PROTECTION ‘FACTFIND’ v2 Chester Partnership 15.09.15

To get the most from our meeting

Preparing for our meeting will ensure you gain maximum value from the time we spend together.

Providing the personal details in this ‘fact find’ document will enable us to better concentrate on helping you identify & prioritise your protection needs.

Any questions you have regarding the relevance of us requesting this info will be answered at our meeting.

Client Name(s)
Fact Find Date
Instructions for use: - / Please complete those sections which have been ‘greyed’ out. Other information will be gathered when we meet.

Scope of Our Advice – Adviser to Complete

Lifestyle Protection Needs / Client Preferences / Instructions
Client 1 / Client 2
Creating an on-going income in the event of death / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Creating a lump sum on death / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Mortgage & Debt / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Repayment on Death / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Repayment on critical / serious illness / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Income on illness / redundancy / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
General Insurance / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Buildings & Contents / Please SelectIn ScopeOut of Scope / Please SelectIn ScopeOut of Scope
Version of SCDD & Terms of Business given to client / TCP Version 1 14.08.15
Date SCDD & Terms of Business given to client / //
Date Fact Find carried out with client / //
How was the advice provided? / Please SelectFace-to-FaceNon Face-to-Face
How is the ID verification stored? / Please SelectElectronic ID ProcessPaperSimplified Due Diligence
Personal Details / Client 1 / Client 2
Title / Please SelectMrMrsMissMsDrProf.Rev.SirDameLadyLord / Please SelectMrMrsMissMsDrProf.Rev.SirDameLadyLord
First Name
Middle name(s)
Surname
Preferred name
Date of Birth / // / //
Gender / Please SelectMaleFemale / Please SelectMaleFemale
Marital Status / Please SelectMarried / Civil PartnershipSingleDivorcedSeparatedWidowedCo-habiting / Please SelectMarried / Civil PartnershipSingleDivorcedSeparatedWidowedCo-habiting
Smoker / Please SelectYesNo / Please SelectYesNo
Appointment Basis? / Please SelectFace to FaceTelephone / Please SelectFace to FaceTelephone
Role in Process? / Please SelectApplicantGuarantorOther / Please SelectApplicantGuarantorOther
Additional Info / Client 1 / Client 2
Main Employment status / Please SelectEmployedSelf-employedDirectorUnemployedHousepersonRetired / Please SelectEmployedSelf-employedDirectorUnemployedHousepersonRetired
Preferred Retirement Age
Do you have any dependents? / Please SelectYesNo / Please SelectYesNo
If Yes please provide: / Name / Date of Birth / Relationship / Gender
1. / // / //
2. / // / //
3. / // / //
Job Title
Current Address / Client 1 / Client 2
House Number & Street
Town / City
County
Postcode
Residential status / Please SelectOwner Occupier with MortgageOwner Occupier without MortgagePrivate TenantCouncil TenantLiving with Friends or Family / Please SelectOwner Occupier with MortgageOwner Occupier without MortgagePrivate TenantCouncil TenantLiving with Friends or Family
Time at this address? / yrs / mths / yrs / mths
New Address / Client 1 / Client 2
Is there a New Property Address? / Please SelectYesNo / Please SelectYesNo
House Number & Street
Town / City
County
Postcode
Country
Contact Details / Client 1 / Client 2
Preferred contact Method / Please SelectHomeWorkMobileEmailPostal Mail / Please SelectHomeWorkMobileEmailPostal Mail
Preferred Contact Time? / Please SelectAny timeDuring office hoursAfter 6pmBefore 9amAt the weekend / Please SelectAny timeDuring office hoursAfter 6pmBefore 9amAt the weekend
Home phone
Work Phone
Mobile phone
Email address
Existing Cover / Client 1 / Client 2
Owner
Policy Type
Provider
Policy Number
Sum Assured – Life
Sum Assured - CIC
Purpose
Premium
Renewal date / // / //
Existing Cover / Client 1 / Client 2
Owner
Policy Type
Provider
Policy Number
Remaining Term
Sum Assured – Life
Sum Assured - CIC
Purpose
Premium
Renewal date / // / //

Adviser to record on separate sheet if more cover in place

Monthly Financial Summary / Client 1 / Client 2
Net Income (A) / £ / £
Expenditure / Client 1 / Client 2
Mortgage & Home
(Mortgage/Rent, Council Tax, Utilities, Phones/Broadband, TV/Sky/Cable, Home Insurance, Domestic Help, Gardener…etc) / £ / £
Lifestyle
(Food, Clothes, Childcare, Eating out, Holidays, Gym/Memberships, Savings/Pensions, Insurance policies…etc) / £ / £
Travel
(Fuel, Public Transport, Servicing/MOT, Road Tax, Parking/Tolls…etc) / £ / £
Borrowing & Debts
(Personal Loans, Car Finance, Credit Cards, Store Cards, Hire Purchase Payments…etc) / £ / £
Day to Day Expenses
(Newspapers/Magazines, Teas/Coffees/Lunches, Cigarettes, Takeaways…etc) / £ / £
Total Monthly Expenditure (B) / £ / £
Disposable Income / Client 1 / Client 2
Amount Disposable (A – B) / £ / £

Client Needs – Adviser to Complete

Detailed Analysis - Adviser to Complete Shortfall Analysis (see supplementary questionnaire)

Basic Planning -

Owner / Please SelectSingleJoint
Lifestyle Need Area / Please SelectLump Sum on DeathIncome on DeathCritical / Serious IllnessIncome Protection
Policy Type / Please SelectLevel Term AssuranceDecreasing Term AssuranceIncreasing Term AssuranceMortgage ProtectionFamily Income BenefitIncome ProtectionAccident & SicknessRedundancyWhole of Life
Lump Sum, or Regular Income Required / £
Is affordability a key factor when considering our recommendation? / Please SelectYesNo
Owner / Please SelectSingleJoint
Lifestyle Need Area / Please SelectLump Sum on DeathIncome on DeathCritical / Serious IllnessIncome Protection
Policy Type / Please SelectLevel Term AssuranceDecreasing Term AssuranceIncreasing Term AssuranceMortgage ProtectionFamily Income BenefitIncome ProtectionAccident & SicknessRedundancyWhole of Life
Lump Sum, or Regular Income Required / £
Is affordability a key factor when considering our recommendation? / Please SelectYesNo

Design Solution – Adviser to Complete

Detailed Shortfall Analysis Completed? / Yes – see SQ / No – as above
Applicant(s)
Policy Type / Please SelectLevel Term AssuranceDecreasing Term AssuranceIncreasing Term AssuranceMortgage ProtectionFamily Income BenefitAccident & SicknessRedundancyWhole of LifeIncome Protection - Own LifeIncome Protection - LOA
Provider
Quote Date / //
Life cover amount / £
CIC / Serious Illness amount / £
Monthly Benefit amount / £
Deferred Period
Monthly Premium / £
Premium Type? / Please SelectGuaranteedReviewable
Term / yrs
Life Basis? / Please SelectSingle lifeJoint LifeJoint Life 1st DeathJoint Life 2nd Death
Life Assured 1
Life Assured 2
Written in Trust / Please SelectYesNo
Is this replacement cover? / Please SelectYesNo
Reasons: -
Has waiver been included? / Please SelectYesNo
Has indexation been included? / Please SelectYesNo
Is application to be made? / Please SelectYesNo
Need area being addressed? / Please SelectIncome on Death or Critical / Serious IllnessCritical / Serious IllnessRepay on Death or Critical - Serious IllnessLond Term DisabilityShort Term DisabilityRedundancy
Commission / Fee? / £

Recommendation 2

Applicant(s)
Policy Type / Please SelectLevel Term AssuranceDecreasing Term AssuranceIncreasing Term AssuranceMortgage ProtectionFamily Income BenefitAccident & SicknessRedundancyWhole of LifeIncome Protection - Own LifeIncome Protection - LOA
Provider
Quote Date / //
Life cover amount / £
CIC / Serious Illness amount / £
Monthly Benefit amount / £
Deferred Period
Monthly Premium / £
Premium Type? / Please SelectGuaranteedReviewable
Term / yrs
Life Basis? / Please SelectSingle lifeJoint LifeJoint Life 1st DeathJoint Life 2nd Death
Life Assured 1
Life Assured 2
Written in Trust / Please SelectYesNo
Is this replacement cover? / Please SelectYesNo
Reasons: -
Has waiver been included? / Please SelectYesNo
Has indexation been included? / Please SelectYesNo
Is application to be made? / Please SelectYesNo
Need area being addressed? / Please SelectIncome on Death or Critical / Serious IllnessCritical / Serious IllnessRepay on Death or Critical - Serious IllnessLond Term DisabilityShort Term DisabilityRedundancy
Commission / Fee? / £

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