a net income of $ per annum (in todays dollars) in

retirement in order to meet your normal living expenses

4. I/we wish to ensure I retain an ongoing cash reserve of at least $ to meet any larger or

emergency expenditures

I/we wish ensure that sufficient funds are retained to meet the following planned

expenditures

Will ex-

ists? Provision for a

testamentary trust

Scope of Advice

Full Adviceor

Limited Scope (tick areas for advice) Wealth Creation Retirement Planning Superannuation Consolidation Personal Protection Estate Planning Business Planning Other: please specify

Attorney Type

Date

Attorneys Name

Tgs

Obeve&

Item Date Value / / $

/ / $

/ / $


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Tgs

Obeve&

TargetsTick any that apply to you You require a review of your existing investing portfolio to ensure it is appropriate to your needs and is well

positioned to meet your objectives. You wish to minimise your ongoing income tax liability You wish to build your wealth within the superannuation environment for retirement

planning purposes You wish to reduce your level of non-deductible debt You wish to maximise your entitlement to Government income support You wish to focus entirely on defensive investments To focus extensively on income investments, but with a minor exposure to growth

investments To focus on a balance between income investments and growth investments, with an

emphasis on income investments To focus extensively on growth investments, but with a minor exposure to income

investments To focus entirely on growth investments You wish to ensure your investments are administered efficiently, taking advantage of the skills of

professional investment managers You wish to ensure you have appropriate risk management and insurance strategies in place to protect

your personal and general assets from unforeseen events You wish to ensure you have appropriate estate planning strategies in place, incorporating Wills and

Powers of Attorney


testamentary trust

Client Partner

Attorney Type

Date

Attorneys Name

Relationship

Client 1 Initials:

Client 2 Initials:


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Dagams

Ne&

Notes & Diagrams


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Financial Services Guide (FSG)

By signing the declaration below, you acknowledge receipt of the Financial Services Guide (FSG) of FinancialSpectrum and the Adviser Profile of the Adviser/s to whom you have been assigned.

Privacy

Financial Spectrum is committed to ensuring the privacy and security of your personal information in

accordance with the principles of the Privacy Amendment (Private Sector) Act 2001 (Privacy Act). As required

under the Privacy Act, we have provided you with a copy of our Privacy Statement which outlines our

information management practices. If you have any questions, please ask your adviser.

Tax File NumberBy signing the following declaration, you are authorising Financial Spectrum to use and disclose your Tax File

Number/s only to fund managers, life insurance companies, and banking service providers as relevant for the

purpose of the provision of financial services in accordance with legislative requirements.

DeclarationI/We acknowledge the information provided in this fact find is a true and accurate record and will be used, along

with any applicable additional information provided by me/us, to prepare advice on my/our agreed needs and

objectives. I/We understand that any services or recommendations provided, on the basis of partial or

incomplete completion may be inappropriate to my/our needs. I/We appreciate that I/we may lose the right toseek compensation from the representative or the principal for any loss suffered by me/us as a consequence of

incomplete or inaccurate information being provided. Where it is required, I/we give permission for our Tax File

Number/s to be retained on our file. All information collected by Financial Spectrum will be kept private and

confidential in accordance with our privacy policy.

..

Office use only

Dsoe

Daao&

FSG Provided Date: / / Version:

Signed Signed

Name Name

Date / / Date / /

Signed

Adviser Name

Date / /

Declaration & Disclosure


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Contacting Financial SpectrumYou can contact Financial Spectrum by:

Calling 02 8238 0888 9am6pm Monday to Friday;

Visiting our website at www.financialspectrum.com.au

Writing to us at:

Financial Spectrum Pty Ltd

GPO Box 4812

Sydney NSW 2001

Sending us an e-mail at [email protected]

Sending us a fax at 02 8238 0808

Personal Client Profile

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