PRIVATE & CONFIDENTIAL
CORE FINANCIAL PLANNING QUESTIONNAIRE
Client 1Title / Mr / Mrs / Miss / Ms / Dr
First Name(s)
Surname
Telephone No’s / Work / Home
Mobile
Email / Work / Home
Client 2
Title / Mr / Mrs / Miss / Ms / Dr
First Name(s)
Surname
Telephone No’s / Work / Home
Mobile
Email / Work / Home
Current Address / Post Code
New Address
(if applicable) / Post Code
Firm Name / Independent Financial Solutions
Adviser Name / Quentin Cooke
Date Completed
16 Low Road
Burwell
Cambridge
CB25 0EJ
T: 01638 615343
F: 01638 615342
E:
The Tenet Financial Planning Questionnaires are designed to be modular in nature, dependent on the advice being given to the client.
For all cases, the Core Financial Planning Questionnaire should be completed fully where possible, with the additional advice specific information gathered in the relevant modules, as indicated below. Where advice is being ‘limited’ to specific areas of need, please indicate the area of need by ticking the end column and ensure that you complete the additional fact find:
Supplementary QuestionnairesNeed Area / Required for advice on: /
Estate Planning / May be required in addition to all other modules.
Planning for Retirement / SHP, PPP, SIPP
Living in Retirement / Investments (as above) where part of Living in Retirement planning, All Annuities, Drawdown, Hybrid Products,
Protection / Life cover, critical illness, income protection, private medical insurance
Adviser Note
Please complete all the appropriate sections. If a section is not applicable, then please strike this through and write N/A. For the avoidance of doubt within this questionnaire, and all supplementary questionnaires, N/A means not applicable.
Contents
Section 1: Aims & Objectives
Section 2: Personal & Family Details
Section 3: Health
Section 4: Employment Details
Section 5: Earnings & Income
Section 6: Expenditure & Affordability
Section 7: Wills
Section 8: Protection Plans
Section 9: Pensions Plans
Section 10: Savings & Investments
Section 11: Mortgages & Other Debt
Section 12: Other Assets
Section 13: Risk Profile
Section 14: Taxation and Investment Allowances
Section 15: Investment Preferences
Section 16: Other Professional Advisers
Section 17: Current Financial Priorities
Section 18: Additional Notes
Section 19: Declaration
Letter of Authority
Section 1:Aims & Objectives
The key to successful financial planning is to have clearly defined aims and objectives to work towards. Aims may best be considered as long term aspirations or ambitions without a clearly defined date or ‘someday maybe’ projects and goals. Objectives are more specific and would generally have a defined timeline linked to them. So an aim might be to leave a current employer, to retrain and then to set up my own business at some time in the future whilst my objective is to have a pension of (the equivalent of) £30,000 a year in today’s terms.
The best objectives to plan against are Specific, Measurable, Achievable, Realistic and Time bound. An example might be to achieve an annual pension income of the equivalent of £30,000 a year in today’s terms, payable for life from age 60.
Please describe your aims and objectives below.
Section 2:Personal & Family Details
Client 1 / Client 2Gender
Marital Status / Married / Civil Partnership / Single / Divorced / Widowed / Living with Partner / Married / Civil Partnership / Single / Divorced / Widowed / Living with Partner
Date of Birth / Age / / / / / /
Smoker status / Smoker / non-smoker /
ex-smoker - yrs. / Smoker / non-smoker /
ex-smoker - yrs.
Children and Dependants
Name / Relationship / DOB / Age / Marital Status / Dependent / Anticipated length of dependency?
Y / N
Y / N
Y / N
Y / N
Y / N
Client 1 / Client 2
Nationality
Country of Residency
Country of Domicile
NB – Tenet ARs cannot currently provide advice to individuals with US citizenship or dual US citizenship
Section 3:Health
Your health can have a significant impact on the cost of protection and also the level of benefits that you may be entitled to. For example, annuity rates are increased for smokers and individuals with certain lifestyle factors, whereas life cover costs are can increase. Please complete the details below so that we can ensure that any quotations we obtain are specific to your circumstances.
Client 1 / Client 2How would you describe your general health? / Excellent / Good / Average / Poor / Excellent / Good / Average / Poor
Height (ft/ins or cms)
Weight (st/lbs or kgs)
Occupation prior to retirement
Have you ever been diagnosed with any of the following?[1] / Hypertension / Y / N / Y / N
High Cholesterol / Y / N / Y / N
Heart condition / Y / N / Y / N
Diabetes / Y / N / Y / N
Cancer, leukaemia, lymphoma, growth, or tumour / Y / N / Y / N
Stroke / Y / N / Y / N
Respiratory/lung disease / Y / N / Y / N
Multiple sclerosis / Y / N / Y / N
Neurological disease / Y / N / Y / N
Other serious illness
(please detail in notes) / Y / N / Y / N
Are you currently a smoker and/or have been in the last 10 years? / Y / N
Date Quit: / Y / N
Date Quit:
Smoker details / Cigarettes per day
Cigars OR ounces/grams of pipe tobacco per day
Notes /Soft Facts
3.1Power of Attorney
Client 1 / Client 2Do you have a Power of Attorney? / Lasting / Enduring / Lasting / Enduring
What does it cover? / Financial / Health & Wellbeing / Both / Financial / Health & Wellbeing / Both
When was it made?
Who has the power of attorney?
Notes /Soft Facts
Section 4:Employment Details
4.1Employment Details
Client 1 / Client 2Employment Status / Employed / Self-Employed /
Retired / Unemployed / Employed / Self-Employed /
Retired / Unemployed
Industry
Occupation
Planned Retirement Date
Start Date*
National Ins. No.
Employer
Business Address
Business Postcode
Do you expect your employment details to change? / Yes / No / Yes / No
Details: / Details :
Notes /Soft Facts
*If less than 1 year’s service, please give previous employment details. Also include if this is a temporary position and details where client works on a part time basis.
Section 5:Earnings & Income
Client 1 / Client 2Gross Earned Income / Basic Salary / £ / Basic Salary / £
Guaranteed Overtime / £ / Guaranteed Overtime / £
Bonus/Commission / £ / Bonus/Commission / £
Regular Bonus/Overtime / £ / Regular Bonus/Overtime / £
Other / £ / Other / £
Value of Benefits in Kind(company car, private health etc.) - Found on P11D statement / £ / £
If Self-Employed state Relevant Earnings / £ / £
Total Monthly Net Income (if known) / £ / £
Date Commenced Self Employment
Accounts Available / Y / N / Y / N
Net Profit Past 3 Years / / / £ / £
/ / £ / £
/ / £ / £
Do you have an Accountant? / Y / N
If ‘yes’ please add to Contact Details / Y / N
If ‘yes’ please add to Contact Details
Do you expect your employment circumstances to change? / Y / N
If ‘yes’ please detail in Notes section / Y / N
If ‘yes’ please detail in Notes section
Gross Annual Deposit Income / £ / £
Gross Annual Investment Income / £ / £
Gross Annual Pension Income / £ / £
Other Gross Income (please give details in Notes) / £ / £
Tax Free Income (please specify) / £ / £
TOTAL GROSS INCOME / £ / £
Tax Rate / Non / Starting / Basic / Higher / Additional / Non / Starting / Basic / Higher / Additional
Notes /Soft Facts
Section 6:Expenditure & Affordability
6.1Expenditure Analysis
Please complete the details below as accurately as possible so that we can obtain a full understanding of your current circumstances.
Client 1 / Client 2 / JointEssential Expenditure / Mortgage / £ / £ / £
Loans / £ / £ / £
Life/Pension Policies / £ / £ / £
Council Tax / £ / £ / £
Gas/Electric/Water / £ / £ / £
Telephone / £ / £ / £
TV/Subscriptions / £ / £ / £
Car Ins./Road Tax / £ / £ / £
Petrol/Travel Expenses / £ / £ / £
Food& Housekeeping / £ / £ / £
Clothes / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Total Essential Expenditure / £ / £ / £
Desirable / Socialising / £ / £ / £
Holidays / £ / £ / £
Interests & Hobbies / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Total Desirable Expenditure / £ / £ / £
Total Expenditure / £ / £ / £
Net Income P.M. / £ / £ / £
Surplus P.M. / £ / £ / £
Will any of the above financial commitments cease in the future? / Please provide details / Please provide details
How much money would you need as an emergency fund? / £
Is this available in an immediately accessible account? / Y / N Details:
Notes /Soft Facts
6.2Statement of Affordability
If you do not wish to complete the full Expenditure Analysis in Section 6.1 (which we strongly recommend that you do), then provide confirmation of your overall position below.
Client 1 / Client 2Is your current level of income sufficient, insufficient or more than sufficient to meet your expenditure? / Insufficient
Sufficient
More than Sufficient / Insufficient
Sufficient
More than Sufficient
If more than sufficient please state monthly surplus / £ / £
I confirm that I have sufficient surplus funds to fund the cost of any financial advice that I may decide to implement.
Section 7:Wills
Please ensure that you provide a copy of your will.
Client 1 / Client 2Have you made a will? / Y / N / Y / N
When was it made?
When was it last reviewed?
Does it reflect your current wishes? / Y / N / Y / N
Name(s) of Executors:
Name(s) of children’s guardians:
Details of Beneficiaries:
Notes /Soft Facts
Page 1 of 29TS&R CFF V1.1March 2015
Section 8:Protection Plans
8.1Income Protection & Sick Pay
Owner / Provider / Policy Number / Amount of Cover(% Salary or Amount) / Deferred Period (months) / Cover to Age / Monthly Premium / Premium (Guaranteed / Reviewable)
£ / G / R
£ / G / R
£ / G / R
£ / G / R
Notes (please provide any additional details that are relevant such as any past claims etc)
8.2Critical Illness
Owner / Provider / Lives Covered / Policy Number / Start Date / Amount of Cover(Sum Assured) / Level/ Decreasing? / Term / Life Cover Included? / Monthly Premium / Premium (Guaranteed / Reviewable)
£ / L / D / yrs / Y / N / £ / G / R
£ / L / D / yrs / Y / N / £ / G / R
£ / L / D / yrs / Y / N / £ / G / R
Notes (please provide any additional details that are relevant, such as link to mortgage etc, any past claims etc)
8.3Life Cover
Owner / Provider / Lives Covered / Policy Number / Start Date / Amount of Cover(Sum Assured on Death) / Type of cover (Level/ Decreasing/ Whole of Life/ etc) / Term / Monthly Premium / Premium (Guaranteed / Reviewable) / Held in Trust?
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
£ / yrs / £ / G / R / Y / N
Notes (please provide any additional details that are relevant to these plans, such as whether they are linked to mortgage etc)
8.4Private Medical Insurance & Health Cash Plans
Owner / Provider / Policy Number / Type of Cover (Single/ Couple / Family) / Monthly Premium / Date of Last Claim£
£
£
£
£
Notes (please provide any additional details that are relevant to these plans, such as any exclusions)
8.5Other
Please provide details of any other protection policies that you may have, or benefit form in the box below, for example Long Term Care policies.
Section 9:PensionsPlans
9.1Defined Contribution Plans (Personal Pensions, Auto Enrolment etc)
Owner / Provider / Policy Number / Policy TypeE.g. PP, SIPP / Start
Date / Individual
Contribution
/ Frequency / Employer
Contribution/ Frequency / Current Value
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
Notes /Soft Facts
Please provide any additional details about these policies, such as if benefits have been taken, any protected tax free cash/pension age that may be in place, Guaranteed Annuity Rates, Guaranteed Minimum Pension rights, Guaranteed Bonus Rates etc.
9.2Defined Benefit Pensions (e.g. Final Salary)
Owner / Employer / Scheme Name / Scheme Retirement age / (Expected) Years’ Service / Active Member / In Payment? / DeathIn service / Spouse’s pension on Death / Expected/ Received Tax Free Cash / Expected /Received Annual Pension
Y / N / Y / N / £ / % / £ / £
Y / N / Y / N / £ / % / £ / £
Y / N / Y / N / £ / % / £ / £
Y / N / Y / N / £ / % / £ / £
Notes /Soft Facts
Record any additional pension related information in this section
9.3Lifetime Allowances
Please provide any HMRC certificates relating to Lifetime Allowance Protection
Client 1 / Client 2Have you applied for Lifetime Allowance Protection from HMRC? / Primary Protection / / Primary Protection /
Enhanced Protection / / Enhanced Protection /
Fixed Protection 2012 / 2014* / / Fixed Protection 2012 / 2014* /
Individual Protection / / Individual Protection /
*Delete as appropriate / *Delete as appropriate
Section 10:Savings & Investments
10.1Savings Plans (Deposit Based including Cash ISAs and NSI&I)
Owner / Account Type / Provider / Amount / Regular Cont & Frequency / Maturity Date / Notice Penalty / Interest Rate / Specific Purpose?£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
£ / £ / %
Notes /Soft Facts
10.2Investments (including Investment Portfolios, Shares, Investment Bonds etc)
Owner / Type (e.g. Shares, Onshore Bond) / Provider / Start Date / Initial Investment / Regular Cont & Frequency / Current Value / Fund(s) / In Trust?£ / £ / £ / Y / N
£ / £ / £ / Y / N
£ / £ / £ / Y / N
£ / £ / £ / Y / N
£ / £ / £ / Y / N
£ / £ / £ / Y / N
£ / £ / £ / Y / N
Notes /Soft Facts
Section 11:Mortgages & Other Debt
11.1Secured
Owner / Product Type / Lender / Repayment MethodSecured / Unsecured / Original Amount / Current Balance Outstanding / Date of Borrowing / Original Term / Monthly Payment / Current Interest Rate/ APR
£ / £ / £ / %
£ / £ / £ / %
£ / £ / £ / %
£ / £ / £ / %
Total Outstanding / £ / Total Monthly / £
Notes/Soft facts:Please add additional details e.g. for product type, where tracker, or similar, add relationship to base rate etc.
11.2Unsecured
Owner / Product Type / Lender / Repayment Method / Original Amount / Current Balance Outstanding / Date of Borrowing / Original Term / Monthly Payment / Current Interest Rate/ APR£ / £ / £ / %
£ / £ / £ / %
£ / £ / £ / %
£ / £ / £ / %
Total Outstanding / £ / Total Monthly / £
Notes/Soft facts:Please add additional details e.g. for product type, where tracker, or similar, add relationship to base rate etc.
Section 12:Other Assets
Asset / Original Date of Purchase/Ownership / Original Value / Current Value / In Trust / Income / Other
House (primary residence) / £ / £ / Y / N / £
Contents/personal possessions / £ / £ / Y / N / £
Personally owned car(s) / £ / £ / Y / N / £
Business interests / £ / £ / Y / N / £
Other property / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Other: / £ / £ / Y / N / £
Notes /Soft Facts
Page 1 of 29TS&R CFF V1.1March 2015
Section 13:Risk Profile
13.1Knowledge & Experience
How would you describe your knowledge and experience of retirement and investment products? Have you held investments before? Have you experienced losses in the past?
Client 1 / Client 213.2Ability to cope with Financial Loss (Adviser use)
A client’s ‘capacity for loss’ refers to a customer’s ability to absorb falls in the value of their investments. If any loss of capital would have a detrimental effect on their standard of living this should be taken into account in assessing the risk that they are able to take.
Please record the details of your discussion with the client(s) and whether, from your assessment, they would be unable to accept the risk of loss of capital.
Client 1 / Client 213.3Willingness to Accept Investment Risk(Adviser Use)
Please record the result from the Tenet risk profiling tool, alternative risk profiling tool or risk profiling process, including the initial outcome and any rationale where the tool result has been amended.
Tool usedClient 1 / Client 2
Profile outcome from tool
Agreed profile (considering knowledge & experience and ability to cope with loss in 6.2):
Where a client wishes to apply a different risk profile to different areas of need, or where a couple wish to apply a different risk profile to individual needs, please indicate in the table below and add notes:
Risk Category / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10Client 1
Client 2 / Pensions
Client 1
Client 2 / Investment & Savings
Client 1
Client 2 / Estate Planning
Notes /Soft Facts
Section 14:Taxation and Investment Allowances
Client 1 / Client 2How much of your annual CGT allowance have you utilised this tax year? / £ / £
Are you planning to utilise your CGT allowance with the disposal of assets in future years? / Yes / No
If yes, how much?
£ / Yes / No
If yes, how much?
£
Do you have any CGT losses from this or previous years? / £ / £
What ISA allowance have you used this tax year? / £ / £
Notes /Soft Facts
Section 15:Investment Preferences
15.1Client Investment Priorities
In terms of your investment strategy, how important would you rate the following?
Veryimportant / Fairly
important / Not so
important / Not important
at all
Tax Efficiency
Cost
Ability to access capital
Ability to vary income
Simplicity of solution
Other:
Notes /Soft Facts
15.2Ethical & Socially Responsible Investments (SRIs)
Client 1 / Client 2Do you have any investment preferences in respect of ethical, social or environmental considerations? / Y / N / Y / N
If ‘Yes’, please detail these considerations and any priority? / Area / / Priority
(1 – 5)
1 = ‘high,
5 = ‘low’ / Area / / Priority
(1 – 5)
1 = ‘high,
5 = ‘low’
Tobacco products / Tobacco products
Armaments / Armaments
Human rights / Human rights
Equal opport. / Equal opport.
Climate change / Climate change
Pollution / Pollution
Other (detail) / Other (detail)
Do you have any faith based considerations (e.g. Islamic Sharia compliant) that you wish to take into account? / Y / N / Y / N
It may not be possible to invest taking into account all SRI considerations. Are you prepared to invest if only your higher priorities are met? / Y / N / Y / N
15.3Review of Existing Investments
Client 1 / Client 2Do you wish to review you existing investments and consider whether it is appropriate to align these to the proposed investment strategy? / Y / N / Y / N
If ‘Yes’ to the above question, which investments are to be reviewed?
Section 16:Other Professional Advisers
Accountant / SolicitorIndividual Name
Firm Name
Firm Address
Telephone
Notes /Soft Facts
Section 17:Current Financial Priorities
Please rank the following statements in order of priority, with 1 being the most important. If any of the below are not applicable, please write N/A in the box.
Client 1 / Client 2Client’s Assessment / Adviser’s Assessment / Client’s Assessment / Adviser’s Assessment
1 / Family Protection (on your or your dependent's death)
2 / Income Protection (during accident/illness/redundancy)
3 / Critical Illness Cover
4 / Private Medical Insurance
5 / Long Term Care
6 / Mortgage/Loan Arrangements
7 / Regular Savings
8 / Planning for Retirement
9 / Inheritance Tax Planning
10 / Lump Sum Investment for Growth
11 / Lump Sum Investment for Income
12 / School Fees/Planning for Education
13 / Reduce Income Tax
(e.g. Independent Taxation)
14 / Business Insurance
15 / Other (Please state)
The following should be given priority (please record why):
Section 18:Additional Notes
Section 19:Declaration
To be completed by Client.
Please read this document carefully before signing.
I confirm that I have provided this information on the understanding that it will be used in the strictest confidence and that it does not place me under any obligation to take up any recommendation that may be made.
Signature / DateClient 1
Client 2
19.1Additional Declarations
Delete if not applicable
I further declare that I have withheld certain details and that I am aware that this may prevent my adviser from being able to provide the best possible advice for my circumstances.
Signature / DateClient 1
Client 2
19.2Release of Information
Please sign and date the relevant boxes on the following page (shown in bold) so that we are able to obtain details of your policies directly from providers.
Adviser note: The back page of this document allows for two separate requests. Please print off additional copies of this page if more are required.
Page 1 of 29TS&R CFF V1.1March 2015
[1] If you have indicated “Yes” to any of the above questions then you may be entitled to an enhanced annuity. You will, however, need to complete an Enhanced Pension Annuity Quotation Request Form which your adviser should download for you from the following link: