Client Fact Find
For Pensions, Investments or Protection Advice
Applicant 1 - Personal Details
All of the information is kept in strict confidence and is used to determine your personal needs and requirements so that we can provide you with a personalised financial plan.
What is your current residential status?
Owner
Living with Parents
Tenant
Other
Full Name
*
Mr.
Mrs.
Ms.
Prefix
First Name
Middle Name
Last Name
Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Current Address
*
Street Address
Street Address Line 2
City
County
Postcode
How many years have you lived at this address?
*
Previous Address
*
Street Address
Street Address Line 2
City
County
Postcode
Mobile Number
E-mail
*
example@example.com
National Insurance Number (NI)
Are you a smoker?
Yes
No
Relationship Status
*
Single
Married
Living with my Partner
Dependants
Name
Surname
Date of birth
Child 1
Child 2
Child 3
Child 4
Additional Information:
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Applicant 1 - Employment & Self Employment Details
Employment
*
Employed
Self Employed
Zero hours Contract
Unemployed
Job Title
*
Employer Name & Address (Head Office)
*
Employer Name
Building and Street name
City
County
Postcode
Work Telephone Number
Employment Start Date (estimate):
*
-
Day
-
Month
Year
Date
Salary per year (before Tax)
*
Hourly Rate
Please provide your last 3 months payslips (Upload File)
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Self Employment
Sole Trader
Limited Company
Partnership
How many years have you been trading?
Please provide your SA302 Accounts and Tax Overviews for the past 2years. (Upload File)
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Other Monthly Income
Amount per month
Personal Independence Payment (PIP/DLA)
Child Benefit
Pension Credit
Universal Credit
Child Maintenance
Other
Please provide a copy of your Benefit entitlement letters from the Department of Work and Pensions (DWP) - All pages must be uploaded. (Upload file)
Browse Files
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of
Credit Agreements
*
Outstanding Balance
Repayment (per month)
Credit Card 1
Credit Card 2
Credit Card 3
Credit Card 4
Credit Card 5
Credit Card 6
Loan 1
Loan 2
Loan 3
Loan 4
Car loan
Other
CCjs
IVA
Have you ever been declared Bankrupt?
*
Yes
No
Additional Information:
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Applicant 2 - Personal Details
All of the information is kept in strict confidence and is used to determine your personal needs and requirements so that we can provide you with a personalised financial plan.
What is your current residential status?
Owner
Living with Parents
Tenant
Other
Full Name
Mr.
Mrs.
Ms.
Prefix
First Name
Middle Name
Last Name
Date of Birth
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Address
I live at the same Address as Applicant 1
I live at a different Address
Current Address
Street Address
Street Address Line 2
City
County
Postcode
How many years have you lived at this address?
Previous Address
Street Address
Street Address Line 2
City
County
Postcode
Mobile Number
E-mail
example@example.com
National Insurance Number (NI)
Are you a smoker?
Yes
No
Dependants
Name
Surname
Date of birth
Child 1
Child 2
Child 3
Child 4
Additional Information:
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Applicant 2 - Employment & Self Employment Details
Employment
Employed
Self Employed
Zero hours Contract
Unemployed
Job Title
Workplace Address (Head Office)
Street Address
Street Address Line 2
City
County
Postcode
Work Telephone Number
Employment Start Date (estimate):
-
Day
-
Month
Year
Date
Salary per year (before tax)
Hourly Rate
Please provide your last 3 months payslips (Upload File)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Self Employment
Sole Trader
Limited Company
Partnership
How many years have you been trading?
Please provide your SA302 Accounts and Tax Overviews for the past 2years. (Upload File)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Other Monthly Income
Amount per month
Personal Independence Payment (PIP/DLA)
Child Benefit
Pension Credit
Universal Credit
Child Maintenance
Other
Please provide a copy of your Benefit entitlement letters from the Department of Work and Pensions (DWP) - All pages must be uploaded. (Upload file)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Credit Agreements
Outstanding Balance
Repayment (per month)
Credit Card 1
Credit Card 2
Credit Card 3
Credit Card 4
Credit Card 5
Credit Card 6
Loan 1
Loan 2
Loan 3
Loan 4
Car loan
Other
CCJs
IVA
Have you ever been declared Bankrupt?
Yes
No
Additional Information:
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Affordability
Household Bills (per month)
*
Applicant 1
Applicant 2
Mortgage/Rent
Buildings and Contents Insurance
Gas/Electric/Fuel
Water rates
Council Tax
Ground Rent / Service Charge
Household maintenance & Cleaning
Tv License and Subscriptions
Telephone (Fixed & Mobile)
Other
Car & Travel expenses (per month)
*
Applicant 1
Applicant 2
Car Insurance
Road Tax
Servicing and Repairs
Petrol & Travel (tolls, parking etc)
Other
Other regular outgoings (per month)
*
Applicant 1
Applicant 2
Payments to Savings account
Clothing
Entertainment
Holidays
Food and Living costs
Childcare & School fees
Subscriptions
Other
Please provide the latest 3 months Bank statements (Upload file)
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Additional Information:
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Existing Mortgage Details
What is the value of your current property?
*
*
Applicant 1
Applicant 2 (if applicable)
Current Lender
Account Number
Amount of loan oustanding
Remaining Years left on the term
Repayment Type
Repayment
Interest Only
Interest Rate Type
Fixed
Variable
Capped
Discount
Current Interest Rate %
Any additional funds? If yes, how much?
Please provide your most recent Mortgage Statement (Upload File)
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Future Planning
Protection - Life and Critical Illness Cover
Policy 1
Policy 2
Policy 3
Policy 4
Client Name
Type (Life or CIC)
Structure (decreasing or Level)
Provider
Sum Assured
Premium
Start Date
End Date
Purpose
Indexation?
WOC
Reviewable or Guaranteed
Estimated Maturity
Value
Additional Information
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Income Protection / ASU
Policy 1
Policy 2
Policy 3
Policy 4
Client Name
Type (IRP / ASU)
Provider
Monthly Benefit
Premium
Start Date
Term / To Age
Deferment Period
Indexation?
WOC
Reviewable or Guaranteed
Value
Additional Information:
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Assets
Applicant 1
Applicant 2
Joint
Home (£)
Other Property (£)
Cars (£)
Cash Deposit (£)
Emergency Fund (£)
Other (£)
Assets continued - Savings
Applicant 1
Applicant 2
Joint
Type
Purpose
Provider
Premium
P.M / P.A
Current Value
Interest Rate
Maturity Date
Investments
Applicant 1
Applicant 2
Joint
Type
Purpose
Provider
Current Value
Amount Invested
Date Invested
Regular Contributions
Maturity Date
Additional Information:
Pensions - Personal or Company
Policy 1
Policy 2
Policy 3
Policy 4
Client Name
Provider
Types (SERPS) etc
Basis of Benefit
Contribution
Frequency
Employer Contribution?
Retirement Age
Fund Value
Transfer Value
W.O.C
Start Date
End Date
Projected Retirement Value
Eligible for Co Pension
Indexed?
Additional Information:
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In the Event of Death / Critical Illness
Applicant 1
Applicant 2
Client Name
Reason Mortgage / Family / IHT
Life Cover Amount
CIC Amount
L/C stay same or reduce
Structure DTA/Level/WOL
Term
Guaranteed / Reviewable
WOC
Lump Sum or Income
TPD?
Additional Information:
In the Event of Sickness
Type ASU/PHI/Unem
Benefit Required
WOC
Level/RPI/%
Defer Period
To Age
Guaranteed / Reviewable
Applicant 1
Applicant 2
Retirement Planning
What Age do you wish to retire?
What level of income required in Retirement?
What is your estimated Pension
What is the shortfall?
Applicant 1
Applicant 2
Investment Planning
Solution 1
Solution 2
Solution 3
Solution 4
Client Name
How much do you wish to invest?
How long are you prepared to invest for?
Do you need to generate income from your investment?
When is income required?
What amount of income required P.A?
Do you wish to invest in a specific type of fund?
Additional Information:
Savings
Applicant 1
Applicant 2
How much do you wish to save a regular amount?
Is there a specific purpose you are saving for?
What amount will you require?
When will you require this money?
How much do you wish to save?
Do you want savings protected?
Additional Information:
Do you have a will?
Yes
No
If yes, when was it last reviewed ?
Do you have any further information you would like to provide?
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