FINANCIAL PLANNING CLIENT FACT FIND FORM

FINANCIAL PLANNING FACT FIND FORM
with Paresh Joshi
Tell Us About You
All information is kept in strict confidence and is used to determine your personal needs and requirements so that we can provide you with a personalised financial plan.
Full Name*
First NameMiddle NameLast Name
Birth Date
MonthDayYear
Spouse's Name*
First NameMiddle NameLast Name
Spouse's Birth Date
MonthDayYear
Correspondence Address in UAE*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Mobile Number*
Residence Telephone Number*
Address in India*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Mobile Number in India
Passport Number*
Passport Expiry Date*
E-mail*
Occupation*
Nominee
What is your gross monthly income in AED ?*
What is your combined approximate savings per month ?*
What is your Occupation?*
What is your nature of duties?*
Any accident, operation, deformity?*
Do you smoke?*
YesNo
Dependents*
Name Surname Date of birth Gender
Child 1
Child 2
Child 3
What motivated you to get in touch with us ? (Please elaborate)*
Previous Policies*
Policy No Company Sum Assured Plan & Term Year of Policy
1
2
3
4
Family History*
Age Health Year of death [If dead] Cause of death
Father
Mother
Assets and liabilities*
Current Value Loan amount Purchase price Year of purchase
Property
Property
Property
Vehicle
Vehicle
Bank Savings
Shares
Other
Other
Other
Do you have a will?
YesNo
If yes, when was it last reviewed ?
What are your financial goals that you would like us to talk about ?
Superannuation and personal insurance
If you know what your employee benefit amounts are, please fill them in below. Alternatively, please send us a copy of your recent superannuation Fund statement which reflects the current fund value. Also, if applicable please send us a statement reflecting an explanation of what personal insurance benefits you have (income protection benefits, life cover, lump sum disability/TPD )
Superannuation Fund name and approximate balance .
(We use this value to incorporate into your Retirement Planning figures)
Superannuation Fund name and approximate balance .
(We use this value to incorporate into your Retirement Planning figures)
If you have life cover, please mention how much cover you have eg. 1,000,000 or 0
If you have Lump Sum Disability/TPD cover, please mention how much you have eg. 1,000,000 or 0
If you have Income protection, please indicate Benefit amount, waiting period and Benefit expiry age.
Monthly Benefit Waiting period Benefit expiry age
Income Disability Benefit
Do you have any Personal insurance objectives? (Please elaborate)
What is your height and weight ?
Approximate days of Sick leave and annual leave ?
Approximate days of Sick leave and annual leave ?
Would you like to plan for your children's education? If so, please indicate your preferences and approximate cost.
Name of Institution Country Annual Fee Future Value
Primary School
Secondary School
University
Do you have any investment objectives? (Please elaborate)
Select your best date and time for a review
with Paresh Joshi
Appointment
Should be Empty:

	Current Value	Loan amount	Purchase price	Year of purchase
Property
Property
Property
Vehicle
Vehicle
Bank Savings
Shares
Other
Other
Other

	Name	Surname	Date of birth	Gender
Child 1
Child 2
Child 3

	Policy No	Company	Sum Assured	Plan & Term	Year of Policy
1
2
3
4

	Age	Health	Year of death [If dead]	Cause of death
Father
Mother

	Name of Institution	Country	Annual Fee	Future Value
Primary School
Secondary School
University

FINANCIAL PLANNING FACT FIND FORM

Select your best date and time for a review