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  • Fact find

  • Are you a new or existing client?
  • Gender*
  • Format: 0000 000 000.
  • Relationship status*
  • Would you like to include your partner on this advice?*
  • Gender*
  • Format: 0000 000 000.
  • First dependent relationship
  • Second dependent relationship
  • Third dependent relationship
  • Fourth dependent relationship
  • Fifth dependent relationship

  • Packages

  • Fees listed above are upfront advice fees and are based on time, complexity and value added. Additional fees may apply (ie admin, implementation, additional services not listed etc) and be will included in your statement of advice for your approval prior to implementing.

  • Please Select One
  • Would you like to include Insurance?
  • Is an SMSF being considered in this advice?
  • Insurance - Areas of importance
  • Timeframe to achieve
  • Superannuation - Areas of importance
  • Timeframe to achieve
  • Wealth - Areas of Importance
  • Timeframe to achieve
  • Desired level of income per year to cover your lifestyle in retirement
  • Retirement - Areas of importance
  • Timeframe to achieve
  • SMSF - Areas of importance
  • Timeframe to achieve
  • Client 1 Gross income excl super*
  • Client 1 Qualifications
  • Client 2 Gross income excl super*
  • Client 2 Qualifications
  • Trustee
  • Superfund value*
  • Are you putting extra into super
  • How much extra per year?
  • Trustee
  • Superfund value*
  • Are you putting extra into super
  • How much extra per year?

  • Budgeting and Cashflow

  • Estimated monthly expenses (excl mortgage/rent)
  • Estimated monthly surplus *
  • Cash in the bank
  • Home situation*
  • Current rent
  • Home value
  • Mortgage value
  • Current mortgage repayment
  • IO or P and I
  • Variable or Fixed
  • Investment property value
  • Mortgage value
  • Current mortgage repayment
  • Rental income
  • IO or P and I
  • Variable or Fixed
  • Investment property value
  • Mortgage value
  • Current mortgage repayment
  • Rental income
  • IO or P and I
  • Variable or Fixed
  • Investment property value
  • Mortgage value
  • Current mortgage repayment
  • Rental income
  • IO or P and I
  • Variable or Fixed
  • Investment property value
  • Mortgage value
  • Current mortgage repayment
  • Rental income
  • IO or P and I
  • Variable or Fixed
  • Investment property value
  • Mortgage value
  • Current mortgage repayment
  • Rental income
  • IO or P and I
  • Variable or Fixed

  • Other Assets

  • Motor vehicles
  • Value*
  • Caravan/boat
  • Value*
  • Share portfolio
  • Value*
  • Managed fund
  • Value*
  • Term deposits
  • Value*
  • Other?
  • Value*

  • Other Liabilities

  • Credit card
  • Value*
  • Personal loan
  • Value*
  • Car loan
  • Value*
  • Other?
  • Value*

  • Insurance (including inside Super)

  • Client 1 Do you hold any Life Insurance? (Incl TPD, IP or Trauma)
  • Life cover
  • Disability
  • Trauma
  • Income protection (per month)
  • Do you have a valid Will?
  • Do you have a valid Power of Attorney (POA)?
  • Do you have Guardianships in place?
  • Client 2 Do you hold any Life Insurance? (Incl TPD, IP or Trauma)
  • Life cover
  • Disability
  • Trauma
  • Income protection (per month)
  • Do you have a valid Will?
  • Do you have a valid Power of Attorney (POA)?
  • Do you have Guardianships in place?
  • Client 1 Height (cm)*
  • Client 1 Weight (kg)*
  • Smoker?*
  • Do you have private health insurance?
  • Have you ever had or been treated for any of the following? (you can select more than one)*
  • Do you have any current health issue/s that you're seeing a doctor about, not listed above?*
  • Are you taking and medications/treatment*
  • Have you ever had an application for insurances refused, deferred or an offered with an increased premium, exclusion or restriction?*
  • Client 2 Height (cm)*
  • Client 2 Weight (kg)*
  • Smoker?*
  • Do you have private health insurance?
  • Have you ever had or been treated for any of the following? (you can select more than one)*
  • Do you have any current health issue/s that you're seeing a doctor about, not listed above?*
  • Are you taking and medications/treatment*
  • Have you ever had an application for insurances refused, deferred or an offered with an increased premium, exclusion or restriction?*

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  • Client Engagement and acknowledgement

    I understand and accept the following:

    • I/We agree to the Client Acknowledgement Terms and Conditions
    • I/We have been provided Financial Services Guide (FSG) V 2.0 the Privacy policy and the Privacy Collection Statement
    • I/We understand that my tax file number is collected under the terms of the Privacy (Tax File Number) Rule 2015 Privacy Collection Statement(TFN Rule) issued under s17 of Privacy Act 1988
  • I/we agree to the preparation of a Statement of Advice covering the following areas:*
  • Client 1 Signature*
  • Submission date
     - -
    2 digit day, 2 digit month, 4 digit year

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

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