Personal Financial Planning Fact Find Form

Client/s *

Advisor *

Date *

Page 1

PERSONAL DETAILS

Page 2

FINANCIAL CIRCUMSTANCES

Income and Expenditure

Page 3

Do you have any, or other financial dependants? Yes No

Have you made a will? Yes No

If so, what are it's main provisions?

Are your circumstances likely to change in the forseeable future?

Page 4

Mortgage Yes No

Protection and Insurance Yes No

Inheritance Tax Planning Yes No

Pension Planning Yes No

Savings and Investment Yes No

Page 5

Loan Amount

Term

Method of repayment? Interest Only Repayment

Single or Joint names? Single Joint

Sum Assured

Term

Policy type? Level Decreasing Term

Life/Lives Assured First Client Second Client Joint

Cover provided? Life Only Life and Critical Illness

Additional Benefits? Waiver Other

Sum Assured?

Term?

Required policy type? Level Decreasing Term

Life/Lives to be insured? First Client Second Client Joint

Cover required? Life Only Life and Critical Illness

Where CI not included? Cost Insurability Other

Additional Benefits? Waiver Other

Page 6

Family Protection

Required cover?

Reason for:- Cost Driven Client's Target Figure Other

Notes

Reason for: Dependancy youngest child To retirement Other

Notes

Notes

Policy Type: Level Renewable Term Other

Lives to be insured: First Client Second Client Joint

Notes

Type of cover required? Life only Life or Critical Illness Life and Critical Illness

Where Critical Illness not included: Cost Insurability Other

Notes

Additional Benefits: Waiver Other

Notes

Page 7

Personal Cover (Critical Illness)

Required cover?

Reason for: Dependancy youngest child To retirement Other

Notes

Term

Reason for: Cost Driven To retirement Other

Notes

Policy Type: Level Renewable Term Other

Notes

Life/Lives to be insured: First Client Second Client Joint

Notes

Type of cover required? Life only Life or Critical Illness Life and Critical Illness

Where CI not included? Cost Insurability Other

Notes

Additional Benefits: PTD Waiver Other

Notes

Page 8

Company Benefit SSP Only Self-employed Details Below

Notes

Period of cover? 1 Month 3 Months Other

Notes

Percentage of income 100% 50% Other

Notes

Deferred Period?

Reason for:- Dependancy youngest child To retirement Other

Notes

Benefit?

Reason for:- Dependancy youngest child To retirement Other

Notes

Term?

Reason for:- Dependancy youngest child To retirement Other

Notes

Page 9

Value of estate?

Nil Rate Band

Estate Subject to IHT

Potential Liability

Notes

Page 10

Pension Planning

Are you a member of your employers pension scheme? Yes No

Are you currently ineligible to join your employer's company pension scheme? Yes No

If yes, what are the conditions for eligibility?

Have you previously chosen not to join your company pension scheme? Yes No

Type of scheme? Final Salary Money Purchase Scheme Group Personal Pension

Date of joining the scheme?

Scheme Retirement Age

Personal Contributions

Additional Voluntary Contributions

Employer Contributions

Accrual Rate (e.g. 80ths/60ths)

Widow/Widower's death in retirement benefits?

Does the scheme allow early/late retirement?

Expected number of years of pensionable service?

Are you contracted out of SERPS? Yes No

Do you have pension benefits accrued from a former employer?

Page 11

Existing Arrangements Personal

How many personal cover plans do you have? 1 2 3

Page 12

What is your expected retirement age?

Could this be delayed in the event of adverse investment conditions? Yes No

Do you want to target a specified pension fund or income at retirement? Fund Income

If so, what is it?

Do you anticipate taking the maximum tax-free cash sum at retirement? Yes No

What do you expect your tax rate to be at retirement? Starting Basic Higher

Do you have any ethical, social or environmental concerns? Yes No

Contributions Regular Single Transfer

Regular Single Contribution?

Reason for:- Dependancy youngest child To retirement Other

Notes

Transfer

Source Final Salary Scheme Money Purchase Company Scheme Personal Pension Scheme

Notes

Page 13

How much do you wish to save each month/year?

When do you need this money or for how long do you want to save?

Are you saving for a specific purpose? Yes No

If yes, please state:-

Is there a target amount of capital you wish to achieve? Yes No

If so, what is it?

In the event of adverse investment conditions could you accomodate a situation where your objectives are not met within the expected timescale? Yes No

What is your anticipated tax rate at maturity? Starting Basic Higher

Do you have any ethical, social or environmental concerns? Yes No

How much do you have to invest?

Are you saving for a specific purpose? Yes No

If yes, please state:-

For how long do you want to invest this money?

Could this be extended in the event of adverse investment conditions? Yes No

Is there a target amount you wish to achieve? Yes No

If so, what is it?

In the event of adverse investment conditions could you accomodate a situation where your objectives are not met within the expected timescale? Yes No

What is your anticipated tax rate at maturity? Starting Basic Higher

Do you have any ethical, social or environmental concerns? Yes No

Page 14

How much do you have to invest?

For how long do you want to invest this money?

Do you require a specifie amount of income (net of tax)? Pounds or percentage.

Could you afford a lower amount in the event of adverse investment conditions? Yes No

Do you have any cash/liquid reserves you could draw upon under such circumstances? Yes No

What is your anticipated tax rate at maturity? Starting Basic Higher

Do you have any ethical, social or environmental concerns? Yes No

Page 15

Details

Page 16

Details

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- Andrew Hope