Form Test – Hewison Redesign

Tell us how we can help

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Client Discovery Form

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Step 1 of 15 - Confidential Client Profile

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Lead ID

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DCF ID

Our Promise to You.

Your privacy is particularly important to us. Discretion and dedication are our assurance, always. To help us provide you with the most accurate and tailored financial advice we need to gather some detailed information about your personal circumstances and financial position. This will allow us to assess and provide bespoke advice and recommendations specific to you and your objectives.

We are committed to protecting your personal information and will always treat this with great care and confidentiality in accordance with our Privacy Policy and current privacy laws.

How did you first hear about us?*

Primary Contact

Name*

Title First Middle Last

Preferred Name*

Marital Status

Email*

Mobile Phone*

Home Phone

Work Phone

Date of Birth*

City of Birth

Country of Birth

Home Address*

Street Address Address Line 2 City State / Province / Region Postcode Country

Postal Address

Same as home address

Street Address Address Line 2 City State / Province / Region Postcode Country

Is there a second person to be included?*

Yes

Second Contact

Name*

Title First Middle Last

Preferred Name*

Marital Status

Email*

Mobile Phone*

Home Phone

Work Phone

Date of Birth*

City of Birth

Country of Birth

Home Address*

Same as Primary Contact

Street Address Address Line 2 City State / Province / Region Postcode Country

Postal Address

Same as Home Address

Street Address Address Line 2 City State / Province / Region Postcode Country

Employment Details

Position / Title

Employer Name

Employment Type

Current Salary Package

Please enter a number greater than or equal to 0.

Employment Start Date

Retirement Age

Please enter a number greater than or equal to 0.

Do you expect any substantial changes to your income in the next two to five years? If yes, please provide us with a little more detail:

Second Contact Employment Details

Position / Title

Employer Name

Employment Type

Employment Start Date

Retirement Age

Please enter a number greater than or equal to 0.

Income Details

Salary (Gross)

Bonus / Profit Share

Rental Income

Investment Income

Centrelink / DVA Income Social Security

Super / Annuity Income

Other income

Total Income

Total Living Expenses

Second Contact Income Details

Salary (Gross)

Bonus / Profit Share

Rental Income

Investment Income

Centrelink / DVA Income Social Security

Super / Annuity Income

Other income

Total Income

Total Living Expenses

Net Income

Income

Expenses

Surplus

Health Details

State of Health

Have you smoked in the last 5 years?

Yes

Do you have private health insurance

Yes

Second Contact Health Details

State of Health

Have you smoked in the last 5 years?

Yes

Do you have private health insurance

Yes

Current Professional Advisers

Accountant

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region Postcode Country

Solicitor

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region Postcode Country

Other

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region Postcode Country

Authorisation & Confirmations

I/We confirm that to the best of my/our knowledge the information recorded in this data collection form is a complete and accurate record of my/our financial situation and particular needs.*

I/We consent to Hewison Private Wealth providing advice and documentation to me/us via email to me /our nominated email address or via Hewison’s website www.hewison.com.au. This includes Statements of Advice, Financial Services Guides, Product Disclosure Statements and Periodic Statements.*

I/We consent to Hewison Private Wealth providing advice and documentation to me/us via email to me /our nominated email address or via Hewison's website www.hewison.com.au. This includes Statements of Advice, Financial Services Guides, Product Disclosure Statements and Periodic Statements.*

I/We have received and read Hewison’s Financial Services Guide.*

I/We have received and read Hewison's Privacy Statement.*

I/We consent to Hewison collecting sensitive information about us/me for the purposes of Hewison providing services to me.

I/We wish to receive weekly E-news from Hewison Private Wealth to keep me up to date with insights and updates.

Privacy Statement

Hewison & Associates Pty Ltd (ABN 51 009 082 257) (referred to as ‘Hewison Private Wealth’, ‘we’, ‘our’, ‘us’) will be collecting your personal information when you complete this form. We are committed to ensuring the confidentiality and security of your personal information. You can contact us by telephoning 03 8548 4800 or emailing info@hewison.com.au.

If you do not provide the personal information we request, we may elect to terminate our retainer with you if we believe we are unable to provide you with a complete service.

We collect personal information about you for the following purposes:

to assist Hewison Private Wealth in providing the financial services you request, including preparing your financial plan, providing financial advice, reviewing financial plans and investment recommendations, and administering your financial affairs.
to complete documentation and forms.
to consider and assess your request for a product or service.
to provide you with information about a product or service.
to protect our business and other clients from fraudulent or unlawful activity.
to conduct our business and perform other management and administration tasks;
to consider any concerns or complaints you may have.
to manage any legal actions involving Hewison Private Wealth.
to comply with relevant laws, regulations and other legal obligations, including the Corporations Act 2001, Anti-Money Laundering and Counter-Terrorist Financing Act 2006, and Rules of Professional Conduct of the Financial Planning Association of Australia; and
to help us improve the financial services offered to our customers, and to enhance our overall business.

We may disclose your personal information to:

a related entity of Hewison Private Wealth.
an agent, contractor or service provider we engage to carry out our functions and activities, such as our lawyers, accountants, debt collectors or other advisors;
professional external auditors.
organisations involved in a transfer or sale of all or part of our assets or business (individuals will be advised of any such transfer or sale);
organisations involved in managing payments, including payment merchants and other financial institutions such as banks;
regulatory bodies, government agencies, law enforcement bodies and courts, including the Financial Planning Association of Australia and the Australian Securities and Investments Commission;
superannuation fund trustees.
insurance providers.
other financial product issuers; and
anyone else to whom you authorise us to disclose it or is required by law.

We do not disclose personal information to overseas recipients.

Our Privacy Policy (available at https://www.hewison.com.au) contains information about how:

you may access the personal information we hold about you.
you may seek the correction of your personal information; and
to make a privacy complaint and how we will deal with your complaint.

Phone

This field is for validation purposes and should be left unchanged.

About us

Let's meet. Face-to-face or virtually, the choice is yours.

Services

Let's meet. Face-to-face or virtually, the choice is yours.

Approach

Let's meet. Face-to-face or virtually, the choice is yours.

Let's meet. Face-to-face or virtually, the choice is yours.

Tell us how we can help

Thank you

Client Discovery Form

Our Promise to You.

Primary Contact

Second Contact

Financial Goals

What are your objectives & financial priorities?

Financial Goals

Children / Dependents

Employment Details

Second Contact Employment Details

Income Details

Second Contact Income Details

Net Income

Superannuation Details

Insurance Details

Insurance Policies

Health Details

Second Contact Health Details

Assets & Liabilities

Family Home

Investment property 1

Investment property 2

Other

Cash on deposit

Shares

Managed Funds

Fixed Interest

Other

Tax Liability

Company Investments

Other

Car

Credit Cards

Home Contents

Other

TOTAL

What’s important to you?

What are your financial priorities?

Do you understand these financial concepts?

Investor Profile

Growth Markets, such as shares and property can fall in value sharply. Sometimes by around 30% in a single year. Over the longer term however they are expected to grow in value. Knowing this:

Investing experience

Estate Planning Details

Second Contact Estate Planning Deatils

Current Professional Advisers

Accountant

Solicitor

Other

Authorisation & Confirmations

Privacy Statement