PALM BEACH – BURLEIGH HEADS – NORTHERN RIVERS – INVERELL

  • ABOUT YOU
  • CONTACT INFORMATION
  • DEPENDANTS
  • EMPLOYMENT
  • INCOME/EXPENSES
  • ASSETS & LIABILITIES
  • Superannuation
  • PERSONAL INSURANCE

ABOUT YOU

Adviser: Steven James Ellis

Authorised Representative No: 229892

FSG Version: V20200101

Date FSG provided:

FOR YOUR INFORMATION Privacy Policy: At Lifespan Financial Planning we recognise that your privacy is very important. Our business is governed by legislation protecting your personal information, including the Privacy Act 1988 and National Privacy Principles established under the Privacy Amendment (Private Sector) Act 2000. We have adopted the Privacy Policy developed by Lifespan Financial Planning a copy of which is on our website or available upon request. Important Notice to Clients: Corporations Law requires that in order to make an investment or insurance recommendation, the adviser must have reasonable grounds for making a recommendation. This means that the adviser must conduct an appropriate investigation as to the investment objectives, financial situation and particular needs of the person concerned. The information requested in this form is necessary to enable a recommendation to be made on a reasonable basis and will be used for that purpose

Title

Marital Status

Gender

Current Health

Have You Every Smoked?

Contact Information

Preferred Mail Method

Preferred Communication Methond

DEPENDANTS

DEPENDANTS

Financially Dependent?

Financially Dependant?

Financially Dependant

Do you expect to continue to financially assist your non-dependant children?

Do any of your dependants suffer from illness or disability?

EMPLOYMENT

Are you degree qualified?

INCOME/EXPENSES

ASSETS

Primary Residence

Investment Property

House Contents - own

Car-own

Liabilities

Fixed/variable

Fixed/variable

Superannuation

PERSONAL INSURANCE

Life, TPD and Trauma

INCOME PROTECTION