All Dependents/Non Dependents

PERSONAL DETAILS

YOU
Mr Mrs Miss Ms Dr / PARTNER (IF APPLICABLE)
Mr Mrs Miss Ms Dr
Surname
First Names
Date of Birth
Marital Status
Home Phone
Business Phone
Mobile
Work Email
Private Email
Home Address
POSTAL ADDRESS DETAILS As Above
Postal Address

ALL DEPENDENTS/NON DEPENDENTS

(include current and previous relationships)
Name / Date of Birth / Sex F/M / Support required to age

Family Tree Information

/ (include current and previous relationships) - Required Yes No
NAME OF CURRENT
Company
Trust
SMSF

OTHER PROFESSIONAL ADVISERS

Accountant: / Email / Phone
Rank their service 10 high / 1 low 1 2 3 4 5 6 7 8 9 10
Solicitor: / Email / Phone
Rank their service 10 high / 1 low 1 2 3 4 5 6 7 8 9 10
Estate Agent: / Email / Phone
Rank their service 10 high / 1 low 1 2 3 4 5 6 7 8 9 10
Other: / Email / Phone
Authority to Contact / Yes No
Copy of Recommendations / Yes No / ToAccountant Solicitor

EMPLOYMENT DETAILS

Current Job Title / Occupation
Start date: / Start date:
Previous Job Title / Occupation
Start date: / Start date:
Employment Status / Self Employed
Employed
Not Employed
Other / 


 / Self Employed
Employed
Not Employed
Other / 



Gross Employment Income / Base / $ / Base / $
Bonus / $ / Bonus / $
Super  9% / $ / Super  9% / $
Employer Name
Employer Phone
Employer Address
Do you intend to stay with your current employer?
Do you feel your current employment situation is secure?
Do you manage staff or employ staff?
Do you foresee any substantial change to your income in the next three years? / Yes No
Yes No
Yes No
Yes No / Yes No
Yes No
Yes No
Yes No
GOVERNMENT PENSIONS / BENEFITS
Are you and/or your partner eligible to receive a government pension/allowance? / Yes No
If Yes, what type of Pension for yourself?
AGED / WIDOWS / PARENT / INVALID / NEW START  / VETERANS*
If Yes, what type of Pension for partner?
AGED / WIDOWS / PARENT / INVALID / NEW START  / VETERANS*
*What type of Veterans Pensions?
WIDOWS / SERVICES / DISABILITY / OTHER (Specify)
ASSETS
Personal Assets / Owner / Current value / Purchase price / Capital Gain / Advice
Client 1 / Client 2 / Joint / Other
Own Home /  /  /  /  / $ / $ / 
Home contents /  /  /  /  / $ / $ / 
Motor vehicle 1 /  /  /  /  / $ / $ / 
Motor vehicle 2 /  /  /  /  / $ / $ / 
Other /  /  /  /  / $ / $ / 
Other /  /  /  /  / $ / $ / 
Investment Property
(street address)* / Owner / Current
value / Purchase price / Weekly rent / Capital Gain / Advice
Client 1 / Client 2 / Joint / Other
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
Bank Accounts & Investments
(company name) / Owner / Current
value / Purchase price / Return Rate % / Capital Gain / Advice
Client 1 / Client 2 / Joint / Other
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
 /  /  /  / $ / $ / $ / 
LOANS/DEBTS/CREDIT CARDS
Company / Owner / Loan Limit / Current Debt / Monthly Repayment / Rate %
Client 1 / Client 2 / Joint / Other
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
 /  /  /  / $ / $ / $
MONTHLY EXPENDITURE
Monthly ($) / YOU/ PARTNER/JOINT
Debt Commitments / Home Loan / $ / 
Investment Loans / $ / 
Personal Loans / $ / 
Credit Cards / $ / 
Fixed Lifestyle Expenses / Rent / $ / 
Electricity / $ / 
Gas / $ / 
Phone Internet Mobile / $ / 
Pay TV / $ / 
Child Care / $ / 
Memberships / $ / 
Cleaner/Gardener / $ / 
Holidays - Domestic / $ / 
Holidays - Overseas / $ / 
Car Registration/Green slip / $ / 
Car Servicing / $ / 
E - tolls / $ / 
Repairs Household / $ / 
Other - / $ / 
Other - / $ / 
Variable Lifestyle Expenses / Groceries / $ / 
Take-away/Lunches / $ / 
Entertainment / $ / 
Alcohol / $ / 
Cigarettes / $ / 
Clothing/Footwear / $ / 
Dry Cleaning / $ / 
Toiletries/Cosmetics/hair / $ / 
Linen/Household Furnishings / $ / 
Public Transport/Taxi / $ / 
Petrol /Oil / $ / 
Medicines/Pharmaceuticals / $ / 
Gifts/Presents / $ / 
Other - / $ / 
Other - / $ / 
Deductible Expenses / Investment property costs / $ / 
Depreciation / $ / 
Salary Sacrifice / $ / 
Tax Deductions / Education costs / $ / 
Work related expenses / $ / 
Income protection / $ / 
Accounting fees / $ / 
Other - / $ / 
Other - / $ / 
SUPERANNUATION SAVINGS
Super Fund 1 / Super Fund 2 / Super Fund 3 / Super Fund 4
Company
Owner
Member Number
Current Value
Employer Contribution ($pa)
Employee Contribution ($pa)
Advice Required / Yes  No  / Yes  No  / Yes  No  / Yes  No 
Super Fund 5 / Super Fund 6 / Super Fund 7 / Super Fund 8
Company
Owner
Member Number
Current Value
Employer Contribution ($pa)
Employee Contribution ($pa)
Advice Required / Yes  No  / Yes  No  / Yes  No  / Yes  No 

ESTATE PLANNING

YOU

/ PARTNER (IF APPLICABLE)
Do you have a Will? / Yes No / Yes No
Do you still consider your Will to be up to date? / Yes No / Yes No
Do you have a testamentary trust as part of your will? / Yes No / Yes No
Enduring Power of Attorney / Yes No / Yes No
Funeral Plan / Yes No / Yes No
Details of Funeral Plan
Whom would you like to leave your assets to in the event of your death? / % / %
% / %
% / %
% / %
Notes or other wishes
RISK PROFILE (N/A for insurance product advice)
1. Which of the following best describes your current stage of life?
a)Single with few financial commitments.
You are keen to accumulate wealth for the future. Some funds must be kept available for enjoyment such as cars, clothes, travel and entertainment. / 
b)A couple without children.
You may be preparing for the future by establishing and furnishing a home. There are a lot of things you need to buy. You are probably better off financially now than you may be in the future. / 
c)Young family.
This is the peak home purchasing stage. You have a mortgage and a very small amount of savings. Probably dissatisfied with your financial position and the amount of money saved. / 
d)Mature family.
You are in your peak earning years and have got the mortgage under control. Your partner may also work and any children you may have are growing up and have either left home or are less financially dependent. You are starting to this about retirement,although it may be many years away. / 
e)Preparing for retirement.
You probably own your home and have few financial commitments, however you want to ensure that you can afford a comfortable retirement. Interested in travel, recreation and self education. / 
f) Retired.
No longer working, you must rely on existing funds and investments to maintain your lifestyle. You may be receiving the pension and are keen to enjoy life and maintain your health. / 
2. What return do you reasonably expect to achieve from your investments?
a) A return without losing any capital. / 
b) Current inflation rate plus 1 – 2% pa. / 
c) Current inflation rate plus 3 – 4% pa. / 
d) Current inflation rate plus 5 – 6% pa. / 
e) Over 9% p.a. / 
3. If you didn’t need your capital for more than 10 years, for how long would you be prepared to see your investment performing poorly before you cashed it in?
a) You would cash in if there was any loss in value. / 
b) Up to 3 months. / 
c) Up to 6 months. / 
d) Up to 1 year. / 
e) Up to 2 years. / 
f) More than 2 years. / 
4. How familiar are you with investment markets?
a) Very little understanding or interest. / 
b) Not very familiar. / 
c) Have enough experience to understand the importance of diversification. / 
d) Understand that markets may fluctuate and that different market sectors offer different income, growth and taxation characteristics. / 
e) Experienced with all investment sectors and understand the various factors which may influence performance. / 
5. The greatest tax savings are generally obtained from more volatile investments, such as Australian Shares. Which balance do you feel most comfortable with?
a) Preferably guaranteed returns, before tax savings. / 
b) Stable, reliable returns, minimal tax savings. / 
c) Some variability in returns, some tax savings. / 
d) Moderate variability in returns, reasonable tax savings. / 
e) Unstable, but potentially higher returns, maximising tax savings. / 
6. What would your reaction be if in 6 months after placing your investments you discover that, in line with what is happening in the financial markets generally, your portfolio has decreased in value by 20%
a) Horror. Security of your capital is critical and you did not intend to take risks. / 
b) You would cut your losses and transfer your money into more secure investment sectors. / 
c) You would be concerned but would wait to see if the investments improve. / 
d) This was a calculated risk and you would leave the investments in place, expecting performance to improve. / 
e) You would invest more funds to lower your average investment price, expecting future growth. / 
7. Which of the following best describes your purpose for investing?
a) You want to invest for longer than 5 years. You understand investment markets and are mainly investing for growth in assets such as shares and property, to accumulate long term wealth. / 
b) You are not nearing retirement, have surplus funds to invest and you are aiming to accumulate long term wealth from a balanced portfolio, comprising of shares, property, fixed interest and cash. / 
c) You have a lump sum (eg inheritance or ETP) and you are uncertain about what secure investment alternatives are available. / 
d) You are nearing retirement and you are investing to ensure you have sufficient funds available to enjoy your retirement. / 
e) You have some specific objectives within the next 5 years for which you want to save enough money. / 
f) You want a regular income stream and/or totally protect the value of your savings. / 
8. For how long would you expect most of your money to be invested before you would need to access it? (Assuming you have made plans to meet short term financial goals and to handle emergencies?)
a) Less than 2 years. / 
b) Between 2 and 3 years. / 
c) Between 3 and 5 years. / 
d) Between 5 and 7 years. / 
e) Longer than 7 years. / 
RISK PROFILES

Defensive

You are a Defensive investor. Risk must be very low and you are prepared to accept lower returns to protect capital. The negative effects of tax and inflation will not concern you, provided your initial investment is protected.

Moderate

You are a Moderate Investor seeking better than basic returns, but risk must be low. Typically an older investor seeking to protect the wealth which you have accumulated, you may be prepared to consider less aggressive growth investments.

Balanced

You are a Balanced investor who wants a balanced portfolio to work towards medium to long term financial goals. You require an investment strategy which will cope with the effects of tax and inflation. Calculated risks will be acceptable to you to achieve good returns.

Growth

You are Growth investor, probably earning sufficient income to invest most funds for capital growth. Prepared to accept higher volatility and moderate risks, your primary concern is to accumulate assets over the medium to long term. Your portfolio may include more aggressive investments.

High Growth

You are a High Growth investor prepared to compromise portfolio balance to pursue potentially greater long-term returns. Your investment choices are diverse, but carry with them a higher level of risk. Security of capital is secondary to the potential for wealth accumulation.

Based on the above questions I would recommend the following risk profile:

If the client does not agree with this risk profile, please indicate what they have requested and reasons why:

When complete please fax to 02 85690912 at least 24 hours before your appointment

ExistingRISK INSURANCE - YOU
Term Life / Trauma / Income Protection / Whole of Life / Endowment
Name of Company
Sum Insured
Start Date
Annual Premium/ Monthly Premium
Renewal Premium
Surrender Value
Maturity Date
Maturity Value
Policy Owner
Life Insured
Substanded Loadings
Last Review Date
ExistingRISK INSURANCE - PARTNER
Term Life / Trauma / Income Protection / Whole of Life / Endowment
Name of Company
Sum Insured
Start Date
Annual Premium/ Monthly Premium
Renewal Premium
Surrender Value
Maturity Date
Maturity Value
Policy Owner
Life Insured
Substanded Loadings
Last Review Date
INCOME PROTECTION
YOU / PARTNER
Maximum Benefit = 75% of gross salary / Yes  No  / Yes  No 
In the event of you being unable to work for a long period of time due to illness or an accident, how long should the monthly benefit continue for? / 2 Years
5 Years
To age 60
To age 65 / 2 Years
5 Years
To age 60
To age 65
If you were unable to work due to accident or illness how long could you reasonably last without your income? / 14 days
30 days
90 days
1 year‪
2 years / 14 days
30 days
90 days
1 year‪
2 years
LIFE INSURANCE
YOU / PARTNER
Liabilities to be paid out? / $ / $
Children’s education expenses? / $ / $
Emergency funds? / $ / $
Funeral expenses? / $ / $
Legacy expenses / bequests? / $ / $
Living income to be replaced per/year? / $ / $
Income to be replaced for how long? / Months / Months
DISABILITY INSURANCE
YOU / PARTNER
Liabilities to be paid out? / $ / $
Emergency funds? / $ / $
Living income to be replaced per/year? / $ / $
Income to be replaced for how long? / Months / Months
Children’s education expenses? / $ / $
TRAUMA INSURANCE
YOU / PARTNER
Liabilities to be paid out? / $ / $
Emergency funds? / $ / $
Living income to be replaced per/year? / $ / $
Income to be replaced for how long? / Months / Months
Children’s education expenses? / $ / $
BUSINESS EXPENSE INSURANCE
YOU / PARTNER
Accounting Fees
Rent
Property Rates & Taxes
Lease Costs
Allowable Salaries - Employees:
Other Employee Costs:
Telephone
Electricity
Gas/Heating/ Water
Cleaning
RISK INSURANCE BACKGROUND
What is your attitude to the following features contained in Risk Products. Defaults are marked with X
YOU / PARTNER
Do you accept the common defaults? / Yes  No  / Yes  No 
Not / Not very / Moderately / Very / Not / Not very / Moderately / Very
Death / Important / Important / Important / Important / Important / Important / Important / Important
Index Linking / x / x
Interim Cover / x / x
Guaranteed Insurability / x / x
Terminal Illness / x / x
GFI Business / x / x
Guaranteed Rates / x / x
Total & Permanent Disability
TPD Definition / x / x
Reducing TPD / x / x
Exclusions / x / x
Trauma & Critical Illness
Range of Conditions / x / x
Definitions of Conditions / x / x
Exclusions / x / x
Survival Period / x / x
Income Protection
Definition of Total Disability / x / x
Guaranteed Benefits / x / x
Benefit Offsets / x / x
Index Linking / x / x
Exclusions / x / x
Definition of Mthly Earnings / x / x
Guaranteed Insurability / x / x
Recurrent Claims / x / x
Waiver of Premiums / x / x
Temporary Return to Work / x / x
No Claim Bonus / x / x
Guaranteed Rates / x / x
Upgrade Guarantee / x / x
Unemployment / x / x
Interim Cover / x / x
Partial Disability / x / x
Rehabilitation / x / x
Scheduled Injury / x / x
Nursing Care / x / x
Accommodation / x / x
Relocation/Transportation / x / x
Death Benefits / x / x
Critical Conditions / x / x
Business Expenses
Business Covered / x / x
Benefit Extension / x / x
RISK INSURANCE BACKGROUND
YOU / PARTNER
Describe current health /  Excellent
 Good
 Poor
 Congenital Conditions /  Excellent
 Good
 Poor
 Congenital Conditions
Do you smoke cigarettes? / No 
Less than 2/wk 
More than 7/wk 
Over 7/wk  / No 
Less than 2/wk 
More than 7/wk 
Over 7/wk 
Do you drink Alcohol? / No 
Less than 2/wk 
More than 7/wk 
Over 7/wk  / No 
Less than 2/wk 
More than 7/wk 
Over 7/wk 
inheritable conditionsHave any of your direct relatives suffered from any inheritable conditions?
Yes No(If yes please provide details below)
YOU / PARTNER
Condition / Age Diagnosed / Condition / Age Diagnosed
Parents
Sisters
Brothers
Other
Lifestyle PursuitsDo you take part in any dangerous activities eg scuba diving, motor racing, football, abseiling etc
YOU / PARTNER
Activity / Details (eg diving depth, frequency of dives etc)
FUTURE REVIEWS
How often do you want to review your Statement of Advice? (tick appropriate box)
 Quarterly  Half Yearly  Yearly
Our next review date will be:
YOUR OBJECTIVES AND NEEDS- (THIS AREA MUST BE COMPLETED)
What is your main reason for seeking advice at this time?
Apart from your main reason what other goals and objectives do you have:
(House, holiday, children, vehicle, retirement, lifestyle, income, estate, etc)
Short Term (0-12 Months):
Medium Term (1-3 Years):
Long Term:
Do you have any other concerns that we should take into consideration?
What do you expect from the financial planning process?
Are you currently contemplating any strategy to achieve your goals and objectives?

CLIENT ACKNOWLEDGEMENT, TAX FILE NUMBER AUTHORISATION AND CLIENT DECLARATION

General Acknowledgement / I have read and understood the information detailed below. I hereby authorize IPRAXIS PTY LTD to use this information for the purposes of preparing, implementing and reviewing a statement of advice and related activities.
I also acknowledge that the information detailed in the Personal Profile was either entered by myself/ourselves or on my behalf by the adviser and is an accurate representation of my current position and needs. The information set out in this form accurately represents my/our objectives, financial situation and or particular needs.
I/we are not aware of any other information which may be relevant to the preparation of my/our Statement of Advice. I/we understand that a financial product recommendation will be based solely on the information supplied in this form within a period of thirty (30) days. Should I/we not proceed with implementation of the Statement of Advice I/we understand that it will be necessary to review the information which has been supplied.
I/we acknowledge that if the information provided is inaccurate or incomplete, I/we should consider the appropriateness of the recommendations in the Statement of Advice, having regard to my/our personal circumstances.
Other Documents / I acknowledge that I have also received the following documents:
• Financial Services Guide
Privacy Policy / The Adviser has informed me that the privacy policy of IPRAXIS PTY LTD has been adopted to ensure the privacy and security of my personal information. I am aware that I may request a copy from my Adviser at any time or retrieve it from the out website, therefore I have received a copy of the IPRAXIS PTY LTD Privacy Policy.
Tax File Number / I give authority for my Tax File Number/s, to be keep on my client file and to be forwarded to financial institutions as requested or as necessary in connection with financial planning advice, which is being provided to me.
Tax File Number/s:
………………
………………
Information Exchange / As you would be aware, it is sometimes beneficial for your adviser to communicate (pass on or receive) your details with another professional so that we may provide you with comprehensive advice and/or services. As such, I may/will communicate your information to these listed professional/s with your authority.
Referral Fees / As part of your advisers business they may pay and receive referral fees with other professionals. These fees are paid by your adviser from the remuneration your adviser receives and are not an additional charge to you. By signing this authority you confirm acceptance and authentication of these payments. The remuneration will be shared between the following: NA 
Name:
Company: / $
%
Statement of Advice / I give authority for the preparation of a Statement Of Advice (SOA). I understand that my adviser will use the information requested in this Personal Profile for the purposes of preparing a SOA for my particular situation. I understand that a fee of $______will be charged for the preparation of the SOA.
Signed: / Signed:
Name Client one: / Name Client two:
Date: / Date:

SOA Checklist