Fact Find

Home
About Us
Advice
Tips
Contact

Smart Slider with ID #22 does NOT EXIST or has NO SLIDES!

Usage: WordPress Shortcode

Start your journey with Chrysalis

Expected time to complete:

15 minutes

"*" indicates required fields

Step 1 of 11 - Basic Details

How many applicants?*

One

Two

Client 1 Name*

Prefix First Last

Preferred Name*

Client 2 Name*

Prefix First Last

Preferred Name*

Client 1's Details

Residential Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address

Same as residential address

Postal Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Marital Status

Date of Birth

DD slash MM slash YYYY

Gender*

Female

Male

Referred to us by

Preferred phone number*

Other phone number

Preferred Email*

Other Email

Tax File Number

Employment Details

Employment Status*

Occupation*

Hours worked per week*

Please enter a number from 0 to 168.

Highest Level of Education*

Employer’s name*

Length of service*

Do you own a company?*

Yes

Are you employed by this company?*

Yes

Do you have a Business, Family Trust and/or Self Managed Super Fund?*

If so, please bring ATO rego documents

Yes

Do you have accrued Long Service, Annual and Sick Leave?*

Yes

How many days approx.?*

Professional Services

Do you have an Accountant?*

Yes

Accountant Name*

Accountant Phone No.*

Do you have an Mortgage broker?*

Yes

Broker's Name*

Broker's Phone No.*

Do you have a Lawyer?*

Yes

Lawyer's Name*

Lawyer's Phone No.*

Client 1 Details

Residential Address

Same as Client 1's

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address

Same as Client 1's

Postal Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Marital Status

Date of Birth

DD slash MM slash YYYY

Gender*

Female

Male

Referred to us by

Preferred phone number*

Other phone number

Preferred Email*

Other Email

Tax File Number

Employment Details

Employment Status*

Occupation*

Hours worked per week*

Please enter a number from 0 to 168.

Highest Level of Education*

Employer’s name*

Length of service*

Do you own a company?*

Yes

Are you employed by this company?*

Yes

Do you have a Business, Family Trust and/or Self Managed Super Fund?*

If so, please bring ATO rego documents

Yes

Do you have accrued Long Service, Annual and Sick Leave?*

Yes

How many days approx.?*

Professional Services

Do you have an Accountant?*

Yes

Same Accountant

Same as Client 1's Accountant

Accountant Name*

Accountant Phone No.*

Do you have an Mortgage broker?*

Yes

Same Broker

Same as Client 1's Broker

Broker's Name*

Broker's Phone No.*

Do you have a Lawyer?*

Yes

Same Lawyer

Same as Client 1's Lawyer

Lawyer's Name*

Lawyer's Phone No.*

Your Children

Do you have any children?*

Yes

Children

Name	Date of Birth	Gender	Actions

There are no Children.

Maximum number of children reached.

Status of your relationship with your children?*

Good

Estranged

Do you have any children from a previous relationship?*

Yes

How many?*

Please enter a number greater than or equal to 0.

Client 1's Current Situation

Do you consider yourself good with money?*

Yes

How much do you think you can save per month?*

Are you an Australian Citizen/Permanent Resident?*

Yes

Are you a citizen of another country?*

Yes

Will you change jobs soon?*

Yes

N/A

Likely timeframe?*

Have you sold investments in the current or previous financial year?*

Yes

Amount*

Has your mortgage been reviewed in the past 2 years*

Yes

N/A

Do you want a strategic mortgage broker to review & ensure your loan is the best rate & structure for you?*

Yes

N/A

Are your personal & company tax returns up to date?*

Yes

N/A

What do you expect from your financial planner and the ongoing partnership?*

Client 2's Current Situation

Do you consider yourself good with money?*

Yes

How much do you think you can save per month?*

Are you an Australian Citizen/Permanent Resident?*

Yes

Are you a citizen of another country?*

Yes

Will you change jobs soon?*

Yes

N/A

Likely timeframe?*

Have you sold investments in the current or previous financial year?*

Yes

Amount*

Has your mortgage been reviewed in the past 2 years*

Yes

N/A

Do you want a strategic mortgage broker to review & ensure your loan is the best rate & structure for you?*

Yes

N/A

Are your personal & company tax returns up to date?*

Yes

N/A

What do you expect from your financial planner and the ongoing partnership?*

Client 1's Estate Planning

Do you have a current will?*

Yes

Year Will last reviewed (Estimate only)*

Did an appropriately qualified professional (ie. solicitor/lawyer) draft your Will?*

Yes

Do you know the location of your will and have you told your executor/s?*

Yes

Have you chosen a legal guardian for your children?*

Yes

N/A

Do you have a testamentary trust in your will?*

Yes

N/A

Do you have a current Power of Attorney?*

Yes

What type?*

Do you have an Enduring Guardian?*

Yes

Do you have a current nominated beneficiary on your superannuation/pension?*

Yes

Unsure

Client 1's Insurance

Current Doctor's Name

First Last

How long with GP?

Doctor’s Address or Name of Medical Centre (if you attend a Medical Centre) and Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Doctor's Phone No.

Do you have Private Health Insurance?

Yes

Do you have any life insurance?

Yes

Type

Life

TPD

Trauma

Income Protection

In the last 12 months have you smoked?

(Tobacco/Vape/Other)

Yes

Are you currently taking regular medication?

Yes

Have you recently seen or about to see a medical consultant (including Physio, Chiro, Osteo, Podiatrist or counsellor)?

Yes

Have you ever had a major illness such as; cancer, stroke, heart disease, diabetes, etc?

Yes

Have any members of your immediate family (parents and siblings) had a major illness such as; cancer, stroke, heart disease, diabetes, etc?

Yes

Age diagnosed

Are there any other health related issues that we should be aware of?

Yes

Please elaborate

Client 1's Superannuation

Do you have Super Fund Choice*

Yes

Not sure

Have you made a personal contribution to super this financial year or the last 2 financial years (in addition to employer contributions)?*

Yes

Name of super fund*

Do you have any overseas investments/super funds?*

Yes

Country*

Since turning age 60 have you left an employment arrangement?*

Yes

N/A

Date left?

DD slash MM slash YYYY

Client 2's Estate Planning

Do you have a current will?*

Yes

Year Will last reviewed (Estimate only)*

Did an appropriately qualified professional (ie. solicitor/lawyer) draft your Will?*

Yes

Do you know the location of your will and have you told your executor/s?*

Yes

Have you chosen a legal guardian for your children?*

Yes

N/A

Do you have a testamentary trust in your will?*

Yes

N/A

Do you have a current Power of Attorney?*

Yes

What type?*

Do you have an Enduring Guardian?*

Yes

Do you have a current nominated beneficiary on your superannuation/pension?*

Yes

Unsure

Client 2's Insurance

Current Doctor's Name*

First Last

How long with GP?

Doctor’s Address or Name of Medical Centre (if you attend a Medical Centre) and Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Doctor's Phone No.

Do you have Private Health Insurance?

Yes

Do you have any life insurance?

Yes

Type

Life

TPD

Trauma

Income Protection

In the last 12 months have you smoked?

(Tobacco/Vape/Other)

Yes

Are you currently taking regular medication?

Yes

Have you recently seen or about to see a medical consultant (including Physio, Chiro, Osteo, Podiatrist or counsellor)?

Yes

Have you ever had a major illness such as; cancer, stroke, heart disease, diabetes, etc?

Yes

Have any members of your immediate family (parents and siblings) had a major illness such as; cancer, stroke, heart disease, diabetes, etc?

Yes

Age diagnosed

Are there any other health related issues that we should be aware of?

Yes

Please elaborate

Client 2's Superannuation

Do you have Super Fund Choice*

Yes

Not sure

Have you made a personal contribution to super this financial year or the last 2 financial years (in addition to employer contributions)?*

Yes

Name of super fund*

Do you have any overseas investments/super funds?*

Yes

Country*

Since turning age 60 have you left an employment arrangement?*

Yes

N/A

Date left?

DD slash MM slash YYYY

Your Goals & Objectives

Goals

Goal	Estimated Funds Required	Comments	Actions

There are no Goals.

Maximum number of goals reached.

How important is it to you and your family, to get yourselves organised to put yourselves on a secure path for your future?

High

Medium

Low

Which areas would you like to review to ensure you are well placed for your future?

Cashflow management

Debt Management

Superannuation

Investments

Pensions

Personal Insurance needs & cover

Estate plans

In regards to your Super/Pension

Do you want:

To have tailored advice about your portfolio as your current arrangements do not provide tailored personal advice

To match your investment risk profile to appropriate fund managers based on your personal circumstances so volatility and performance is in line with your expectations

To have tailored advice about improving investment performance to maximise your capital by using investment managers and options not available in your current fund(s)

To be able to see your account details, investment performance, statements and access reports online

One account instead of several, to make it easier to keep track of portfolio and make changes as needed

Advice about Allocated Pension/ Annuities that will provide a regular tax effective income in retirement

To consider implementing a transition to retirement pension, if appropriate

To know upon death, you have some certainty that your super benefits will be paid where you want them to go

The option to access to term deposits within an investment portfolio

Ongoing service and advice, personalised assistance with completing paperwork and help keeping you on track towards your personal goals. Someone to help answer your questions on how your financial situation is impacted when world events occur, economic conditions vary, legislation changes and tax rules changes

In regards to your Insurance

Do you want:

To have all your insurance with the one company to make your insurance easier to manage both now and in the event of a claim.

Where possible, to have your insurance premiums paid through super so it doesn’t impact on your cashflow.

Guaranteed renewable insurance which means once accepted, the insurance company guarantees to renew your cover until policy expiry, so long as you continue to pay your premiums (so they can’t cancel your cover or place any further restrictions on your cover at their discretion or because of any change to your health or occupation).

Indexed cover so your insurance cover increases each year to keep up with the increasing costs of living.

The option to lock in level premiums which cost more in the short term but are more affordable long term.

A policy that does not have a benefit amount which reduces over time.

An insurance policy which is not tied to your employment.

An insurance policy that is highly rated which will provide comprehensive cover and give you the best likelihood of a successful claim.

To review your insurance with a view to reducing your insurance costs.

Other

Do you want:

Guidance on Wills, Powers of Attorney and Enduring Guardians

Help with Centrelink, Department of Veterans Affairs and/or Aged Care

What is important to you?*

To get financially organised and put you on a secure path for your future via a plan designed specifically for you.

Investments

Superannuation

Pensions

Estate Plans

Personal Insurance Cover

Help with spending, budgeting and saving

To be able to see the performance of each individual investment online and in statements

Access to a range of investment options, such as shares, property, fixed interest, cash etc

The option to access to term deposits within an investment portfolio

A consolidated report of your portfolio to make it easier to provide the details to your Accountant to prepare your tax return. A benefit of this may be reduced Accounting Fees and quicker turn around time to process your tax return

Learn more about investments and investing concepts

Be more informed about your money - receive invites to seminars and/or information on investment updates,

new strategies and communication of important and timely financial information

Personalised assistance with completing paperwork in relation to your investments and insurance.

Investment monitoring, personalised projections and strategy modelling to keep you on track towards your personal goals.

Ongoing service that includes formal meetings and information on the performance of your investment portfolio, the progress of the strategies towards goals we set together

Someone to help answer your questions on how your financial situation is impacted when world events occur, economic conditions vary, legislation alters and tax rules change

Your advisor has access to your investment and insurance information and the ability to action changes approved by you

Someone to contact you when there are recommended changes to your portfolio based on economic and market changes

Guidance on Wills, Powers of Attorney and Enduring Guardians

Advice that considers tax minimisation for your beneficiaries upon your passing

Help with Centrelink, Department of Veterans Affairs and/or Aged Care

Your Investment Experience & Comfort Level

What degree of risk have you taken with your financial decisions in the past?*

Very small

Small

Medium

Large

Very Large

Which of the following best describes your current stage of life?*

You are preparing for the future by establishing a home. You may or may not have children. You are expecting to have or already have a high purchase rate of household and consumer items.

You own your own home. You have a mortgage and potentially childcare or other regular costs and maintain only small cash balances.

You are in your peak earning years and your mortgage is under control. You work and you may or may not have children that are growing up or have left home. You may be ready to start thinking about your retirement years.

You are preparing for retirement. You own your home and have few financial burdens. You want to ensure you can afford a comfortable retirement.

You have few financial burdens. You are ready to accumulate wealth for future short-term and long-term goals.

You are retired. You rely on existing funds and investments to maintain your lifestyle in retirement. You may already be receiving a government pension and/or superannuation pension.

What is the primary reason you are investing your funds?*

Long-term capital growth and income

Long-term capital growth

To meet income needs

For capital security

How secure is your current and future income from your existing salary, pensions or other investments?*

Not secure

Reasonably secure

Very secure

Somewhat secure

Which of the following best describes your understanding of investment markets?*

Very experienced. I use research and other investment information to make investment decisions. I understand the various factors which influence investment performance and market cycles.

Some experience. I have an understanding of the various factors which influence investment performance.

Some exposure, but not much experience. I don’t fully understand investments, including the sharemarket.

I am not very familiar when it comes to investment concepts or investment markets.

Not familiar at all with investments and feel uncomfortable with the complexity.

When considering your investments and making investment decisions, do you think about the impact of possible losses or possible gains?*

I am always concerned about possible losses.

I am somewhat concerned about possible losses.

I usually think more about possible gains than losses.

I always think more about possible gains than losses.

In order to earn a return above the level of bank interest rates you may need to hold investments that go up and down in value (i.e. more volatile investments). How important is it to you to protect your investment and minimise the prospect of ANY fall in the value?*

Very important. Protecting my existing investment from ANY fall in value is my main objective.

Important, but I’m comfortable for at least a small part of my portfolio to have volatility in order to improve returns over the longer term.

Somewhat important but I’m prepared to take on a reasonable amount of volatility in order to increase my chance of higher returns over the longer term.

Not particularly important as I’m comfortable that having exposure to volatility is the best way to maximise returns over the longer term.

What rate of investment return do you reasonably expect to achieve?*

Cash or bank deposit rates

Inflation plus 2% per annum

Inflation plus 4% per annum

Inflation plus 6% per annum

Inflation plus 8% per annum

How long are you looking at investing your savings before you think you would need to access it?*

In 2 years or less

Within 3 - 5 years

Within 6 - 10 years

Not for 10+ years

(This question assumes you already have plans in place to meet short-term cashflow and/or emergencies.)

Assume you had an initial investment portfolio worth $100,000. If, due to market conditions, your portfolio fell to $75,000, would you:*

Sell all of the investments to cash immediately? You do not intend to take any risks.

Sell a portion of your portfolio to cut your losses and reinvest into more secure and conservative investments?

Hold the investment and sell nothing, expecting performance to improve in the near future?

Buy more investments to take advantage of cheaper prices?

(If your portfolio has experienced a drop like this, choose the answer that corresponds to your actual behaviour.)

When investing your money, investment returns and investment risks usually go together. For example, investments that produce above average returns will usually involve above average risk. How much of the money that you're considering for investment would you be willing to place in investments where both investment returns and risks are expected to be above average (e.g. invested in shares)?*

None - I would prefer to keep it all in Cash even though inflation may erode my spending power over time.

Up to 35% - I expect to get small returns with very little risk but aiming to generate better longer terms returns than Cash.

35% to 60% - I am happy taking some growth assets in order to generate better long term returns in order to keep ahead of inflation.

61% to 80% - I am happy to invest primarily in growth assets to generate higher, long term returns so that I can better manage the impact of inflation on my investments.

Over 80% - investing in growth assets will ensure that my money is working harder for me over the long term as I want my investments to at least keep up with inflation.

How often would you be prepared to tolerate a negative return to receive progressively higher returns?*

Never

One year in ten

One year in seven

One year in four

One year in three

{all_fields:nohidden}

Date

DD slash MM slash YYYY