Fact Find Document

Confidential Fact Finder

Please read the important notice below:

The Corporations Act requires that an adviser providing financial services advice must have reasonable grounds for providing that advice. This means that the adviser must conduct appropriate enquiries as to the investment objectives, financial situation and particular needs of the person concerned. The information requested in this form is necessary to enable a recommendation to be made on a reasonable basis and will be used for that purpose.

Please complete this form as thoroughly as you can. If you are unsure, please leave it blank and we will assist you at your appointment.

SECTION 1

PERSONAL DETAILS	Client 1	Client 2
Title	Mr/Mrs/Miss/Ms/Dr	Mr/Mrs/Miss/Ms/Dr
NAME
SURNAME
Gender	Male/Female	Male/Female
Marital Status	Single/Married/Divorced	Single/Married/Divorced
Date Of Birth
Preferred Name
Australian Citizen	Yes / No	Yes / No

CONTACT DETAILS	Client 1	Client 2
Street Address
Suburb	Suburb	Suburb
Moved In Date (Home)	Home #
Mobile Phone #	Mobile #
Email Address - @
Preferred Contact	Mobile/Email/Home/Work	Mobile/Email/Home/Work
Previous Address (2 yrs ago)	Suburb

EMPLOYMENT	Client 1	Client 2
Employer / Business
Job Title
Duties Performed
Qualifications
Status	Full / Part / Self / Director
Start Date
Employer’s Address
Suburb
Phone Number	Ph.
Fax Number	Fx.
Previous JOB (>2 years)
Employer
Job Title
Date Ceased
Changing your Job Soon?	Yes / No	Yes / No
New Job
Details

CHILDREN	Child 1	Child 2	Child 3	Child 4
NAME
Health	Poor/Fair/Good	Poor/Fair/Good	Poor/Fair/Good	Poor/Fair/Good
Date of Birth
Dependant To	17/18/19/20/21	17/18/19/20/21	17/18/19/20/21	17/18/19/20/21
Gender	Male/Female	Male/Female	Male/Female	Male/Female

ESTATE PLANNING	Client 1	Client 2
Do You Have A Will	Y/N	Date	Y/N	Date
Executor
Power Of Attorney – Who?	Y/N	Name	Y/N	Name
Life Tenancy / Testament Trust?	Life Tenancy / Testamentary	Life Tenacy / Testamentary

Nearest RELATIVE to YOU
Address
Suburb
Phone Number
Mobile Phone Number
Relationship	Mother/Father/Brother/Sister	Mother/Father/Brother/Sister

SECTION 2

ACCOUNTANT	Client 1	Client 2
Accountant’s Name
Firm
Phone Number
Fax Number
Address
Suburb
Email Address

SOLICITOR / ADVISER	Client 1	Client 2
Solicitor’s Name
Firm
Phone Number
Fax Number
Address
Suburb
Email Address

Client 1	CREDIT HISTORY	Client 2
Yes / No	Do you have any DEFAULTS?	Yes / No
Yes / No	Have you been BANKRUPT?	Yes / No

ENTITY / TRUST (Name)	Directors	Shares Owned
Co.
Co. or Trust
Trustees	Appointors
TRUST
SMSF

SECTION 3

FAMILY HOME	PROPOSED NEW PROPERTY
Address	Address
Suburb	Suburb
Ownership (%)	%	Ownership (%)	%
%	%
Bank	Bank
Branch	Branch

Purchase Price	$	Purchase Price	$
Purchase Date	Saved / Deposit	$
Value Today	$	FHOG	Yes / No

Loan Amount	$	Loan Amount	$
Fixed / Variable	Fixed/Variable	Fixed / Variable	Fixed/Variable
Repayment	$	Repayment	$
Frequency	Week/FN/Month	Frequency	Week/FN/Month
Interest Rate	%
Loan Amount	$	Loan Amount	$
Fixed / Variable	Fixed/Variable	Fixed / Variable	Fixed/Variable
Repayment	$	Repayment	$
Frequency	Week/FN/Month	Frequency	Week/FN/Month
Interest Rate	%	RENT	$

Electricity	$	Security
Water/Utilities	$	Body Corp	$
Gas	$	Solicitor Fees	$
Insurance	$	Mortgage Rego	$181	Times .
Rates	$	Bank Fees	$
$	$

INVESTMENT PROPERTY 1	INVESTMENT PROPERTY 2
Address	Address
Suburb	Suburb
Ownership (%)	%	Ownership (%)	%
%	%
Bank	Break Fee	Bank	Break Fee
Branch	$	Branch	$

Purchase Price	$	Purchase Price	$
Purchase Date	Purchase Date
Value Today	$	Value Today	$

Loan Amount	$	Loan Amount	$
Fixed / Variable	Fixed/Variable	Fixed / Variable	Fixed/Variable
Repayment	$	Repayment	$
Frequency	Week/FN/Month	Frequency	Week/FN/Month
Interest Rate	%	Interest Rate	%
Loan Amount	$	Loan Amount	$
Fixed / Variable	Fixed/Variable	Fixed / Variable	Fixed/Variable
Repayment	$	Repayment	$
Frequency	Week/FN/Month	Frequency	Week/FN/Month
Interest Rate	%	Interest Rate	%
Utilities / Gas	$	Utilities / Gas	$
Rate / Insurance	$	Rate / Insurance	$
RENT	$	RENT	$

SECTION 4

GOALS & OBJECTIVES
Short Term 1-2 years
Medium Term 3-5 years
Long Term 5 years +

SUPERANNUATION	CLIENT 1
Who?	Who?	Who?
Policy #	Rollover	Bal $	Policy #	Rollover	Bal $	Policy #	Rollover	Bal $
Y/N	Y/N	Y/N
F U N D
SUPERANNUATION	CLIENT 2
Who?	Who?	Who?
Policy #	Rollover	Bal $	Policy #	Rollover	Bal $	Policy #	Rollover	Bal $
Y/N	Y/N	Y/N
F U N D

SALARY SACRIFICE	Client 1	Client 2
Are you prepared to Salary Sacrifice to your Superannuation?	Yes / No	Yes / No
$0 / Annum	$0 / Annum

RETIREMENT INCOME
Select Age / Client 1	Retirement Age	Select Age / Client 1

As a Couple	ANNUAL INCOME IN RETIREMENT	As an Individual
$0	$0

LUMP SUM INCOME IN RETIREMENT	Age	$0	Age	$0	Age	$0	Age	$0

Yes / No	In Retirement – would you like to work Full Time / Part Time?	Yes / No

SECTION 5

Client 1	INCOME PROTECTION	Client 2

Policy #	Policy #
Life Co.	Life Co.
Premium	$	Premium	$
Frequency	Mth / Qtr / Half / Yr	Frequency	Mth / Qtr / Half / Yr
Policy Owner	Policy Owner:
Benefit Amount	$	Benefit Amount	$
Waiting Period	14/30/60/90/180/365 Days	Waiting Period	14/30/60/90/180/365 Days
Benefit Period	2/5/6 Yrs - To Age 55/65/70	Benefit Period	2/5/6 Yrs - To Age 55/65/70
Agreed/Indemnity	Agreed/Indemnity	Agreed/Indemnity	Agreed/Indemnity

Client 1	LIFE & TPD	Client 2

Policy #	Policy #
Life Co.	Life Co.
Premium	$	Premium	$
Frequency	Mth / Qtr / Half / Yr	Frequency	Mth / Qtr / Half / Yr
Policy Owner:	Policy Owner:

Life	$	TPD	$	Life	$	TPD	$

Client 1	TRAUMA	Client 2

Policy #	Policy #
Life Co.	Life Co.
Premium	$	Premium	$
Frequency	Mth / Qtr / Half / Yr	Frequency	Mth / Qtr / Half / Yr
Policy Owner:	Policy Owner:

Trauma	$	Child	$	Trauma	$	Child	$
Life	$	TPD	$	Life	$	TPD	$

Client 1	WORK SUPER – LIFE & TPD	Client 2

Policy Number	Policy Number
Premium	$	Premium	$
Frequency	Wk / Fn / Qtr / Half / Year	Frequency	Wk / Fn / Qtr / Half / Year
Indexed	Yes / No	Indexed	Yes / No

Life	$	TPD	$	Life	$	TPD	$

REVIEW	Income Protection	Life	TPD	Trauma

NAME OF USUAL DOCTOR	LAST VISIT	REASON
Dr
Centre
Address

NAME OF USUAL DOCTOR	LAST VISIT	REASON
Dr
Centre
Address

SECTION 6

INCOME - eg. $100000 | (Week, Fort, Month, Half, Year)
Wages / Salary	$	Wages / Salary	$
Overtime	$	Overtime	$
Distributions Trust/Co	$	Distributions Trust/Co	$
SGC @ 9.5%	$	SGC @ 9.5%	$
Shares – Dividends	$	Shares- Dividends	$
Benefits- Centrelink	$	Benefits- Centrelink	$
Pension Payments	$	Pension Payments	$
Salary Sacrifice	$	Salary Sacrifice	$

PERSONAL EXPENSES - eg. Car Repairs | $1000 | (Week, Fort, Month, Half, Year)
Car Insurance	$	$
Car Insurance	$	$
Car Insurance	$	$
Health Insurance	$	$
Groceries	$	$
Personal	$	$
Utilities	$	$
Electricity	$	$
Sports	$	$
Education	$	$
Transport	$	$
Holidays	$	$

ASSETS	LIABILITIES
Car 1	$	$	Credit Card Bal.
Car 2	$	$
Boat	$	$
Caravan	$	$
Personal	$	$
$	$
$	$
$	$
$	$
$	$
$	$

SHARES & MANAGED FUNDS
$	$	$	$	$
$	$	$	$	$
$	$	$	$	$

PERSONAL LOAN / LEASES / HIRE PURCHASE
Name	Item	Owner	Repayments	Frequency	Years
$	Frequency
$	Frequency

SECTION 7

RISK PROFILE	CLIENT 1	CLIENT 2
Question 1.	In general, how would your best friend describe you as a risk taker?	Select	Select
(a)	A real risk avoider	1
(b)	Cautious	2
(c)	Willing to take risks after completing adequate research	3
(d)	A real gambler	4
Question 2.	You are on a TV game show and can choose one of the following. Which would you take?	Select	Select
(a)	$2,000 in cash	1
(b)	A 50% chance at winning $10,000	2
(c)	A 25% chance at winning $20,000	3
(d)	A 5% chance at winning $200,000	4
Question 3.	You have just finished saving for a “once-in-a-lifetime” vacation. Three weeks before you plan to leave, you lose your job. What do you do in this circumstance?	Select	Select
(a)	Cancel the vacation	1
(b)	Take a much more modest vacation	2
(c)	Go, reasoning that you need the time to prepare for a job search	3
(d)	Extend your vacation as this might be your last chance to go first class	4
Question 4.	If you unexpectedly received $40,000 to invest, what would you do?	Select	Select
(a)	Deposit in a bank account, money market, or an insured CD	1
(b)	Invest it in safe high-quality bonds or bond mutual funds	2
(c)	Invest it in shares or share unit trusts	3
Question 5.	In terms of experience, how comfortable are you investing in stocks or stock?	Select	Select
(a)	Not at all comfortable	1
(b)	Somewhat comfortable	2
(c)	Very comfortable	3
Question 6.	When you think of the word “risk”, which of the following words comes to mind first?	Select	Select
(a)	Loss	1
(b)	Uncertainty	2
(c)	Opportunity	3
(d)	Thrill	4
Question 7.	Some experts predict prices of assets, such as gold, jewels, collectibles, & real estate are to increase in value. Bond prices may fall; however, experts tend to agree Government Bonds are relatively safe. Majority of your investment assets are in high interest government bonds. What do you do in this circumstance?	Select	Select
(a)	Hold the bonds	1
(b)	Sell the bonds, put 1/2 in money market account, the other in hard assets	2
(c)	Sell the bonds and put the total proceeds into hard assets	3
(d)	Sell the bonds, put all the money into hard assets and borrow additional money to buy more	4
Question 8.	Given the best and worst case returns of the four investment choices below, which would you prefer?	Select	Select
(a)	$500 gain best case; $0 gain/loss worst case	1
(b)	$1,500 gain best case; $500 loss worst case	2
(c)	$5,000 gain best case; $2000 loss worst case	3
(d)	$10,000 gain best case; $5,000 loss worst case	4
Question 9.	In addition to whatever you own, you have been given $2,000. You are now asked to choose between:	Select	Select
(a)	A sure gain of $1,000	1
(b)	A 50% chance to gain $2,000 and a 50% chance to gain nothing	3
Question 10.	In addition to whatever you own, you have been given $2,000. You are now asked to choose between:	Select	Select
(a)	A sure loss of $1,000	1
(b)	A 50% chance to lose $2,000 and a 50% chance to lose nothing	3
Question 11.	Suppose a relative left you an inheritance of $200,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?	Select	Select
(a)	A savings account or money market unit fund	1
(b)	A unit trust that owns shares and bonds	2
(c)	A portfolio of 15 common stocks	3
(d)	Commodities like gold, silver and oil	4
Question 12.	If you had to invest $40,000, which of the following investment choices would you find most appealing?	Select	Select
(a)	60% in low-risk investments, 30% in medium-risk investments, 10% in high-risk investments	1
(b)	30% in low-risk investments, 40% in medium-risk investments, 30% in high-risk investments	2
(c)	10% in low-risk investments, 40% in medioum-risk investments, 50% in high-risk investments	3
Question 13.	Your trusted friend / neighbour, an experienced geologist, is putting together a group of investors to fund an exploratory gold mining venture. The venture could pay back 50 to 100 times the investment if successful. If the mine is a bust, the entire investment is worthless. Your friend estimates the chance of success is only 20%. If you had the 'Money', how much would you invest?	Select	Select
(a)	Nothing	1
(b)	One month's salary	2
(c)	Three month's salary	3
(d)	Six month's salary	4
INVESTORS RISK PROFILE AND SCORE

Client 1	Client 2
Do you agree with this assessment?	Yes / No	Yes / No
If not, what do you believe your risk assessment should be?

PARAMETERS for CALCULATIONS
Rate of Return on SHARES	Rate of Return on PENSION	Rate of Return on PROPERTY	Rate of Return on TREND	10yr Loan Rate	Loan Rate Now
Select%	Select%	Select%	Select%	Select%	%

Investment Options You are Considering: X

SECTION 8

Client 1	HEALTH	Client 2
Excellent / Very Good / Good / Fair / Poor	Current Health	Excellent / Very Good / Good / Fair / Poor
#	Smoke per Day	#	Drink Per Day	Smoke | Drink	#	Smoke per Day	#	Drink Per Day
Ailments
Treatments

FAMILY HISTORY – HEREDITARY
Family Member	Family Member
Hereditary Disease	Hereditary Disease
Age Onset	Age Death	Age Onset	Age Death

Client 1	Client 2
LIFE COVER – In the event of Death:	Please Change Your Choice
Would you like to cover your Funeral, Etc (Final) expenses?	Yes	Yes
Would you like to Reduce/Eliminate your Debts?	Yes	Yes
Would you like to leave any Bequests – Who & Amount?	No	No
Who	$	Who	$	Who	$
Would you like to have funds to Equalise your Estate? (Optional)	No	No
Would you like to have additional funds if Terminally Ill?	No	No
Would you like to provide for your Children’s Education?	Yes	Yes
Would you like to provide funds to meet Lifestyle Expenses?	Yes	Yes
Domestic Assistance provided to the remaining Partner?	No	No

TPD COVER - In the event of Permanent Disablement: :	Please Change Your Choice
Would you like to cover your Medical Costs?	Yes	Yes
Would you like to Reduce/Eliminate your Debts?	Yes	Yes
Would you like to Renovate your Home or Move?	Yes	Yes
TRAUMA COVER – In the event of a Critical Illness: :	Please Change Your Choice
Would you like to assist in Medical Costs and Rehabilitation?	Yes	Yes
Would you like to Reduce or Eliminate your Debt?	Yes	Yes
Would you like to take a voluntary period off work to recover?	No	No

Notes: X

Risk Profile Acknowledgement

I/We acknowledge that I/we have answered the questions in the Risk Profile questionnaire to the best of my/our knowledge. I/We agree with and accept the Risk Profile recommended by the adviser above or I/we acknowledge that I/we have requested a different risk profile from what was recommended as stated below:

Please indicate your selected Risk Profile if this differs from that determined above (please insert a tick in the appropriate box).

Risk Profile	Secure	Conservative	Mod-Conservative	Moderate	Mod-Aggressive	Aggressive
CLIENT 1
CLIENT 2

I/We further acknowledge that any ensuing recommendations will be based on both this risk profile and also any particular objectives and needs I/we have identified and notified to the adviser.

Risk Profile Acknowledgement	Client 1	Client 2
SIGNATURE
NAME
DATE

Acknowledgements and Authorisations

Tax File Number Declaration

From time to time we will be requested to supply your tax file number (TFN) to product issuers. Please indicate whether you grant us authority to do this and retain your TFN on our files.

Client 1	Client 2
Authority	Yes No	Yes No
Tax File Number

Tax file numbers will only be used where written authority has been obtained from you.

By completing and signing this declaration, I/we are authorising our adviser to hold my tax file number in a secure location and use it for the following financial product and strategy recommendations related purposes/documents in accordance with legislative requirements:

Matters for superannuation investment purposes as required by the Superannuation laws, such as inclusion on application forms.

Matters for non-superannuation investment purposes as required by the Taxation laws, such as inclusion on application forms.

I/We have been informed of the legal basis for collection and are aware that declining to provide a TFN is not an offence and know the consequences of not providing a TFN.

That the manner of obtaining the TFN was not unreasonably intrusive.

The disclosure of the TFN will only be disclosed to fund managers and life insurance companies as relevant.

Tax File Number Authorisation	Client 1	Client 2
Signature
Name
Date

Privacy Act

Where we retain your information and use that information in the future, we are obliged to seek your consent. Please indicate your decision on the following by checking the applicable box:

I/We would like to be kept informed of new products and/or services as they arise.	Yes No
I/We authorise you to provide personal financial information to third parties as required. (e.g. mortgage brokers, accountants etc)	Yes No
I/We authorise you to provide all personal financial information to my spouse/partner.	Yes No
I/We wish to be placed on a “No Call – No Contact” register which ensures NO contact, regarding financial products without express consent.	Yes No If yes, please ensure evidence is maintained on file of addition to register

Client Declaration

In the event that I/we have requested limited financial advice I/we acknowledge that the representations outlined below apply in so far as they relate to that specific financial advice requested.

I am aware a fee of $	(GST Include) is charged for the preparation of Statement of Advice.

The information provided in this discovery document is complete and accurate to the best of my/our knowledge (except where I/we have indicated that I/we have chosen not to provide the information).I/We understand and acknowledge that by either not fully or accurately completing the discovery document, that any recommendation or advice given by the adviser in these circumstances may be inappropriate to my/our needs and that I/we risk making a financial commitment to a financial product that may be inappropriate for the needs identified.

I/We acknowledge that I/we have received the FinancialLink Financial Services Guide (FSG) and have access to a copy of the FinancialLink Privacy Statement. I/We confirm that I/we agree to the collection, use and disclosure of our information from and to our advisers as listed below, where this is required by my adviser in the provision of financial services to me/us.I/We have completed all areas of this document and agree to provide you, my adviser with all relevant information.

Client Declaration	Client 1	Client 2
Signature
Name
Date

Adviser Declaration

I have provided you with a copy of the FinancialLink Financial Services Guide (FSG) and Privacy Policy prior to any financial product and strategy recommendations being made and personal and sensitive information being collected. As a recipient of TFN information, I, as a FinancialLink authorised representative have taken reasonable steps to ensure:

That you have been informed of the legal basis for collection, that declining to provide a TFN is not an offence and the consequences of not providing a TFN.

That the manner of obtaining the TFN was not unreasonably intrusive.

The disclosure of the TFN will only be disclosed to fund managers and life insurance companies as relevant and required by Superannuation and Taxation laws.

Adviser Name	Signature	Date
MICHAEL LOBODARZ