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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
Fact Find DocumentConfidential Fact Finder
Please read the important notice below:The Corporations Act requires that an adviser providing financial services advice must have reasonable grounds for providing that advice. This means that the adviser must conduct appropriate enquiries as to the investment objectives, financial situation and particular needs of the person concerned. The information requested in this form is necessary to enable a recommendation to be made on a reasonable basis and will be used for that purpose.
Please complete this form as thoroughly as you can. If you are unsure, please leave it blank and we will assist you at your appointment.
SECTION 1
PERSONAL DETAILS Client 1 Client 2Title Mr/Mrs/Miss/Ms/Dr Mr/Mrs/Miss/Ms/Dr
NAME
SURNAME
Gender Male/Female Male/Female
Marital Status Single/Married/Divorced Single/Married/Divorced
Date Of Birth
Preferred Name
Australian Citizen Yes / No Yes / No
CONTACT DETAILSStreet Address
Suburb Suburb Suburb
Moved In Date (Home) Home #
Mobile Phone # Mobile #
Email Address - @
Preferred Contact Mobile/Email/Home/Work Mobile/Email/Home/Work
Previous Address Suburb
EMPLOYMENTEmployer / Business
Job Title
Duties Performed
Qualifications
Status Full / Part / Self / Director Full / Part / Self / Director
Start Date
SECTION 2
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
Employer’s Address
Suburb
Phone Number
Fax Number
Previous JOB (>2 years)
Employer
Job Title
Date Ceased
Changing your Job Soon? Yes / No Yes / No
New Job
Details
CHILDREN Child 1 Child 2 Child 3 Child 4NAME
Health Poor/Fair/Good Poor/Fair/Good Poor/Fair/Good Poor/Fair/Good
Date of Birth
Dependant To 17/18/19/20/21 17/18/19/20/21 17/18/19/20/21 17/18/19/20/21
Gender Male/Female Male/Female Male/Female Male/Female
ESTATE PLANNING Client 1 Client 2Do You Have A Will Y/N Date Y/N Date
Executor
Power Of Attorney – Who? Y/N Name Y/N Name
Life Tenancy / Testament Trust? Life Tenancy / Testamentary Life Tenacy / Testamentary
Name of Nearest Living RELATIVE to YOU
Address
Suburb
Phone Number
Mobile Phone Number
Relationship Mother/Father/Brother/Sister Mother/Father/Brother/Sister
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 3
ACCOUNTANT Client 1 Client 2Accountant’s Name
Firm
Phone & Fax
Address
Suburb
Email Address
SOLICITOR / ADVISER Client 1 Client 2Solicitor’s Name
Firm
Phone & Fax
Address
Suburb
Email Address
Client 1 CREDIT HISTORY Client 2Yes / No Do you have any DEFAULTS? Yes / No
Yes / No Have you been BANKRUPT? Yes / No
SHARES & MANAGED FUNDS
$ $ $ $ $
$ $ $ $ $
PERSONAL LOAN / LEASES / HIRE PURCHASEName Item Owner Repayments Frequency Years
$ Frequency$ Frequency$ Frequency
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 4
COMPANY NAMEDirectors Shares Owned By
Directors Shares Owned By
ASSETSName / type Amount Owned by
$$$$$$$$
DEBTSName / type Amount Owned by
$$$$$$
TRUST NAMETrustee / Beneficiary Appointor
Trustee / Beneficiary Appointor
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 5
FAMILY HOME PROPOSED NEW PROPERTYAddress AddressSuburb SuburbOwnership % % Ownership % %
% %Bank Break FeeBranch
Purchase Price $ Purchase Price $Purchase Date Saved / Deposit $Value Today $ First Home Yes / No
Loan Amount $ Loan Amount $Fixed / Variable Fixed/Variable Fixed / Variable Fixed/VariableRepayment $ Interest Rate %Frequency Week/FN/Month Frequency Week/FN/MonthInterest Rate %Loan Amount $ Loan Amount $Fixed / Variable Fixed/Variable Fixed / Variable Fixed/VariableRepayment $ Interest Rate %Frequency Week/FN/Month Frequency Week/FN/MonthInterest Rate % RENT $
Electricity $ SecurityWater/Utilities $ Body Corp $Gas $ Solicitor Fees $Insurance $ Mortgage Rego $ Times .Rates $ Bank Fees $
$ $
INVESTMENT PROPERTY 1 INVESTMENT PROPERTY 2Address AddressSuburb SuburbOwnership % % Ownership % %
% %Bank Break Fee Bank Break FeeBranch $ Branch $
Purchase Price $ Purchase Price $Purchase Date Purchase DateValue Today $ Value Today $
Loan Amount $ Loan Amount $Fixed / Variable Fixed/Variable Fixed / Variable Fixed/VariableRepayment $ Repayment $Frequency Week/FN/Month Frequency Week/FN/MonthInterest Rate % Interest Rate %Loan Amount $ Loan Amount $Fixed / Variable Fixed/Variable Fixed / Variable Fixed/VariableRepayment $ Repayment $Frequency Week/FN/Month Frequency Week/FN/MonthInterest Rate % Interest Rate %Utilities / Gas $ Utilities / Gas $Rate / Insurance $ Rate / Insurance $
_______________________________________________________________________________________Page 5 Fact Find Document
Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
RENT $ RENT $SECTION 6
GOALS & OBJECTIVES
Short Term 1-2 years
Medium Term 3-5 years
Long Term 5 years +
SECTION 7
SUPERANNUATION CLIENT 1Fund Fund Fund
Policy # Roll over
Bal $ Policy # Roll over
Bal $ Policy # Roll over
Bal $
Y/N Y/N Y/N
1
2
3
4
SUPERANNUATION CLIENT 2Fund Fund Fund
Policy # Roll over
Bal $ Policy # Roll over
Bal $ Policy # Roll over
Bal $
Y/N Y/N Y/N
1
2
3
4
Please AnswerRETIREMENT
Select Age AGE to Retire Select Age
If a Couple? INCOME in Retirement (Today’s Dollar)
If on your Own?$0 $0
LUMP SUM INCOME Age $0 Age $0 Age $0 Age $0
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
IN RETIREMENTSECTION 8
Client 1 INCOME PROTECTION Client 2Policy # Policy #
Life Co. Life Co.
Premium $ Premium $
Frequency Mth / Qtr / Half / Yr Frequency Mth / Qtr / Half / Yr
Policy Owner Policy Owner:
Benefit Amount $ Benefit Amount $
Waiting Period 14/30/60/90/180/365 Days Waiting Period 14/30/60/90/180/365 Days
Benefit Period 2/5/6 Yrs - To Age 55/65/70 Benefit Period 2/5/6 Yrs - To Age 55/65/70
Agreed/Indemnity Agreed/Indemnity Agreed/Indemnity Agreed/Indemnity
Client 1 LIFE & TPD Client 2Policy # Policy #
Life Co. Life Co.
Premium $ Premium $
Frequency Mth / Qtr / Half / Yr Frequency Mth / Qtr / Half / Yr
Policy Owner: Policy Owner:
Life $ TPD $ Life $ TPD $
Client 1 TRAUMA Client 2Policy # Policy #
Life Co. Life Co.
Premium $ Premium $
Frequency Mth / Qtr / Half / Yr Frequency Mth / Qtr / Half / Yr
Policy Owner: Policy Owner:
Trauma $ Child $ Trauma $ Child $
Life $ TPD $ Life $ TPD $
Client 1 WORK SUPER – LIFE & TPD Client 2Policy Number Policy Number
Premium $ Premium $
Frequency Wk / Fn / Qtr / Half / Year Frequency Wk / Fn / Qtr / Half / Year
Indexed Yes / No Indexed Yes / No
Life $ TPD $ Life $ TPD $
REVIEW Income Protection Life TPD TraumaSECTION 10
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
INCOME Example: Gross Wages | $80,000 | Annually
Gross Wages $ - Wages / Salary $ -
Overtime $ - Overtime $ -
Distributions $ - Distributions $ -
Benefits- Centrelink $ - Benefits- Centrelink $ -
Pension Payments $ - Pension Payments $ -
Salary Sacrifice $ - Salary Sacrifice $ -
PERSONAL EXPENSES Example: Car Repairs | $1000 | Weekly
Car Insurance $ - $ -Car Insurance $ - $ -
Car Insurance $ - $ -
Health Insurance $ - $ -
Groceries $ - $ -
Personal $ - $ -
Utilities $ - $ -
Electricity $ - $ -
Sports $ - $ -
Education $ - $ -
Transport $ - $ -
Holidays $ - $ -
SALARY SACRIFICE Client 1 Client 2Are you prepared to
Salary Sacrifice to your Superannuation?
Yes / No Yes / No
$0 / Annum $0 / Annum
Yes / No In Retirement – would you like to work Full Time / Part Time? Yes / No
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 11
ASSETSName / type Amount Owned by
$$$$$$$$$
DEBTSName / type Amount Owned by
$$$$
NAME OF USUAL DOCTOR LAST VISIT REASON
DrCentre
Address
NAME OF USUAL DOCTOR LAST VISIT REASON
DrCentre
Address
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 12
RISK PROFILE CLIENT 1 CLIENT 2
Question 1. In general, how would your best friend describe you as a risk taker? 1 2 3 4 select
1 2 3 4 select
(a) A real risk avoider 1(b) Cautious 2(c) Willing to take risks after completing adequate research 3(d) A real gambler 4
Question 2. You are on a TV game show and can choose one of the following. Which would you take?
1 2 3 4 select
1 2 3 4 select
(a) $2,000 in cash 1(b) A 50% chance at winning $10,000 2(c) A 25% chance at winning $20,000 3(d) A 5% chance at winning $200,000 4
Question 3.You have just finished saving for a “once-in-a-lifetime” vacation. Three weeks before you plan to leave, you lose your job. What do you do in this circumstance?
1 2 3 4select
1 2 3 4 select
(a) Cancel the vacation 1(b) Take a much more modest vacation 2(c) Go, reasoning that you need the time to prepare for a job search 3(d) Extend your vacation as this might be your last chance to go first class 4
Question 4. If you unexpectedly received $40,000 to invest, what would you do? 1 2 3 select
1 2 3 select
(a) Deposit in a bank account, money market, or an insured CD 1(b) Invest it in safe high-quality bonds or bond mutual funds 2(c) Invest it in shares or share unit trusts 3
Question 5. In terms of experience, how comfortable are you investing in stocks or stock?
1 2 3 select
1 2 3 select
(a) Not at all comfortable 1(b) Somewhat comfortable 2(c) Very comfortable 3
Question 6. When you think of the word “risk”, which of the following words comes to mind first?
1 2 3 4 select
1 2 3 4 select
(a) Loss 1(b) Uncertainty 2(c) Opportunity 3(d) Thrill 4
Question 7.
Some experts predict prices of assets, such as gold, jewels, collectibles, & real estate are to increase in value. Bond prices may fall; however, experts tend to agree Government Bonds are relatively safe. Majority of your investment assets are in high interest government bonds. What do you do in this circumstance?
1 2 3 4 select
1 2 3 4 select
(a) Hold the bonds 1(b) Sell the bonds, put 1/2 in money market account, the other in hard assets 2(c) Sell the bonds and put the total proceeds into hard assets 3
(d) Sell the bonds, put all the money into hard assets and borrow additional money to buy more 4
Question 8. Given the best and worst case returns of the four investment choices below, which would you prefer?
1 2 3 4 select
1 2 3 4 select
(a) $500 gain best case; $0 gain/loss worst case 1(b) $1,500 gain best case; $500 loss worst case 2(c) $5,000 gain best case; $2000 loss worst case 3(d) $10,000 gain best case; $5,000 loss worst case 4
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
Question 9. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:
1 3 select
1 3 select
(a) A sure gain of $1,000 1(b) A 50% chance to gain $2,000 and a 50% chance to gain nothing 3
Question 10. In addition to whatever you own, you have been given $2,000. You are now asked to choose between:
1 3 select
1 3 select
(a) A sure loss of $1,000 1(b) A 50% chance to lose $2,000 and a 50% chance to lose nothing 3
Question 11.Suppose a relative left you an inheritance of $200,000, stipulating in the will that you invest ALL the money in ONE of the following choices. Which one would you select?
1 2 3 4 select
1 2 3 4 select
(a) A savings account or money market unit fund 1(b) A unit trust that owns shares and bonds 2(c) A portfolio of 15 common stocks 3(d) Commodities like gold, silver and oil 4
Question 12. If you had to invest $40,000, which of the following investment choices would you find most appealing?
1 2 3 select
1 2 3 select
(a) 60% in low-risk investments, 30% in medium-risk investments, 10% in high-risk investments 1
(b) 30% in low-risk investments, 40% in medium-risk investments, 30% in high-risk investments 2
(c) 10% in low-risk investments, 40% in medioum-risk investments, 50% in high-risk investments 3
Question 13.
Your trusted friend / neighbour, an experienced geologist, is putting together a group of investors to fund an exploratory gold mining venture. The venture could pay back 50 to 100 times the investment if successful. If the mine is a bust, the entire investment is worthless. Your friend estimates the chance of success is only 20%. If you had the 'Money', how much would you invest?
1 2 3 4 select
1 2 3 4 select
(a) Nothing 1(b) One month's salary 2(c) Three month's salary 3(d) Six month's salary 4
INVESTORS RISK PROFILE AND SCORE
18 Cash 24 Conserve 30 Moderate 36 Balance 42 Growth 47Aggressive Client 1 Client 2
Do you agree with this assessment? Yes / No Yes / No
If not, what do you believe your risk assessment should be?
PARAMETERS for CALCULATIONSRate of Return on SHARES
Rate of Return on PENSION
Rate of Return on PROPERTY
Rate of Return on TREND
10yr LoanRate
Loan RateNow
Select% Select% Select% Select% Select% %
Investment Options You are Considering:X
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Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
SECTION 13
Client 1 HEALTH Client 2
Excellent / Very Good / Good / Fair / Poor Current Health
Excellent / Very Good / Good / Fair / Poor
- Smokes / Day - Drinks / Day Smoke | Drink - Smokes / Day - Drinks / Day
Ailments
Treatments
FAMILY HISTORY – HEREDITARY FAMILY HISTORY – HEREDITARYFamily
MemberFamily
MemberHereditary
DiseaseHereditary
DiseaseAge Onset Age Death Age Onset Age DeathAge Onset Age Death Age Onset Age Death
Client 1 Client 2LIFE COVER – In the event of Death: Please Change Your Choice
Would you like to cover your Funeral, Etc (Final) expenses? Yes YesWould you like to Reduce/Eliminate your Debts? Yes YesWould you like to leave any Bequests – Who & Amount? No NoWho $ Who $ Who $
Would you like to have funds to Equalise your Estate? (Optional) No NoWould you like to have additional funds if Terminally Ill? No NoWould you like to provide for your Children’s Education? Yes YesWould you like to provide funds to meet Lifestyle Expenses? Yes YesDomestic Assistance provided to the remaining Partner? No No
TPD COVER - In the event of Permanent Disablement: : Please Change Your ChoiceWould you like to cover your Medical Costs? Yes YesWould you like to Reduce/Eliminate your Debts? Yes YesWould you like to Renovate your Home or Move? Yes Yes
TRAUMA COVER – In the event of a Critical Illness: : Please Change Your ChoiceWould you like to assist in Medical Costs and Rehabilitation? Yes YesWould you like to Reduce or Eliminate your Debt? Yes YesWould you like to take a voluntary period off work to recover? No No
Notes:X
_______________________________________________________________________________________Page 12 Fact Find Document
Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
Risk Profile AcknowledgementI/We acknowledge that I/we have answered the questions in the Risk Profile questionnaire to the best of my/our knowledge. I/We agree with and accept the Risk Profile recommended by the adviser above or I/we acknowledge that I/we have requested a different risk profile from what was recommended as stated below:
Please indicate your selected Risk Profile if this differs from that determined above (please insert a tick in the appropriate box).
Risk ProfileCLIENT 1 Cash Conservative Moderate Balanced Growth Aggressive
CLIENT 2 Cash Conservative Moderate Balanced Growth Aggressive
I/We further acknowledge that any ensuing recommendations will be based on both this risk profile and also any particular objectives and needs I/we have identified and notified to the adviser.
Acknowledgement Client 1 Client 2
SIGNATURE
NAME
DATE
Acknowledgements and AuthorisationsTax File Number Declaration
From time to time we will be requested to supply your tax file number (TFN) to product issuers. Please indicate whether you grant us authority to do this and retain your TFN on our files.
Client 1 Client 2AUTHORITY Yes No Yes No
TAX FILE NUMBER
Tax file numbers will only be used where written authority has been obtained from you.
By completing and signing this declaration, I/we are authorising our adviser to hold my tax file number in a secure location and use it for the following financial product and strategy recommendations related purposes/documents in accordance with legislative requirements: Matters for superannuation investment purposes as required by the Superannuation laws, such as
inclusion on application forms. Matters for non-superannuation investment purposes as required by the Taxation laws, such as inclusion
on application forms. I/We have been informed of the legal basis for collection and are aware that declining to provide a TFN
is not an offence and know the consequences of not providing a TFN. That the manner of obtaining the TFN was not unreasonably intrusive. The disclosure of the TFN will only be disclosed to fund managers and life insurance companies as
relevant.Authorisation Client 1 Client 2
SIGNATURE
NAME
DATE
_______________________________________________________________________________________Page 13 Fact Find Document
Private and Confidential Michael Lobodarz. Authorised Representative of FinancialLink Financial Services: 240938
Privacy ActWhere we retain your information and use that information in the future, we are obliged to seek your consent. Please indicate your decision on the following by checking the applicable box:
I/We would like to be kept informed of new products and/or services as they arise.
Yes No
I/We authorise you to provide personal financial information to third parties as required. (e.g. mortgage brokers, accountants etc)
Yes No
I/We authorise you to provide all personal financial information to my spouse/partner.
Yes No
I/We wish to be placed on a “No Call – No Contact” register which ensures NO contact, regarding financial products without express consent.
Yes NoIf yes, please ensure evidence is maintained on file of addition to
register
Client DeclarationIn the event that I/we have requested limited financial advice I/we acknowledge that the representations outlined below apply in so far as they relate to that specific financial advice requested.
I am aware a fee of $ (GST Include) is charged for the preparation of Statement of Advice.
The information provided in this discovery document is complete and accurate to the best of my/our knowledge (except where I/we have indicated that I/we have chosen not to provide the information).I/We understand and acknowledge that by either not fully or accurately completing the discovery document, that any recommendation or advice given by the adviser in these circumstances may be inappropriate to my/our needs and that I/we risk making a financial commitment to a financial product that may be inappropriate for the needs identified.
I/We acknowledge that I/we have received the FinancialLink Financial Services Guide (FSG) and have access to a copy of the FinancialLink Privacy Statement. I/We confirm that I/we agree to the collection, use and disclosure of our information from and to our advisers as listed below, where this is required by my adviser in the provision of financial services to me/us.I/We have completed all areas of this document and agree to provide you, my adviser with all relevant information.
Client Declaration Client 1 Client 2
SIGNATURE
NAME
DATE
Adviser DeclarationI have provided you with a copy of the FinancialLink Financial Services Guide (FSG) and Privacy Policy prior to any financial product and strategy recommendations being made and personal and sensitive information being collected. As a recipient of TFN information, I, as a FinancialLink authorised representative have taken reasonable steps to ensure: That you have been informed of the legal basis for collection, that declining to provide a TFN is not an
offence and the consequences of not providing a TFN. That the manner of obtaining the TFN was not unreasonably intrusive. The disclosure of the TFN will only be disclosed to fund managers and life insurance companies as
relevant and required by Superannuation and Taxation laws.
Adviser Name Signature Date
MICHAEL LOBODARZ
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