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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 ____________________________________________
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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.
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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) _________ _______________ _________
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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:
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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.