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Client Discovery Form (Old)

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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*

Day

Month

Year

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*

Day

Month

Year

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

Financial Goals

What are your objectives & financial priorities?

Example: Grow Wealth, Reduce Debt, Transition & Plan for Retirement, Fund School Fees, Fund Travel, Budget & Savings Plan, Assist children and/or grandchildren, Establish SMSF, Invest & Protect Funds.

Financial Priority 1*

Timing (years)

Please enter a number greater than or equal to 0.

Amount Required ($)

Financial Priority 2

Timing (years)

Please enter a number greater than or equal to 0.

Amount Required ($)

Financial Priority 3

Timing (years)

Please enter a number greater than or equal to 0.

Amount Required ($)

Financial Priority 4

Timing (years)

Please enter a number greater than or equal to 0.

Amount Required ($)

Financial Priority 5

Timing (years)

Please enter a number greater than or equal to 0.

Amount Required ($)

Financial Goals

These are more specific goals you wish to achieve from current or potential financial strategies. It is the attainment of these goals that will enable you to achieve your lifestyle objectives. Please tick all that apply to you.

Generate an annual income of (specify in 'Retirement Income Goal') in retirement to fund living expenses

Retirement Income Goal

Build wealth and accumulate assets tax-effectively for retirement

Build wealth (other than for retirement) tax‐effectively

Review your current investments to determine if they are aligned to your goals. Diversify your assets across a broader range of investments.

Diversify your assets across a broader range of investments

Have more control over and have a better understanding of your investments

Manage your income and cash flow to improve your financial position

Secure your standard of living in retirement by producing a stable income

Protect yourself and/or your family in case of illness, accident or death

Provide for your beneficiaries in a secure and tax‐effective way

Save for a short‐term goal (e.g., home deposit, overseas holiday)

Ensure your mortgage is paid off by retirement

Consider ways to manage your investments and professional assistance

Primary Contact anticipates retiring at age:

Please enter a number from 20 to 100.

Second Contact anticipates retiring at age:

Please enter a number from 20 to 100.

I want to achieve financial freedom by year

Tell us more about these goals.

What specifically would you like to cover during our first meeting?

Do you have children / dependents

Yes

Children / Dependents

Child / Dependent 1

First Last

Date of Birth

Day

Month

Year

Financially Dependent?

Yes

Financially dependent to what age?

Please enter a number from 0 to 100.

Child / Dependent 2

First Last

Date of Birth

Day

Month

Year

Financially Dependent?

Yes

Financially dependent to what age?

Please enter a number from 0 to 100.

Child / Dependent 3

First Last

Date of Birth

Day

Month

Year

Financially Dependent?

Yes

Financially dependent to what age?

Please enter a number from 0 to 100.

Child / Dependent 4

First Last

Date of Birth

Day

Month

Year

Financially Dependent?

Yes

Financially dependent to what age?

Please enter a number from 0 to 100.

Child / Dependent 5

First Last

Date of Birth

Day

Month

Year

Financially Dependent?

Yes

Financially dependent to what age?

Please enter a number from 0 to 100.

Employment Details

Position / Title

Employer Name

Employment Type

Current Salary Package

Please enter a number greater than or equal to 0.

Employment Start Date

Day

Month

Year

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

Day

Month

Year

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

Superannuation Details

Superannuation Fund 1

Current Value ($)

Owner

Primary Contact

Secondary Contact

Superannuation Fund 2

Current Value ($)

Owner

Primary Contact

Secondary Contact

Superannuation Fund 3

Current Value ($)

Owner

Primary Contact

Secondary Contact

Superannuation Fund 4

Current Value ($)

Owner

Primary Contact

Secondary Contact

To the best of your knowledge, have you made any lump sum contributions to superannuation in the last three years?

Yes

What was the Superannuation lump-sum contribution amount?

Insurance Details

Insurance Policies

List policies you hold for Life & TPD / Trauma / Income Protection

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Policy Type

Life & TPD

Trauma

Income Protection

Insurer

Benefit ($)

Annual Premium ($)

Owner

Primary Contact

Secondary Contact

Other Insurances held

Home & Contents

Motor Vehicle

Personal Indemnity

Business / Key Person

Mortgage

Private Health

Other

Other Insurance Type

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

Assets & Liabilities

Family Home

Property

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Investment property 1

Property

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Investment property 2

Property

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Other

Property

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Cash on deposit

Savings / Investments

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Savings / Investments

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Managed Funds

Savings / Investments

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Fixed Interest

Savings / Investments

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Other

Savings / Investments

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Tax Liability

Business Interest

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Current Value

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Purchase Value

Owing

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Lender

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Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

This field is hidden when viewing the form

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Company Investments

Business Interest

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Other

Business Interest

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Car

Personal

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Credit Cards

Personal

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Home Contents

Personal

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

Other

Personal

Current Value

Purchase Value

Owing

Lender

Rate (%)

Repayment Frequency

Weekly

Fortnightly

Monthly

Loan type

Fixed

Variable

Owner

Primary Contact

Secondary Contact

Joint

TOTAL

Total Assets

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Total Purchase

Total Liabilities

Net Position

What’s important to you?

What are your financial priorities?

Is growing the value of your assets important to you?

Yes

Is the reliable generation of income important to you?

Yes

Is leaving assets to others upon your death important to you?

Yes

Is the tax efficiency of your affairs important to you?

Yes

Do you understand these financial concepts?

Inflation is the rate prices that increase each year

Yes

Income investments like term deposits earn interest however the capital value decreases due to inflation.

Yes

Growth assets like real estate and shares grow in value over time, however, sometimes decrease in value in the short term due to market fluctuation.

Yes

When investment markets fluctuate, it is referred to as market volatility. Volatility does not mean you lose money.

Yes

Comments

Investor Profile

How long are you willing to invest your money to achieve your financial goals?

1-3 years

3-5 years

5-10 years

10+ years

Do you expect to require any capital withdrawal from your investment?

Yes

When do you expect to withdraw?

Over the time frame of your investment, what annual % return would you expect?

1-5%

5-7%

7-10%

10-15%

15%+

Would you be satisfied if HPW implemented a strategy that achieves your specific goals over an agreed timeframe?

Yes

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:

a) How would you feel if a portion of your investment portfolio fell temporarily?

b) Are you comfortable investing in these asset classes?

In a falling market, are you likely to want to buy or sell assets?

Buy

Sell

Investing experience

Have you invested in Australian Shares?

Yes

Have you invested in International Shares?

Yes

Have you invested in Property?

Yes

Have you invested in Fixed Income?

Yes

Assuming you have had some investing experience, please describe your best and worst investing experience:

Have you had a financial planner previously? If so, please detail your experience:

Estate Planning Details

Do you have a will?

Yes

Date your will was reviewed

Day

Month

Year

Who are your main beneficiaries?

Are there provisions for a Testamentary Trust?

Yes

Have you made any provisions for any bequests?

Yes

Are you likely to receive an inheritance in the next 10 years?

Yes

Do you have a Power of Attorney (POA)

Yes

What type of POA do you have?

Medical POA

Financial POA

Guardian

Second Contact Estate Planning Deatils

Do you have a will?

Yes

Date your will was reviewed

Day

Month

Year

Who are your main beneficiaries?

Are there provisions for a Testamentary Trust?

Yes

Have you made any provisions for any bequests?

Yes

Are you likely to receive an inheritance in the next 10 years?

Yes

Do you have a Power of Attorney (POA)

Yes

What type of POA do you have?

Medical POA

Financial POA

Guardian

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

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