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Review Questionnaire
Client 1:
Client 2:
Adviser Name:
Date Completed:
Private and confidential.
Your Details
Client 1
Client 2
Title
Select
Mr
Mrs
Ms
Miss
Master
Dr
Select
Mr
Mrs
Ms
Miss
Master
Dr
Given Name(s)
Preferred Name
Surname
Date of Birth
Home Address
Business Address
Address of Correspondence
Home Phone
Work Phone
Mobile Phone
Fax
Email Address
Other
Preferred Method of Contact
Select
Work
Mobile
Email
Select
Work
Mobile
Email
Employment
Client 1
Client 2
Occupation
Position
Employment Status
Select
Full Time
Part Time
Casual
Contract
Self-Employed
Permanent Part-Time
Select
Full Time
Part Time
Casual
Contract
Self-Employed
Permanent Part-Time
Hours worked per week
Health Details
Client 1
Client 2
Health
Select
Poor
Average
Good
Excellent
Select
Poor
Average
Good
Excellent
Needs and Objectives
Details
Income
Income (p.a.)
Client 1 (p.a.)
Client 2 (p.a.)
Salary/Business Income
Rental Income
Share/Investment Income
Interest
Pension Income
Government Benefits
Trust Distributions
Workers Compensation
Total Income
Annual Expenses
Client 1 (p.a.)
Client 2 (p.a.)
Total Household Expenses
Loan Repayments
School Fees
Total Expenses
Your Lifestyle Assets
Type
Client 1 (p.a.)
Client 2 (p.a.)
Home
Contents
Vehicles
Your Investment Assets
Asset
Owner
Value
Investment Property
Shares
Managed Funds
Term Deposit
Cash
Your Liabilities
Type
Owner
Value
Home Loan
Investment Loan
Credit Card
Changes to your personal circumstances and finances
Have there been any changes in the last 12 months? Are there likely to be any changes in the next year or so?
Topics for discussion
Please list any topics, issues or concerns you would like to discuss with us during your annual review meeting.
Signatures
Client 1
Clear
Submit