FACT FIND FORM
|
PERSONAL DETAILS |
|
|
Self |
Spouse/Partner |
|
Surname |
|
|
|
|
||
|
Forenames |
|
|
|
|
||
|
Home Address |
|
|
|
|
||
|
Postcode |
|
|
|
|
||
|
Telephone No. (Home) |
|
|
|
|
||
|
Fax No. (Home) |
|
|
|
|
||
|
Telephone No. (Business) |
|
|
|
|
||
|
Fax No. (Business) |
|
|
|
|
||
|
Date of Birth |
|
|
|
|
||
|
Marital Status |
|
|
|
|
||
|
National Insurance No. |
|
|
|
|
||
|
Tax Office |
|
|
|
|
||
|
Tax reference No. |
|
|
|
HEALTH DETAILS |
Self Spouse/Partner
Are you currently in good health? Yes q No q Yes q No q
If not, please give details _______________ __________________
Do you smoke? Yes q No q Yes q No q
If no, have you smoked in the last
12 months? Yes q No q Yes q No q
Please give details of your
Height and weight _______(ht)_____(wt) _____(ht)_____(wt)
Do you follow any hazardous pursuits?
(e.g. skiing, hang gliding, diving) Yes q No q Yes q No q
If so, please give details ___________________ _________________
___________________ _________________
___________________ _________________
|
OCCUPATION DETAILS |
Self Spouse/Partner
Occupation/Profession ______________________ _______________________
Status Self Employed q Self Employed q
Employee q Employee q
Company Director q Company Director q
Not in employment q Not in employment q
If you are a company director,
do you together with associates
own more than 20% of the
company’s shares? Yes q No q Yes q No q
If you are self employed, when
did self employment commence? _____________________ _____________________
Business/Employer’s address ______________________ _____________________
______________________ _____________________
______________________ _____________________
Length of time with current
Employer _____ Year _____Months ______Year _____Months
Previous self employment/
employment, over the last
7 years:
Please give details ______________________ ______________________
______________________ ______________________
______________________ ______________________
|
EMPLOYEE BENEFITS |
Self Spouse/Partner
Are you a member of a company?
pension scheme or group personal
pension scheme?
(Please give details in pension
scheme arrangements section) Yes q No q Yes q No q
Does your employer offer a pension
arrangement which you have not
joined? Yes q No q Yes q No q
If yes, please give details _________________ _______________
Is life cover/dependents’ benefits
provided? Yes q No q Yes q No q
If yes, how much? _________________ _______________
Is medical insurance cover
(e.g. BUPA) provided? Yes q No q Yes q No q
If yes, please give details _________________ _______________
Is income replacement insurance
cover provided whilst ill? Yes q No q Yes q No q
If yes, please give details _________________ _______________
Does your employer offer any share
incentive schemes or share option
schemes which are open to you? Yes q No q Yes q No q
If yes, please give details _________________ _______________
Are you provided with any other
benefits in kind? Yes q No q Yes q No q
If yes, please give details _________________ _______________
_________________ _______________
Please supply a copy of current Employee Benefits Handbook if appropriate.
|
ANNUAL INCOME DETAILS (PLEASE SUPPLY GROSS FIGURES) |
Self Spouse/Partner
Basic salary ____________________ ________________________
Profit Related Pay/Guaranteed
Bonuses ____________________________________________
Overtime/commission/bonuses ____________________________________________
If self employed, business income/net profits (Please supply copies of last 3 years’ accounts
____________________________________________
Pensions - State ____________________________________________
- Former Employer ____________________________________________
- Other ____________________________________________
Any State Benefits ____________________________________________
Bank/Building Society Interest ____________________________________________
Dividends and Tax Credits ____________________________________________
Regular Insurance Company
Investment Bond withdrawals (please give details if exceeding 5% per annum)
____________________________________________
Personal Equity Plans ISA’s ____________________________________________
Guaranteed Income Bonds ____________________________________________
Other, e.g. distributions from trusts, please give details
____________________________________________
TOTAL GROSS INCOME ____________________________________________
|
ANNUAL OUTGOINGS |
Self Spouse/Partner
£ £
Mortgage Repayments ____________________ _________________________
Loans/HP/Credit Cards/ Other repayments ______________________ _______________________
Total Household Expenses
(e.g. Gas, Electricity, Telephone, Food etc.) ___________________ __________________________
Other Regular Payments, for
Example
- Pension contributions ____________________________________________
- Life Assurance Premiums ____________________ _________________________
- School Fees ____________________ _________________________
- Motor Expenses ____________________ _________________________
- Holidays ____________________ _________________________
- Other ____________________ _________________________
TOTAL OUTGOINGS ____________________ _________________________
Is the income stated sufficient
to meet your outgoings? Yes q No q Yes q No q
If not, what is your required
net of tax income requirement? £ _____________pa/pm £ _________________pa/pm
If preferred, please state your
joint net income requirement? £ ___________________ pa/pm
SURPLUS INCOME/SHORTFALL
Having considered the answers
to the questions in relation to
your income and outgoings
what do you consider your
current gross surplus income
to be usually? £ ______________pa/pm £ _________________pa/pm
This figure is relevant in helping us to plan your future investment strategy taking into account your preferences and objectives.
|
ASSETS AND OTHER INVESTMENTS (PLEASE GIVE CURRENT VALUATIONS) |
Self Spouse/Partner Joint Comments
£ £ £
FIXED ASSETS Purchase
Price &
Date
Main Residence (current
Market value) _________ _______________ _________ ___________
Less outstanding
Mortgage _________ _______________ _________
Net Value _________ _______________ _________
Contents and
Valuables _________ _______________ _________
Purchase
Price &
Date
Other property/
Land (current
Market value) _________ _______________ _________ ___________
_________ _______________ _________ ___________
Less oustanding
Loans _________ _______________ _________
Net Value _________ _______________ _________
Acquisition
Date
Private company
Shares/partnership
Interest (current
Market value) _________ _______________ _________ ___________
Other (please give
Details) _________ _______________ _________ ___________
_________ _______________ _________ ___________
TOTAL FIXED
ASSETS _________ _______________ _________
MARKETABLE
ASSETS
Expectations within
12 months:
Tax free cash _________ _______________ _________
Severance payment
(net) _________ _______________ _________
|
ASSETS AND OTHER ETC. (CONTINUED) |
Inheritance _________ _______________ _________
Other (e.g. maturing
Life/savings policies,
National Savings
Certificates – please
Give details) _________ ________________ _________
_________ ________________ _________
Total of expectations
Within 12 months _________ ________________ _________
Liquid Assets:
Bank accounts _________ ________________ _________
Building Society
Accounts _________ ________________ _________
Other (please give
Details) _________ ________________ _________
Total liquid assets _________ ________________ _________
Self Spouse/Partner Joint
£ £ £
Other Assets:
Tax Exempt Special Savings
Accounts (TESSA) _______ ______________
National Savings Investments
(e.g. Deposits/accounts, Savings
Certificates, Bonds) _______ ______________ __________
Guaranteed Income Bonds _______ ______________ __________
Guaranteed Growth Bonds _______ ______________ __________
Gilts, fixed interest stock,
preference shares _______ ______________ __________
Life Assurance policies _______ ______________ __________
Insurance Company Investment
Bonds (onshore/offshore) _______ ______________ __________
Unit trusts and Investment
Trusts _______ ______________ __________
Personal Equity Plans (PEPs)/
ISA’s _______ ______________
Equities _______ ______________ __________
Enterprise Zone Trusts (EZT) _______ ______________
Business Expansion Schemes
(BES) and BES Shares _______ ______________
Enterprise Investment
Schemes (EIS) _______ ______________ __________
Venture Capital Trusts (VCT) _______ ______________ __________
Offshore Investments,
Please give details _______ ______________ __________
_______ ______________ __________
Other assets/investments
(e.g. Antiques/Collectors’
items, valuables – please give
details) _______ ______________ __________
_______ ______________ __________
Total other assets _______ ______________ __________
TOTAL MARKETABLE
ASSETS _______ ______________ __________
Please give details of any anticipated major capital expenditure and timing:
|
DETAILS OF CURRENT FINANCIAL PLANNING ARRANGEMENTS |
Life assurance/critical illness insurance/income replacement insurance/personal accident and sickness/investment plans)
1 2 3
Insurance company/Provider ____________ _____________ ___________
Policy number ____________ _____________ ___________
Owner ____________ _____________ ___________
Life assured ____________ _____________ ___________
Type of policy ____________ _____________ ___________
Unit linked/With profits ____________ _____________ ___________
Premium amount and frequency ____________ _____________ ___________
Sum assured/Level of benefit ____________ _____________ ___________
Commencement date ____________ _____________ ___________
Maturity/Expire date ____________ _____________ ___________
Current value ____________ _____________ ___________
Estimated Maturity Value ____________ _____________ ___________
Policy written under trust Yes q No q Yes q No q Yes q No q
Purpose of policy ____________ _____________ ___________
Other notes (including details
of trust beneficiaries, charges
over policies, income
replacement – deferred period,
waiver of premium benefit etc.) ____________ _____________ ___________
____________ _____________ ___________
____________ _____________ ___________
4 5 6
Insurance company/Provider ____________ _____________ ___________
Policy number ____________ _____________ ___________
Owner ____________ _____________ ___________
Life assured ____________ _____________ ___________
Type of Policy ____________ _____________ ___________
Unit linked/With profits ____________ _____________ ___________
Premium amount and frequency ____________ _____________ ___________
Sum assured/Level of benefit ____________ _____________ ___________
Commencement date ____________ _____________ ___________
Maturity/Expiry date ____________ _____________ ___________
Current value ____________ _____________ ___________
Estimated Maturity Value ____________ _____________ ___________
Policy written under trust Yes q No q Yes q No q Yes q No q
Purpose of policy ____________ _____________ ___________
Other notes (including details
of trust beneficiaries, charges
over policies, income replace-
ment - deferred period, waiver
of premium benefit etc.) ____________ _____________ ___________
____________ _____________ ___________
____________ _____________ ___________
Please use the notes section at the end of the questionnaire if you need more space.
|
PENSION SCHEME ARRANGEMENTS |
Please enter details of all company sponsored pension schemes. Additional Voluntary Contributions, Free Standing Additional Voluntary Contribution policies, Personal Scheme Transfers, Buy-Out Bonds, Personal Pension policies and Retirement Annuity policies in this section.
Arrangement 1 Arrangement 2 Arrangement 3
Scheme name, if appropriate ____________ ____________ ____________
Name and address of Pension
Scheme Trustees, if appropriate ____________ ____________ ____________
Pension provider/investment
manager ____________ ____________ ____________
Type of arrangement (eg. Final
Salary/Money Purchase/Personal
Pension) ____________ ____________ ____________
If final salary, state accrual rate
(eg. 1/60th) ____________ ____________ ____________
Unit linked/With profits/
Deposit ____________ ____________ ____________
Commencement date ____________ ____________ ____________
Policy/member number ____________ ____________ ____________
Date pensionable service
commenced ____________ ____________ ____________
Normal retirement age ____________ ____________ ____________
Current pensionable salary ____________ ____________ ____________
Contracted-In/Contracted-Out
of SERPS? For which years? ____________ ____________ ____________
Contributions payable by:
Employer ____________ ____________ ____________
Employee (actual payment) ____________ ____________ ____________
Frequency of contributions
(eg. Monthly/annually/single) ____________ ____________ ____________
Has a transfer value been paid
to the arrangement? Yes q No q Yes q No q Yes q No q
If yes, how much? ____________ ____________ ___________
Current fund value, if
Appropriate ____________ ____________ ___________
|
PENSION SCHEME ARRANGEMENTS (CONTINUED) |
Arrangement 1 Arrangement 2 Arrangement 3
Current fund value, if appropriate _____________ _____________ _____________
Projected benefits at normal
retirement age:
Tax free cash sum _____________ _____________ _____________
Pension _____________ _____________ _____________
Current death benefits _____________ _____________ _____________
Other notes (including details of
arrangements written under
trust and nominated
beneficiaries) _____________ _____________ _____________
Please supply any relevant pension documentation available.
|
MORTGAGE/OTHER LOAN DETAILS |
Loan 1 Loan 2 Loan 3
Lender ______________ _______________ _______________
Account Reference Number ______________ _______________ _______________
Original loan amount £ ____________ £ _____________ £ _____________
Date taken out ______________ _______________ _______________
Amount outstanding £ ____________ £ _____________ £ _____________
Term of loan ______________ _______________ _______________
Anticipated repayment date ______________ _______________ _______________
Type of mortgage/loan (eg.
Pension, endowment, PEP,
capital repayment, interest
only) ______________ _______________ ______________
Interest rate – Fixed/variable ______________ _______________ ______________
Monthly payments £ ____________ £ _____________ £ ____________
Please supply details of which loans are covered against sickness/accident, redundancy or death and the type of cover
Please supply details of security provided for each loan
|
FAMILY DETAILS |
Parents/Grandparents
Annual Value of Estate Name Date of Birth State of Health gross income (approx.)
1. ______________________ ____________ _____________ ____________ _____________
2. ______________________ ____________ _____________ ____________ _____________
3. ______________________ ____________ _____________ ____________ _____________
4. ______________________ ____________ _____________ ____________ _____________
5. ______________________ ____________ _____________ ____________ _____________
6. ______________________ ____________ _____________ ____________ _____________
Has any inheritance tax/estate preservation planning been undertaken recently?
If yes, please give details: ______________________________________________________________
______________________________________________________________
Children/Other dependents
Name Date of Birth Relationship Present marital status
2. ____________________ ____________ ______________ ___________________
3. ____________________ ____________ ______________ ___________________
4. ____________________ ____________ ______________ ___________________
5. ____________________ ____________ ______________ ___________________
6. ____________________ ____________ ______________ ___________________
If any of the above children or other dependents receive a significant gross income, or own or have an interest in a significant amount of assets, please supply details.
|
SCHOOL FEES PROVISION |
Are school fees payable or foreseen? Yes q No q
Has any provision been made? Yes q No q
If yes to either, please give brief
details (including name(s) of
school(s), fees payable etc.) _______________________________________________________
_______________________________________________________
_______________________________________________________
|
TRUSTS |
Self Spouse/Partner
Have you set up any trusts? Yes q No q Yes q No q
Are you the beneficiary of
any trusts? Yes q No q Yes q No q
If yes to either, please give
brief details showing estimated
capital value, a note of income
you receive and who the
beneficiaries of each trust are. _________________________________________________________
_________________________________________________________
_________________________________________________________
|
WILLS |
Self Spouse/Partner
Have you made a Will? Yes q No q Yes q No q
If yes, was it drafted by a
professional adviser? Yes q No q Yes q No q
When was the Will last
reviewed? _____________________ ____________________
Please give details of the main
provisions if more convenient,
please attach a copy. ________________________________________________________
________________________________________________________
________________________________________________________
|
GIFTS |
Self Spouse/Partner
Have you made any gifts in
the last 7 years? Yes q No q Yes q No q
If yes, please give details _______________________ _______________________
_______________________ _______________________
_______________________ _______________________
|
EXISTING ARRANGEMENTS |
Self Spouse/Partner
Protection for you and your family
Do you feel that your current level of
life cover is sufficient to meet the
needs of your dependents? Yes q No q Yes q No q
If no, how much additional cover do
you believe you require? _____________________ ______________________
If you should suffer long term
sickness or disability:
Do you feel that your current
arrangements are sufficient to
meet your needs? Yes q No q Yes q No q
If no, how much additional cover
do you believe you require? _____________________ ______________________
Savings:
Do you feel that your current level of
commitment to regular savings is
adequate? Yes q No q Yes q No q
Retirement Provision
What percentage of your income
would you like to take as a pension? ___________________% ___________________%
By how much would you like to see
your pension increase each year?
(0%, 3%, 5%, or Retail Prices index) ____________________ _____________________
At what age would you like to retire? ____________________ _____________________
Do you feel that your current pension
arrangements are sufficient to meet
your needs in retirement? Yes q No q Yes q No q
Investments
Do you feel that your spread of
investments reflects your current
attitude to risk? (See attitude to
risk section) Yes q No q Yes q No q
If no why not? ______________________ _____________________
|
EXISTING ARRANGEMENTS (CONTINUED) |
Self Spouse/Partner
Estate Preservation
Do you wish to preserve as much as
possible of your estate for your
beneficiaries on death? Yes q No q Yes q No q
Have you taken any steps to achieve
this? Yes q No q Yes q No q
If yes, please give details _____________________ _____________________
Would you consider further
planning to achieve this? Yes q No q Yes q No q
|
FUTURE PLANS (FAMILY INTERESTS, EXPECTATIONS |
Please give details below:
|
ATTITUDE TO RISK |
Please indicate which of the following descriptions can best be used to define your attitude to risk.
Self Spouse/Partner
Minimal Risk: Predictable capital returns, but not
guaranteed to give protection against inflation
(unless index-linked). q q
Low Risk: Designed to give conservative but
relatively stable level of growth and/or income
although extreme circumstances may affect these
objectives. Most capital placed in secure investments
in the knowledge that this limits the potential for
capital growth or loss in capital and/or income. q q
Moderate Risk: A significant proportion of capital
is placed in investments which have the potential
for growth and/or income growth. The underlying
assets of these investments are widely spread and
their values may fall as well as rise especially in the
short term. q q
High Risk: A substantial proportion of capital is
placed in investments with the aim of maximising
the potential for higher growth and/or income,
although this involves taking a greater degree of
risk. These investments are highly volatile and
will be mainly held in asset backed investments
where values may fall as well as rise. q q
|
YOUR OBJECTIVES |
In considering your objectives below, it is advisable to estimate the term over which you would like them to be achieved. The following indications may help you in this.
S = Short Term - up to 5 years
M = Medium Term - 5-10 years
L = Long Term - over 10 years
Please indicate in each of the sections below those areas where you require advice showing your order of priority (eg 1, 2, 3 etc) risk attitude and your preferred investment term.
Priority Risk Category Term
(Minimal/Low/ (S, M, L)
Moderate/High)
Investments
Adequate cash reserves Yes q No q ____________ ______________ _________
Growth maximisation Yes q No q ____________ ______________ _________
Income maximisation Yes q No q ____________ ______________ _________
Balance of growth/income Yes q No q ____________ ______________ _________
Review of existing
arrangments Yes q No q ____________ ______________ _________
Pensions
Funding for retirement Yes q No q ____________ ______________ _________
Priority Risk Category Term
(Minimal/Low/ (S, M, L) Moderate/High)
Pension options at retirement Yes q No q ________ _______________ ________
Review of existing arrangements Yes q No q ________ _______________ ________
_
Protection
Life Cover Yes q No q ________ _______________ ________
Health Cover Yes q No q ________ _______________ ________
Estate preservation Yes q No q ________ _______________ ________
Review of existing arrangements Yes q No q ________ _______________ ________
Loan arrangements
Mortgage(s) Yes q No q ________ _______________ ________
Other loan(s) Yes q No q ________ _______________ ________
Review of existing arrangements Yes q No q ________ _______________ ________
What type of investments are you prepared to consider?
Bank/Building Society accounts Yes q No q Possibly q
National Savings Investment Bonds/Certificates Yes q No q Possibly q
Guaranteed Income/Growth Bonds Yes q No q Possibly q
Gilts, fixed interest stock, preference shares Yes q No q Possibly q
Life Assurance policies Yes q No q Possibly q
Insurance Company Investment Bonds Yes q No q Possibly q
Unit trusts, Investment Trusts’ etc. Yes q No q Possibly q
Individual Savings Accounts (ISAs) Yes q No q Possibly q
Equities Yes q No q Possibly q
EZT, EIS, VCT Yes q No q Possibly q
Offshore Investments Yes q No q Possibly q
Others, please give details _______________________________________
What Investments or markets are you not prepared to consider?
Please give details:
Summary of your expectations relative to your objectives
|
RESIDENCE AND DOMICILE |
Self Spouse/Partner
Are you UK resident? Yes q No q Yes q No q
Please advise if you do not
know or you are unsure ______________________________________________
Are you UK domiciled? Yes q No q Yes q No q
Please advise if you do not
know or you are unsure ______________________________________________
Where do you intend to reside in the
foreseeable future and in retirement? ______________________________________________
|
PROFESSIONAL ADVISERS/CONTACTS |
Capacity Name & Address Name of contact Telephone/Fax Number
Accountant ______________________ _____________________ ___________
______________________ ___________
______________________
Solicitor ______________________ _____________________ ___________
______________________ ___________
______________________
Bank ______________________ _____________________ ___________
______________________ ___________
______________________
Stockbroker ______________________ _____________________ ___________
______________________ ___________
______________________
Financial
Adviser ______________________ _____________________ ___________
______________________ ___________
______________________
Doctor ______________________ _____________________ ___________
______________________ ___________
______________________
Please indicate and give details where different for spouse/partner:
|
NOTES |
Please make any additional notes/comments which you feel are relevant:
|
DECLARATION |
I/We confirm that the information provided adequately reflects my/our personal circumstances, priorities and attitude to risk.
I/We understand that where I/we have decided to provide information, the provided
will be restricted to specific areas and will not take into account all of my/our personal circumstances.
I/We provide the information contained in this questionnaire on the understanding that it will be used in strict confidence and that it places me/us under no obligation to take up any suggested recommendation.
Signature of self Signature of spouse/partner
_____________________________________ ______________________________________
Name _______________________________ Name ________________________________
Date ________________________________ Date ________________________________