The Advice Hub Application Form

The Advice Hub

Financial Advice Fact Find
Who we are

The Advice Hub was founded in 2017 and was built on the premise of bringing accessibility to financial services and advice to everyday kiwis and their families. We pride ourselves on our long-standing client relationships which have been built through transparency, ethical decision-making, and professionalism.
What we do

The Advice Hub has a team of financial advisers specialised in providing advice on and the implementation and management of solutions in wealth management, personal insurance and lending advice.
Privacy
Confidentiality & Storage

The information you supply in the following pages is personal and will be kept and stored securely by the Adviser and The Advice Hub Ltd
Purpose

An Adviser making a financial recommendation must have a reasonable basis for making that recommendation. That means that the Adviser must conduct an appropriate investigation as to the financial goals, financial situation and particular needs of the person/s concerned, and any recommendations must take these into account. The information requested in these documents is sought to enable recommendations to be made on a reasonable basis, and will be used for that purpose. Although you are free to elect products yourself, it is strongly advised that you give full and complete information to enable provision of a suitable recommendation. The information will be retained by the Adviser, the practice The Advice Hub Ltd, in order to provide an on-going service to you and to comply with New Zealand regulations.
Warning

If you do not provide part or all of the information requested, it may not be possible to fully assess your financial needs and objectives. This may result in you receiving inadequate advice or financially committing yourself to a product that may not be appropriate to your needs and/or circumstances.
Access

You have the right under the Privacy Act 2020 to request access to and correction of any personal information about you held by the Adviser.
Please select your adviser

Personal Details
How many people are looking to apply? (note, if more than 2, please fill out one a new form for every two applicants)

123Other
Client 1

	Client 1
First Name
Last Name
Preferred Name
Date of Birth
Email
Mobile Number
Country of Birth
NZ Residency Status
Marital status

Photo ID

Please upload a copy of either: Your passport (photo page and signature page along with visa page if applicable) or your driver licence (front and back)
Cancelof
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at this address?
Employment (if applying for lending, please provide 3 years' history)
Client 2

	Client 2
First Name
Last Name
Preferred Name
Date of Birth
Email
Mobile Number
Country of Birth
NZ Residency Status
IRD Number
Marital Status
Relationship to Client 1

Photo ID

Please upload a copy of either: Your passport (photo page and signature page along with visa page if applicable) or your driver licence (front and back)
Cancelof
Address - If applying for lending, please provide 3 years' history
Employment (if applying for lending, please provide 3 years' history)
Children/Dependants

Expenses

At the end of each pay cycle, do you have money left over?

YesNo
How much are you over or under by?
Frequency
Notes

Assets & Liabilities

Assets
Do you own residential or commercial property?

YesNo
Property Assets
Property Manager
Name & contact details
Are your properties "Healthy Homes Certified"?
Non-Property Assets
KiwiSaver
Liabilities
Do you have a mortgage?

YesNo
Mortgages
Do you have any other debts (Credit Cards, Overdrafts, Personal or vehicle loans, BNPLs

YesNo
Non-mortgage debts
Notes

Financial Planning

Estate Questions


Do you have a Will?
Does you Will suit your current situation?
Who holds a copy of the will?
Are there likely to be will disputes in your family?
Have you granted someone 'Power of Attorney' (PoA)?
If yes, who is your PoA?

Client 2 - Estate Questions


Do you have a Will?
Does you Will suit your current situation?
Who holds a copy of the will?
Are there likely to be will disputes in your family?
Have you granted someone 'Power of Attorney' (PoA)?
If yes, who is your PoA?

Your Professional Team

	Name	Email	Mobile
Accountant
Solicitor
Mortgage Broker
Property Manager
Realtor
Other

Client Declaration
I/We acknowledge I/we have read and understood the information relating to the Privacy Act 2020 and how my/our information may be used.

I/We understand the services being provided are restricted to the scope of service or subject to specific limitations indicated on the scope of service page.

I/We confirm that once the planning process is complete, I/we am/are happy for the Adviser to obtain non-obligatory estimates, quotes and/or pre-approvals on my/our behalf.

I/we give permission for the Adviser to approach product providers for an indicative approval and quote.

I/we give permission for the Adviser to pass on our personal details to the referrals selected.

I/We declare that the information provided by me/us to the named Adviser in all the documents attached to this Declaration is to the best of my/our knowledge accurate.

I/We further understand that implementation of any recommendations will be subject to my/our acceptance of the terms offered and completion of the required application forms.

I/We wish to proceed with the construction of a financial plan based on the following information disclosed by us.

I hereby authorise all companies to transfer or release any and all account or product information to The Advice Hub Ltd on request, and to give them any information which will help them advise me in any future financial planning I may be contemplating, until such time as I cancel this authority, in writing.

By signing this client authority below I/we agree to the terms and confirm my/our consent to the use of the information by the Adviser for the purposes of advising on my/our present and future financial planning requirements.
I've received a copy of my adviser's disclosure statement*

YesNo
Date

DayMonthYear
Date
Client 1 Signature

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Date

DayMonthYear
Date
Co-signer's Signature

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Should be Empty:

	Amount ($)	Frequency
Rent (Now)
Rent (Future)
Body Corpoate
Owner-Occupied Rates
Investment Rates

	Amount ($)	Frequency
Health & Medical Care
House & Contents Ins.
Invesment Property Ins.
Vehicle Ins.
Health/Medical/Funeral/Pet Ins.
Life & Risk Ins.

	Amount ($)	Frequency
Utilities
Groceries
Childcare
Child Support/Maintenance
Personal Care & Clothing
Education
Transport

	Amount ($)	Frequency
Additional KiwiSaver
Entertainment & Recreation
Tithing/Donations
Pets/Animals

	Yes	No
High Blood Pressure
Abnormal or high cholesteral
Respiratory or breathing disorder (asthma, lung disorder, bronchitis, etc.)
Cancer, tumour or abnormal PAP/cervical smears
Mental health condition (including depression)
Any ongoing musculoskeletal issues
Any other perceived medical isues

The Advice Hub

Who we are

What we do

Privacy

Confidentiality & Storage

Purpose

Warning

Access

Scope of Service

Goals and Objectives to plan

Personal Details

Client 1

Client 2

Income

Expenses

Assets & Liabilities

Liabilities

Insurance

Client 1

Client 2

Existing Cover

Financial Planning

Client Declaration

	Yes	No
Have you ever been to hospital for an operation or treament?
Are you taking any medication

	Yes	No
Cancer
Stroke
Heart Disease
Diabetes Type I
Diabetes Type II
mental health Condition (Including Depression)
Multiple Sclerosis

	Yes	No
Abseiling
Aviation
Competitive boxing
Equestrian
Hang gliding
Scuba diving (over 30m or solo)
Motor racing
Parachuting
Skydiving
Power boat racing
Mountaineering
Competitive martial arts
Voluntary firefighting

	Sum Insured	Provider	Policy Number
Life Insurance
Trauma Cover
Total Disability Cover
Income Protection (Monthly Benefit)
Health Insurance