Client Information Form

Mr/Mrs/Ms/Miss

Surname

Christian Name

Tax File Number

Date of Birth

Name

Tax File Number

ABN

Name

Tax File Number

ABN

Name

Tax File Number

ABN

Name

Tax File Number

ABN

Occupation/Business Activity

Postal Address

Residential Address

Phone

Work

Mobile

Fax

Email

Non-confidential Information
YesNo

Mr/Mrs/Ms/Miss

Surname

Christian Name

Phone

Email

Tax File Number

Date of Birth

Any Separate Income

Christian Name

Any Separate Income

Date of Birth

Christian Name

Any Separate Income

Date of Birth

Christian Name

Any Separate Income

Date of Birth

Christian Name

Any Separate Income

Date of Birth

Annual Income $

Life Insurance $ (If applicable)

Total & Permanent Disability $ (If Applicable)

Income Protection $ (If Applicable)

Tax & AccountingAnnual Financial StatementsIncome Tax Returns (& advice)ASIC compliance annual returnsData entry/bookkeepingPayroll servicesPreparation of BAS statementsPayroll TaxLand TaxBusiness AdviceAsset protection/CGT structure advice

Management AccountingInternal accounting softwareProcess reviewBusiness planningBudgeting & MonitoringPersonal Super/Retirement PlanningPersonal Financial Planning & InsurancesPersonal Investment AdvicePersonal Debt ReviewPersonal Goal Setting

Previous Accountant Name

Previous Accountant Phone Number

Financial Planner Name (If Applicable)

Financial Planner Phone Number

Solicitor Details (If Applicable)

Solicitor Phone Number

Insurance Broker Details (If Applicable)

Insurance Broker Phone Number

Name of Accounting Software

Do you have a Business Auskey?
YesNo

How did you hear about us?
ReferralWebsiteGoogleOther

If referred, by whom?

Reason for changing?

Do you have a Will in place?
YesNo

Dated

Where is it held?

Do you have a Power of Attorney in Place?
YesNo

Dated

Where is it held?

Please list any concerns that you have with your current situation that you would like to focus on?

Do you currently receive, or have you sought, financial planning advice before? If “Yes”, please describe your experience.

Briefly describe your past experience with investments (i.e., shares, managed funds, term deposits) and personal insurances (ie, life, TPD, trauma, income protection cover).

Are there any particular strategies, investments, fund managers or insurance companies you are particularly interested in or prefer to avoid?

Additional Information

Additional files