Personal Lifestyle Profile

By completing these questions and providing us with such necessary information, we will be able to prepare provide as much value to you during your first and complementary meeting with us.  Please take some time to complete this questionnaire and submit to Parkside InvestorPlus.  Once we have reviewed the information, we will be in touch with you to confirm your initial appointment.  Of course, the information you provide is, and remains, absolutely confidential and will not be used for any purpose other than to assist you with financial planning and lifestyle strategies.  Once you have keyed in your answers, simply click on the "Send to Parkside Now" button at the bottom of this page.

 
Title: Title:

Full Given Names:

 Full Given Names
                                    
Surname
 Surname
Date of Birth: Date of Birth:
Contact Details: You Your Partner

Residential Address:

 

Residential Address (if Different)

 
Home Phone  Home Phone 
Work Phone    Work Phone   
Mobile              Mobile             
Email: Email:
                                                                          Proof of Identity:  You (Required by law) Your Partner
Passport Number            

Passport Number             

Country of issue               

Country of issue               
Driver's Licence Number Driver's Licence Number
Tax File Number  

Tax File Number  
How Did you hear about us?
General Questions
How did you hear about us?
Have you worked with a financial planner before? If so, why have you approached us?
What do you think we can do for you
How important is religion to you?  Very important     Somewhat Important  Not  important       Impartial
How important are pets to you?  Very important   Somewhat Important  Not  important     Impartial
What are your hobbies and pastimes?
Financial Goals: You Financial Goals:  Your Partner
List your top 3 Financial goals: List your top 3 Financial Goals (If different)
List your top 3 Lifestyle Goals List your top 3 Lifestyle Goals (If different)
Asset Value: You Your Partner                            Joint
Home:                            $                  $  $                                                      
Cash Savings: $   $ $  

Investment Property/Shares:

 $   $      $                               
Managed Funds: $   $      $
Unit Trusts:      $   $      $  
   Superannuation:       $   $      $  
     $   $   $  
       $   $      $
Business Shares/Assets: $   $      $ 
Other:  $   $      $ 
Total Assets:  $   $      $ 
Liabilities: You Your Partner                Joint

Home Loan:

 $ $ $
Car Loan: $ $ $
Credit Card Debt: $ $ $
Investment Property/Loans: $ $ $
Other $ $ $
Total Liabilities: $ $ $
Inheritances:     You Your Partner
Actual: $ $
Pending: $ $
Annual Income: You Your Partner
Salary: $ $
Car: $ $
Superannuation: $ $
Dividend Income: $ $
Rental Income: $ $
Interest Earned: $ $
Annual bonus: $ $
Other Income: $ $
Total Annual Income: $ $
Annual Expenses:                          You Your Partner
Loan repayments: $ $
Groceries/Shopping: $ $
Education Expenses: $ $
Transport/Travel: $ $
Health: $ $
Recreation: $ $
Total Annual Expenses: $ $
Insurance You  Your Partner
Are you a smoker? Yes                             No

Yes                             No
Do you have any health issues that might affect future insurance premiums or coverage? Yes                             No Yes                             No
Life Insurance $ $
Trauma Insurance $ $
Income Protection $ $
Health Insurance Yes                             No Yes                             No                  
Estate Planning You Your Partner
Do you have a current Will? Yes                             No Yes                             No
When was it last updated?   
Do you have Enduring Guardianship? Yes                             No Yes                             No
Do you have Enduring Power of Attorney? Yes                             No Yes                             No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                                         

What Affects You

Below is a list of items that may impact on your lifestyle.  Please tick those which you feel are the most important issues facing you at the moment.
Issue                                                                                            

 
Do you have general concerns about your current lifestyle and or ability to take it into and beyond retirement? Yes No                              
Are any of these important to you - raising, educating or providing for children? Yes No                               
Are you concerned about a lack of holiday and/or leisure time? Yes No                            
Do you like to regularly maintain and upgrade motor vehicles, personal property or residential property Yes No                           
Do you have all documents in place to ensure your beneficiaries are protected and your assets safe from taxation or abuse after your passing Yes No                          
Can your business and family  continue to enjoy their lifestyle in the event of your injury or death? Yes  No                           
Superannuation issues Yes No                         
Inability to save Yes No                        
Possibility of becoming redundant or retrenched Yes No                        
Increasing your wealth via accumulation Yes No                       
An interest in a philanthropic legacy, scholarship establishment or charitable funding Yes No                       
A need to ensure an exit or succession plan for your business Yes No                      
Management of Debt including Personal Loans, Credit Card Debt and Mortgage management Yes No                     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thank you for taking the time to complete this questionnaire. 

We will help build and protect your wealth, to secure and
 enhance your lifestyle by managing a financial blueprint for your life