KiwiSaver Scheme Worksheet
The information you provide in this worksheet will enable me to prepare a KiwiSaver Scheme plan for you. (All information provided is confidential)
Title: Mr, Mrs, Ms, Miss, Dr
Personal Details: Full Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
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Employer
Occupation
Annual Salary/Wages (pre tax)
IRD Number
ie TAX RATE: 10.5% | 17.5% | 28% Unsure
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KiwiSaver Scheme Requirements
I am saving for my first home: Yes/No
I anticipate buying my first home in how many years
Expect that I will spend $ towards a home loan
I own my own home: Yes/No
I am interest in KiwiSaver scheme as a retirement savings plan. Yes/No
I already have a KiwiSaver Scheme investment and would like you to review it: Yes/No
Name of Existing KiwiSaver Scheme
Approx Value of KiwiSaver Scheme
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I have other savings for my retirement
Name of Investment Providers
Approx Value of investments
There are lifestyle factors which may influence my investment decision (such as an intention to live overseas or health concerns).
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CONTRIBUTIONS
will contribute (% of salary) to my KiwiSaver Scheme: 3% | 4% | 6% | 8% |10%
My employer contributes (% of salary) to my KiwiSaver Scheme: 3% | other %
I wish to make an additional regular contribution of $ weekly | fortnightly | monthly
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Risk Profile
What type of investor are you.
Complete a Risk Profile: YES/No
If No, please complete the attached Risk Profile
File Upload
Browse Files
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I am interested in a KiwiSaver Scheme where the mix of my investments is automatically adjusted as I move closer to retirement to ensure that my investment is always structured in keeping with my investment horizon. Yes/No
Client Acknowledgements
I confirm that the information provided in this worksheet is, to the best of my knowledge, accurate, complete, and correct. I understand this information will form the basis of the KiwiSaver Scheme plan you will prepare for me.
Signature
Date:
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please verify that you are human
*
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