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Date :

Date

Client 1 Full Name*

Client 1 Date of Birth*

Date

Client 1 Age*

Client 1 Martial Status*

Are you an Australian Resident?*

YesNo

Client 2 Full Name

Client 2 Date of Birth

Date

Client 2 Age

Client 2 Martial Status*

Are you an Australian Resident?

YesNo

Home Address*

Street Address

Street Address Line 2

SuburbState

Post Code

Are you renting through*

Real Estate AgentPrivatelyOther

How long have you been renting? (whether at 1 or more properties)*

6 months12 monthsOther

How much rent are you paying per week?*

$ Rent paid per week

Have you ever owned a home?*

YesNo

Have you had personal savings for more that 3 months?*

YesNo

If "yes", what is your combined savings?

$

Home Phone Number

Client 1 Mobile*

Client 2 Mobile

Client 1 Email

example@example.com

Client 2 Email

example@example.com

Preferred person to contact*

Number, name and age of children*

Personal Information

Client 1 Employment

Client 2 Employment

Assets

Liabilities

Superannuation

Self-Managed Superannuation Fund (SMSF)

Insurance