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.

inner-logo

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

logo

inner-logo

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

logo

Get notified about the latest
News and Resources