Your Rich Life SnapshotΔ Updates Your Rich Life Snapshot This helps us understand your current situation, what’s important to you and where you’d like your money to take you. We use this information to prepare for our conversation and tailor your Rich Life strategy, so when we meet the focus is on you, not the paperwork. First NameLast NameWhat is your mobile number?What is your email address?What is your current address?Street SuburbCityStatePost CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweWhat is your date of birth?Relationship status– Select –MarriedDe factoSingleDivorcedWidowedPartners First NamePartners Last NameWhat is your partner’s mobile number?What is your partner’s date of birth?What is your partner’s email address?What is your main reason for reaching out to us?Are there any important priorities, topics or decisions that matter most to you right now? If so, what are these?Do you have any specific goals or aspirations?What would you most like to get out of our conversation?Is this your first time seeking advice from a financial adviser?Please select oneYesNoUnsureWhat is your current employment status?Employed full timeEmployed part timeSelf employedEmployed as a casualContractingRetiredNot currently workingWhat are your current employment statuses?YouPartnerEmployed full timeEmployed part timeSelf employedEmployed as a casualContractingRetiredNot currently workingWhat is your occupation?What is your partner’s occupation?What is your approximate employment income (excluding super, but including bonuses)?What is your partner’s approximate employment income (excluding super, but including bonuses)?Do you receive Centrelink benefits? If so, how much per fortnight?Are you currently saving? Yes NoHow much are you saving each month?Do you own your principal place of residence? If yes, what is the value?Do you hold any term deposits or readily available cash? If yes, what is the value?Do you have any plans or intentions with your cash available? Examples could be – caravan, car, pay off mortgage, make super contributions, gift to kids, renovations)Do you own any investment properties? If yes, what is the value?Do you hold any Shares or Managed funds? If yes, what is the value?If you have a mortgage on your home, how much is remaining?If you have debt on your investment properties, how much is remaining?Do you have any other debts? If so, what are these and their approximate value?What are your intentions with your home over the next few years? Hold Renovate Sell Rent Unsure- looking for guidanceDo you have any other assets that you expect to receive in the near future? (i.e. inheritance, business sale, insurance proceeds) Inheritance Business sale Insurance proceeds Property Sale No OtherWho is your superannuation fund provider?What is the approximate value of your superannuation fund?Do you know how your super is invested?Do you make additional contributions to superannuation?Select one of the following optionsYesNoUnsureAre you drawing a regular income stream from your superannuation?Select one of the following optionsYesNoUnsureDo you have multiple superannuation funds?Select one of the following optionsYesNoUnsureWho is your partner’s superannuation fund provider?What is the approximate value of your partner’s superannuation fund?Do you know how your partner’s super is invested?Does your partner make additional contributions to superannuation?Select one of the following optionsYesNoUnsureIs your partner drawing a regular income stream from their superannuation?Select one of the following optionsYesNoUnsureDoes your partner have multiple superannuation funds?Select one of the following optionsYesNoUnsureDo you have personal insurance in place? Tick all that apply Life Cover Total & Permanent Disablement Trauma Cover Income Protection Only the default cover in my superannuation Business insurance (buy-sell, key man) I do not have any personal insurance I am unsure if I have any personal insuranceDo you have personal insurance in place? Tick all that applyYouPartnerLife CoverTotal & Permanent DisablementTrauma CoverIncome ProtectionOnly the default cover in my superannuationBusiness insurance (buy-sell, key man)I do not have any personal insuranceI am unsure if I have any personal insuranceDo you have the following: Tick all that apply Wills Enduring Power of Attorney Advanced Health DirectiveDo you have the following: Tick all that applyYouPartnerWillEnduring Power of AttorneyAdvanced Health DirectiveI am unsure if I have any of the aboveSubmit Form
