Date
/
Day
/
Month
Year
Date
Initial Meeting Information
Name
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Last Name
Partner's Name
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Last Name
Preferred Name
Partner's Preferred Name
Date of Birth
/
Day
/
Month
Year
Date
Partner's Date of Birth
-
Day
-
Month
Year
Date
E-mail
example@example.com
Partner's E-mail
Gender
Male
Female
Partner's Gender
Male
Female
Relationship
Single
Married
Defacto
How did you find out about RetireInvest?
Health & Lifestyle
Health
Excellent
Good
Average
Poor
Partner's Health
Excellent
Good
Average
Poor
Employment
Employment Status
Full time
Part time
Casual
Unemployed
Retired
Partner's Employment Status
Full time
Part time
Casual
Unemployed
Retired
Any planned changes?
Contact Details
Home Phone Number
-
Area Code
Phone Number
Partner's Home Phone Number
-
Area Code
Phone Number
Mobile Phone Number
Partner's Mobile Phone Number
Residential Address
Postal Address
Same as Residential Address
Other
Family & Entities
Do you have any children
Yes
No
Are there any factors that need to be considered in relation to your children?
Do you have any other financial dependents?
Yes
No
Do you have or operate a trust, SMSF or private company?
Yes
No
Details on companies, trusts or SMSF (eg names, purpose, etc)
Assets & liabilities
Lifestyle Assets (Home, cars, boat, etc)
Investment Assets (Cash, shares, investment property, etc)
Superannuation & Pension Funds
Fund Name
Owner
Value $
Accum or Pension
Pension p.a.
Contributing to fund
1
Accum
Pension
Yes
No
2
Accum
Pension
Yes
No
3
Accum
Pension
Yes
No
4
Accum
Pension
Yes
No
5
Accum
Pension
Yes
No
6
Accum
Pension
Yes
No
Liabilities (Loans)
Description
Borrower
Amount
P&I or Interest only
Repayments p.a.
Interest Rate
1
P&I
Interest only
2
P&I
Interest only
3
P&I
Interest only
4
P&I
Interest only
Income (Salary, CentreLink, etc)
Owner
Description
Income pa
1
2
3
4
5
6
Total income (calculated from table)
What changes are expected in relation to income?
Expenses (Cost of living, Loan Payments, etc)
Owner
Descriptuon
Expense pa
1
2
3
4
5
6
What changes are expected in relation to expenses? If retiring, what income do you want to receive in retirement?
Insurance
Life Insurance
Life Insured
Type
In Super fund?
Cover
$
Premium p.a.
1
Death
TPD
Death & TPD
IP
Trauma
Yes
No
2
Death
TPD
Death & TPD
IP
Trauma
Yes
No
3
Death
TPD
Death & TPD
IP
Trauma
Yes
No
4
Death
TPD
Death & TPD
IP
Trauma
Yes
No
Heath Insurance
Yes
No
Partner's Heath Insurance
Yes
No
Estate Planning
Do you have?
Will
Yes
No
Partner's Will
Yes
No
Enduring Power of Attorney
Yes
No
Partner's Enduring Power of Attorney
Yes
No
Advanced health directive
Yes
No
Partner's Advanced health directive
Yes
No
Objectives
Short term objectives (0-12 months)?
Medium term objective (1 -3 years)?
Long term objective (3+ years)?
Areas you would like to discuss in the meeting?
Any other areas that are important to you?
Submit
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