Co Branded Authority Form

Expert Wealth Pty Ltd
ABN 79 634 625 406 AFSL 538287
P 02 9061 7172 E team@expertwealth.com.au
A Level 3/87-89 Foveaux St Surry Hills NSW 2010

To whom it may concern,

I authorise Expert Wealth to access all my policies to complete a complimentary review, and assist in maximising my tax deduction (where applicable)
I authorise your company to change my existing Adviser to my new Expert Wealth Adviser for ALL policies held.

Full name*

First NameLast Name

Date of Birth*

DayMonthYear

Who is your Expert Wealth Financial Adviser*

Address*

Street Address

SuburbState

Postcode

Email*

example@example.com

Mobile*

Insurance

Insurance Policy # (if known)

Super

Policy # (if known)

Other policies (if not listed)

I understand and accept the following:

My new Expert Wealth Financial Adviser will have access to my information in order to conduct a review.
My existing Adviser will no longer have access to my information and will not be responsible or remunerated for advising me in relation to my policy/s and/or investment/s.
My new Expert Wealth Adviser will be responsible and remunerated, for advising me in relation to my policy/s and/or investment/s.
If the client is within the responsibility period, please provide Authority to Access only, and not a change the adviser.
I authorise any personal or medical information to be supplied to or by my financial adviser, to any insurer, medical or 3rd party organisation for the purpose of providing insurance recommendations.
I have been provided with the following important documents
- Financial Services Guide (FSG) V 2.0.
- Privacy policy.
- Privacy Collection Statement.

To help us, please select which files you will be uploading

Drivers licencePolicy statements if available (e.g. Insurance, Super, Home loan)

Office Use Only: Adviser Code/s

Adviser code/s Paris Bisley

Financial Adviser: Paris Bisley of Expert Wealth 538287 ASIC Number 410462 paris@expertwealth.com.au 02 9061 7172&#13;&#10;ALL SUPPORT STAFF AT EXPERT WEALTH Including but not limited to: Vasmita Nathu, Keten Umaraliya

Adviser code/s William Hurst

Financial Adviser: William Hurst of Expert Wealth 538287 ASIC Number 404043 will@expertwealth.com.au 02 9061 7172&#13;&#10;ALL SUPPORT STAFF AT EXPERT WEALTH Including but not limited to: Vasmita Nathu, Keten Umaraliya

Adviser code/s Daniella Roovers

Financial Adviser: Daniella Roovers of Expert Wealth 538287 ASIC Number  263291 daniella@expertwealth.com.au 07 3667 7669&#13;&#10;ALL SUPPORT STAFF AT EXPERT WEALTH Including but not limited to: Vasmita Nathu, Keten Umaraliya

Adviser code/s Lisa Barber

Financial Adviser: Lisa Barber of Expert Wealth 538287 ASIC Number  247688 lisa@expertwealth.com.au 02 7252 2455&#13;&#10;ALL SUPPORT STAFF AT EXPERT WEALTH Including but not limited to: Vasmita Nathu, Keten Umaraliya

Existing policy upload

Full name*

First NameLast Name

Date

Authority to access info and new adviser