Mortgage & Insurance Fact Find

MORTGAGE & INSURANCE FACT FIND

Customer(s) Name(s) / <CLIENT.FIRSTNAME_1> <CLIENT.SURNAME_1>
<CLIENT.FIRSTNAME_2> <CLIENT.SURNAME_2>
Adviser Name / <ADVISOR.FIRSTNAME> <ADVISOR.SURNAME>
Firm Name / <ADVISOR.BRANCH>
Date Fact Find Started / <SALESINFO.INITIALCONTACTMADE>
Date IDD Issued / <SALESINFO.IDDPRODUCED>
Date Data Protection Statement Issued
Date Fee Agreement Issued (if any)
This questionnaire is designed to provide a financial adviser with information required by the Financial Services and Markets Act 2000.
Periodically your adviser may need to confirm the information is correct.
To ensure that suitable advice is provided and recommendations are based on sound information, it is important that the questions are answered as fully as possible, where relevant.

Your home may be repossessed if you do not keep up repayments on your mortgage.

If the mortgage is in a currency other than sterling, changes in the exchange rate may increase the sterling equivalent of your debt.

APPLICANT DETAILS

1st Applicant / 2nd Applicant
Title / <CLIENT.TITLE_1> / <CLIENT.TITLE_2>
First name / <CLIENT.FIRSTNAME_1> / <CLIENT.FIRSTNAME_2>
Middle name / <CLIENT.MIDDLENAME_1> / <CLIENT.MIDDLENAME_2>
Surname / <CLIENT.SURNAME_1> / <CLIENT.SURNAME_2>
Previous surname / <CLIENT.PREVIOUSSURNAME_1> / <CLIENT.PREVIOUSSURNAME_2>
Current Address / <CLIENT.PRESENTADDRESS_1> / <CLIENT.PRESENTADDRESS_2>
Sex / <CLIENT.SEX_1> / <CLIENT.SEX_2>
Date of Birth / <CLIENT.DOB_1> / <CLIENT.DOB_2>
Telephone numbers - Home / <CLIENT.HOME_TEL_NO_1> / <CLIENT.HOME_TEL_NO_2>
Mobile / <CLIENT.MOBILE_TEL_NO_1> / <CLIENT.MOBILE_TEL_NO_2>
Work / <CLIENT.WORK_TEL_NO_1> / <CLIENT.WORK_TEL_NO_2>
Email address / <CLIENT.EMAIL_1> / <CLIENT.EMAIL_2>
Contact Method / <CLIENT2.PREFERRED_METHOD_OF_CONTACT_1> / <CLIENT2.PREFERRED_METHOD_OF_CONTACT_2>
Preferred Time / <CLIENT.BEST_TIME_TO_CONTACT_1> / <CLIENT.BEST_TIME_TO_CONTACT_2>
Relationship to other applicant / <CLIENT.RELATIONSHIP_1> / <CLIENT.RELATIONSHIP_2>
Nationality / <CLIENT.NATIONALITY_1> / <CLIENT.NATIONALITY_2>
Do you have any dependants / <CLIENT2.DEPENDANTS_1> / <CLIENT2.DEPENDANTS_2>
Dependants details / <CLIENT2.DEPENDANTSDETAIL_1> / <CLIENT2.DEPENDANTSDETAIL_2>
Date moved into your current address / <CLIENT2.PRESENTADDRESS_DATEMOVED_1> / <CLIENT2.PRESENTADDRESS_DATEMOVED_2>
Current residential status / <CLIENT2.RESIDENTIALSTATUS_1> / <CLIENT2.RESIDENTIALSTATUS_2>
If renting, how much do you pay ? / £<CLIENT2.RENTAMOUNT_1> per <CLIENT2.RENTFEQ_1> / £<CLIENT2.RENTAMOUNT_2> per <CLIENT2.RENTFEQ_2>
Previous address if less than 3 years (Detail other
addresses on separate page if necessary) / <CLIENT.PREVIOUSADDRESSES_1> / <CLIENT.PREVIOUSADDRESSES_2>
Are you on the electoral roll there? / <CLIENT2.ELECTORALROLL_1> / <CLIENT2.ELECTORALROLL_2>
Do you have any religious beliefs that could affect
mortgage planning? / <CLIENT.RELIGIOUS_1> / <CLIENT.RELIGIOUS_2>

HEALTH DETAILS

1st Applicant / 2nd Applicant
Are you in good health? / <CLIENT.GOODHEALTH_1> / <CLIENT.GOODHEALTH_2>
Have you smoked in the last 12 months / <CLIENT.SMOKER_1> / <CLIENT.SMOKER_2>

OCCUPATION DETAILS

1st Applicant / 2nd Applicant
Occupation status (Employed/Self Employed/ Retired/Not
Employed) / <CLIENT.EMPLOYMENT_STATUS_1> / <CLIENT.EMPLOYMENT_STATUS_2>
Current employer / <CLIENT.EMPLOYERNAME_1> / <CLIENT.EMPLOYERNAME_2>
Current employer address / <CLIENT.EMPLOYERADDRESS_LINE1_1>
<CLIENT.EMPLOYERADDRESS_LINE2_1>
<CLIENT.EMPLOYERADDRESS_LINE3_1>
<CLIENT.EMPLOYERADDRESS_LINE4_1>
<CLIENT.EMPLOYERADDRESS_POSTCODE_1> / <CLIENT.EMPLOYERADDRESS_LINE1_2>
<CLIENT.EMPLOYERADDRESS_LINE2_2>
<CLIENT.EMPLOYERADDRESS_LINE3_2>
<CLIENT.EMPLOYERADDRESS_LINE4_2>
<CLIENT.EMPLOYERADDRESS_POSTCODE_2>
Occupation / Job Title / <CLIENT.OCCUPATION_1> / <CLIENT.OCCUPATION_2>
On what basis? / <CLIENT2.EMPLOYEDBASIS_1> / <CLIENT2.EMPLOYEDBASIS_2>
Hours worked per week / <CLIENT2.BASIC_HOURS_WORKED_1> / <CLIENT2.BASIC_HOURS_WORKED_2>
If contract worker, specify end of term of contract / <CLIENT2.EMPLOYED_CONTRACTENDS_1> / <CLIENT2.EMPLOYED_CONTRACTENDS_2>
Current employment start date / <CLIENT2.EMPLOYERSTARTDATE_1> / <CLIENT2.EMPLOYERSTARTDATE_2>
Details of probationary period, if any / <CLIENT2.EMPLOYEDPROBATION_1> / <CLIENT2.EMPLOYEDPROBATION_2>
Your expected retirement age / <CLIENT2.RETIREMENTAGE1> Years Old / <CLIENT2.RETIREMENTAGE2> Years Old
If current employment is less than 1 year please give details of
your previous occupation(s)
Previous Occupation/Job Title / <CLIENT2.PREVIOUSOCCUPATION_1> / <CLIENT2.PREVIOUSOCCUPATION_2>
Previous employer / <CLIENT2.PREVIOUSEMPLOYERNAME_1> / <CLIENT2.PREVIOUSEMPLOYERNAME_2>
Time in employment
Started
Left / <CLIENT2.PREVIOUSEMPLOYERSTARTDATE_1>
<CLIENT2.PREVIOUSEMPLOYERENDDATE_1> / <CLIENT2.PREVIOUSEMPLOYERSTARTDATE_2>
<CLIENT2.PREVIOUSEMPLOYERENDDATE_2>
More Previous Employment / <CLIENT2.MOREPREVOCC1.1>
<CLIENT2.MOREPREEMP1.1>
<CLIENT2.MOREPREVEMPSTART1.1>
<CLIENT2.MOREPREVEMPLEFT1.1>
<CLIENT2.MOREPREVOCC1.2>
<CLIENT2.MOREPREEMP1.2>
<CLIENT2.MOREPREVEMPSTART1.2>
<CLIENT2.MOREPREVEMPLEFT1.2>
<CLIENT2.MOREPREVOCC1.3>
<CLIENT2.MOREPREEMP1.3>
<CLIENT2.MOREPREVEMPSTART1.3>
<CLIENT2.MOREPREVEMPLEFT1.3> / <CLIENT2.MOREPREVOCC2.1>
<CLIENT2.MOREPREEMP2.1>
<CLIENT2.MOREPREVEMPSTART2.1>
<CLIENT2.MOREPREVEMPLEFT2.1>
<CLIENT2.MOREPREVOCC2.2>
<CLIENT2.MOREPREEMP2.2>
<CLIENT2.MOREPREVEMPSTART2.2>
<CLIENT2.MOREPREVEMPLEFT2.2>
<CLIENT2.MOREPREVOCC2.3>
<CLIENT2.MOREPREEMP2.3>
<CLIENT2.MOREPREVEMPSTART2.3>
<CLIENT2.MOREPREVEMPLEFT2.3>

INCOME DETAILS

1st Applicant / 2nd Applicant
If employed:
Basic salary p.a. / £<CLIENT.BASIC_INCOME_1> / £<CLIENT.BASIC_INCOME_2>
Guaranteed additional p.a. (overtime, bonus etc.) / £<CLIENT2.INCOME_GUARANTEED> / £<CLIENT2.INCOME_GUARANTEED_2>
Regular additional p.a. (overtime, bonus etc.) / £<CLIENT2.INCOME_REGULAR> / £<CLIENT2.INCOME_REGULAR_2>
Other earned income (please specify) / £<CLIENT2.SECONDINCOME1> / £<CLIENT2.SECONDINCOME2>
If self-employed:
Number of years accounts available / <CLIENT2.SEYEARSACCOUNTS> Years / <CLIENT2.SEYEARSACCOUNTS_2> Years
Net profit last year / £<CLIENT2.SEYEARLASTNET> / £<CLIENT2.SEYEARLASTNET_2>
Previous year / £<CLIENT2.SEYEAR2NET> / £<CLIENT2.SEYEAR2NET_2>
Year before that / £<CLIENT2.SEYEAR3NET> / £<CLIENT2.SEYEAR3NET_2>
Details of any other income / £<CLIENT2.OTHER_INCOME> / £<CLIENT2.OTHER_INCOME_2>
Details of where other income is from (e.g. pensions, rental,
investment, state benefits, allowances) / <CLIENT2.OTHER_INCOMEFROM_1> / <CLIENT2.OTHER_INCOMEFROM_2>
Total Annual Income / £<CLIENT2.TOTALINCOMEPA> / £<CLIENT2.TOTALINCOMEPA_2>
Net Monthly Take Home pay (TI) / £<CLIENT2.TOTALNETINCOMEPERMONTH> / £<CLIENT2.TOTALNETINCOMEPERMONTH_2>
Tax Rate / <CLIENT2.TAXRATE_1> / <CLIENT2.TAXRATE_2>
Are you willing and able to prove your income / <FFMORTGAGE.PROVE_INCOME_1> / <FFMORTGAGE.PROVE_INCOME_2>

CREDIT HISTORY

1st applicant / 2nd applicant
Have you ever had any adverse credit issues or mortgage/loan refused?
(If No then other questions in this section are not applicable) / <CLIENT2.PREV_CREDIT_ISSUES_1> / <CLIENT2.PREV_CREDIT_ISSUES_2>
Have you ever had a mortgage or a loan application refused? / <CLIENT2.PREV_MORTGAGE_REFUSED_1> / <CLIENT2.PREV_MORTGAGE_REFUSED_2>
Have you ever had a judgment for debt or a loan default registered against you? / <CLIENT2.PREV_CCJ_1> / <CLIENT2.PREV_CCJ_2>
Have you ever been declared bankrupt or made an arrangement with your creditors? / <CLIENT2.PREV_BANKRUPT_1> / <CLIENT2.PREV_BANKRUPT_2>
Have you ever failed to keep up your payments under any previous or current
mortgage, rental or loan agreement? / <CLIENT2.PREV_ARREARS_1> / <CLIENT2.PREV_ARREARS_2>

NB. If you answered ‘Yes’ to any of the above, please ensure that the Credit History & Current Credit Issues questionnaire is completed

FINANCIAL COMMITMENTS (excluding current mortgage payments)

Please provide further details in notes if necessary

Monthly liabilities details / <COMMITMENTS.TEXT>
1st Applicant / 2nd Applicant / Joint
Total Committed Monthly Liabilities (TL) / £<COMMITMENTS.TOTAL_APP1> / £<COMMITMENTS.TOTAL_APP2> / £<COMMITMENTS.TOTAL_JOINT>

BUDGET PLANNER

Current Mortgage / £<CLIENT2.BUDGET_CURRENTMORTGAGES>
Current Rent / £<CLIENT2.BUDGET_CURRENTRENT>
Hire Purchase / £<CLIENT2.BUDGET_HP>
Other Loans / £<CLIENT2.BUDGET_OTHER_LOAN>
Credit/Store Cards / £<CLIENT2.BUDGET_CREDIT_CARD>
Maintenance for Dependants / £<CLIENT2.BUDGET_MAINTENANCE>
Utility Bills / £<CLIENT2.BUDGET_UTILITY_BILLS>
Council Tax / £<CLIENT2.BUDGET_COUNCIL_TAX>
Telephone/Mobile / £<CLIENT2.BUDGET_TELEPHONE_MOBILE>
Food & Clothing / £<CLIENT2.BUDGET_FOOD_CLOTHING>
Motoring, fares, other travel / £<CLIENT2.BUDGET_TRAVEL_MOTOR>
Contributions/Pensions / £<CLIENT2.BUDGET_CONTRIBUTIONS_PENSIONS>
Educational Fees / £<CLIENT2.BUDGET_EDUCATIONAL_FEES>
Going out, holidays, other leisure / £<CLIENT2.BUDGET_LEISURE>
Alcohol/Tobacco / £<CLIENT2.BUDGET_ALCOHOL_TOBACCO>
Household goods / £<CLIENT2.BUDGET_HOUSEGOODS>
Home insurance and other household services / £<CLIENT2.BUDGET_HOMEINSURANCE>
Medicines, hairdressing, other personal items / £<CLIENT2.BUDGET_MEDICINES>
Regular savings / £<CLIENT2.BUDGET_SAVINGS>
Other / £<CLIENT2.BUDGET_OTHER>
Total Combined Income / <CLIENT2.BUDGET_TOTAL_COMBINED_INCOME>
Current Total Monthly Expenditure / £<CLIENT2.BUDGET_TOTALOUTGOINGS>
Current Disposable Income / <CLIENT2.BUDGET_CURRENT_DISPOSABLE_INCOME>
Maximum Budget available to meet Mortgage needs / £<CLIENT2.BUDGET_NEWMORTGAGE>

CURRENT MORTGAGE DETAILS (Details of additional mortgages can be found on a separate sheet)

Mortgage 1
Lender / <CURRENTMORTGAGE.PROVIDER>
Owner / <CURRENTMORTGAGE.HOLDER>
Address / <CURRENTMORTGAGEDETAILS.ADDRESS_LINE1>
<CURRENTMORTGAGEDETAILS.ADDRESS_LINE2>
<CURRENTMORTGAGEDETAILS.ADDRESS_LINE3>
<CURRENTMORTGAGEDETAILS.ADDRESS_LINE4>
<CURRENTMORTGAGEDETAILS.ADDRESS_POSTCODE>
Amount of Loan outstanding / £<CURRENTMORTGAGEDETAILS.LOAN_AMOUNT>
Term remaining / <CURRENTMORTGAGEDETAILS.TERM> Years
Current interest rate / <CURRENTMORTGAGEDETAILS.CURRENTRATE>%
Monthly mortgage payment / £<CURRENTMORTGAGE.PAYMENT>
Interest rate type / <CURRENTMORTGAGEDETAILS.RATETYPE>
If applicable when does rate end? / <CURRENTMORTGAGE.BENEFITENDDATE>
Are there any penalties if you transfer or repay your existing mortgage
now? / <CURRENTMORTGAGEDETAILS.TRANSFERPENALTIES>
Are you prepared to pay these if you transfer/repay your current
mortgage? / <CURRENTMORTGAGEDETAILS.ERP_PREPARED_TO_PAY>
How much is the penalty? / £<CURRENTMORTGAGEDETAILS.ERP_DETAILS>
ERC End Date / <CURRENTMORTGAGEDETAILS.TIEINENDDATE>
If selling, what is the sale price? / £<CURRENTMORTGAGEDETAILS.VALUATION>
Are your current mortgage terms portable to a new property? / <CURRENTMORTGAGEDETAILS.PORTABLE>
Repayment method / <CURRENTMORTGAGEDETAILS.REPAYMENT_METHOD>
If Interest Only how do you intend to repay the capital? / <CURRENTMORTGAGEDETAILS.REPAYMENT_VEHICLE>
If Split: how much is interest only? / £<CURRENTMORTGAGEDETAILS.INTERESTONLY_AMOUNT>
Do you want to continue using it / them for any new mortgage
arrangement? / <CURRENTMORTGAGEDETAILS.KEEPREPAYVEHICLEONNEWMORT>

PROPERTY TO BE MORTGAGED

Address of property to be mortgaged: / <FFPROPERTY.ADDRESS_LINE1>
<FFPROPERTY.ADDRESS_LINE2>
<FFPROPERTY.ADDRESS_LINE3>
<FFPROPERTY.ADDRESS_LINE4>
<FFPROPERTY.ADDRESS_POSTCODE>
Year built / <FFPROPERTY.YEARHOUSEBUILT>
Number of bedrooms / <FFPROPERTY.NUMBEROFBEDROOMS>
Property type (Detached, Semi-Detached, Terraced etc) / <FFPROPERTY.PROPERTY_TYPE>
What is the property tenure? (Freehold, Leasehold, Feuhold, Commonhold) / <FFPROPERTY.TENURE>
If Leasehold, what is the term remaining on the property? / <FFPROPERTY.LEASEYEARS>
Is the property of non-standard construction (i.e. not thatched roof, barn conversion etc)? / <FFPROPERTY.NONSTANDARD>
Are you buying on a Shared Ownership scheme? / <FFPROPERTY.SHARED_OWNERSHIP>
If you are buying on a Shared Ownership scheme:
Percentage of property to be purchased / <FFPROPERTY.SHARED_OWNERSHIP_PERCENT>%
Which Shared Ownership body are you buying from? / <FFPROPERTY.SHARED_OWNERSHIP_BODY>
Monthly Rent Payment / £<FFPROPERTY.SHARED_OWNERSHIP_RENT>
Will this be the only property you own? / <FFPROPERTY.ONLY_PROPERTY_1>
If No, Is this your main residence? / <FFPROPERTY.MAIN_RESIDENCE_1>
If No, do you have a mortgage on the other? / <FFPROPERTY.OTHER_MORTGAGES_1>
If No, do you intend to clear any of these other mortgages? / <FFPROPERTY.CLEAR_OTHER_MORTGAGES_1>

MORTGAGE REQUIREMENTS

Loan Purpose / <FFMORTGAGE.LOAN_PURPOSE>
Purchase Price or value of the property / £<FFMORTGAGE.PURCHASE_PRICE>
How much do you want to borrow? / £<FFMORTGAGE.LOAN_AMOUNT>
Over what term? / <FFMORTGAGE.TERM> Years
Loan to Value / <FFMORTGAGE.LTV>%
Are you borrowing an additional amount e.g.; home improvements, fees, etc? / <FFMORTGAGE.ADDITIONALBORROWING>
If borrowing additional amount
Amount / £<FFMORTGAGE.ADDITIONALBORROWINGAMOUNT>
Reason / <FFMORTGAGE.ADDITIONALBORROWINGREASON>
Funds available to complete mortgage transaction
Amount of funds available? / £<FFMORTGAGE.DEPOSIT>
Source of funds available / <FFMORTGAGE.DEPOSIT_SOURCE>
Preferences
An upper limit on your mortgage costs for a specific period / <FFMORTGAGE.PREF_UPPERLIMITONCOSTS>
If Yes / <FFMORTGAGE.PREF_UPPERLIMITONCOSTSTEXT>
To fix your mortgage costs for a certain period / <FFMORTGAGE.PREF_FIXCOSTS>
If Yes / <FFMORTGAGE.PREF_FIXCOSTSTEXT>
A discount on your mortgage repayments in the early years / <FFMORTGAGE.PREF_DISCOUNT>
If Yes / <FFMORTGAGE.PREF_DISCOUNTTEXT>
Access to an initial cash sum (Cashback) / <FFMORTGAGE.PREF_CASHBACK>
If Yes / <FFMORTGAGE.PREF_CASHBACKTEXT>
No early settlement interest on full or part repayment / <FFMORTGAGE.PREF_NO_ERC>
If Yes / <FFMORTGAGE.PREF_NO_ERCTEXT>
Making limited overpayments without early repayment charges / <FFMORTGAGE.PREF_NO_ERC_ONOVERPAY>
If Yes / <FFMORTGAGE.PREF_NO_ERC_ONOVERPAYTEXT>
No tie-in after a fixed, discounted or capped interest period / <FFMORTGAGE.PREF_NO_ERC_TIEIN>
If Yes / <FFMORTGAGE.PREF_NO_ERC_TIEINTEXT>
No higher lending charge / <FFMORTGAGE.PREF_NO_HLC>
If Yes / <FFMORTGAGE.PREF_NO_HLCTEXT>
Speed of mortgage completion / <FFMORTGAGE.PREF_SPEED>
If Yes / <FFMORTGAGE.PREF_SPEEDTEXT>
Ability to add fee to the loan / <FFMORTGAGE.PREF_ADDFEES>
If Yes / <FFMORTGAGE.PREF_ADDFEETEXT>
Ability to vary the repayment amount or take repayment holidays / <FFMORTGAGE.PREF_VARYPAYMENT>
If Yes / <FFMORTGAGE.PREF_VARYPAYMENTTEXT>
Ability to link your finances (e.g. bank account, savings, mortgage) / <FFMORTGAGE.PREF_LINKSAVINGS>
If Yes / <FFMORTGAGE.PREF_LINKSAVINGSTEXT>
Might your income or expenditure change significantly within the foreseeable future? (3 to 7 years)
Income / <FFMORTGAGE.PREF_INCOMECHANGE>
Timescale/Amount/Reason / <FFMORTGAGE.PREF_INCOMECHANGETEXT>
Expenditure / <FFMORTGAGE.PREF_EXPENDCHANGE>
Timescale/Amount/Reason / <FFMORTGAGE.PREF_EXPENDCHANGETEXT>
Do you have any plans to pay off some or all of the mortgage within the term? / <FFMORTGAGE.PREF_PAYOFF>
Timescale/Amount/Reason / <FFMORTGAGE.PREF_PAYOFFTEXT>
Are you likely to move home within the mortgage term (other than this transaction)? / <FFMORTGAGE.PREF_MOVEHOME>
Timescale/Type of new home/Reason / <FFMORTGAGE.PREF_MOVEHOMETEXT>
Are you concerned about the possibility of future interest rate movements? / <FFMORTGAGE.PREF_CONCERNEDABOUTRATESMOVEMENTS>
Reason / <FFMORTGAGE.PREF_CONCERNEDABOUTRATESMOVEMENTSTEXT>

MORTGAGE REQUIREMENTS cont.

Attitude to Risk
You prefer to accumulate savings to repay your mortgage when it is due. You understand there is a risk that your savings may not be sufficient to do so. / <FFMORTGAGE.ATTITUDE_INTERESTONLY>%
You prefer to have the certainty that your mortgage loan is repaid at the end of the term. This means taking out a repayment mortgage that is designed to use each monthly payment to pay interest and pay back part of the capital outstanding. If you keep up your payments your entire loan will be repaid at the end of the mortgage term. / <FFMORTGAGE.ATTITUDE_REPAYMENT>%
You are not concerned with making regular monthly contributions towards repaying the capital element of the mortgage. You will make your own arrangements to clear the debt / <FFMORTGAGE.ATTITUDE_NOREPAYMENTMETHOD>

EXISTING PLANS

<FFINSURANCE.EXISTING PLANS>

COVER REQUIRED

1st Applicant / 2nd Applicant
If you or your partner die, is it important that you protect
against the financial consequences of death? / <FFINSURANCE.LIFE1> / <FFINSURANCE.LIFE2>
If you or your partner were to suffer a critical illness or
permanent disability, is it important to repay your mortgage
and other loans? / <FFINSURANCE.CIC1> / <FFINSURANCE.CIC2>
If you or your partner were unable to work due to illness,
accident or unemployment, is it important to you to be able
to pay your mortgage/ loans and bills? / <FFINSURANCE.ASU1> / <FFINSURANCE.ASU2>
Do you wish to protect your buildings? / <FFINSURANCE.BUILD1> / <FFINSURANCE.BUILD2>
Do you wish to protect your contents? / <FFINSURANCE.CONT1> / <FFINSURANCE.CONT2>

LIFE PROTECTION/ TERM

You have indicated that you require life protection in the event of Applicant 1/Applicant 2’s death.
1st Applicant / 2nd Applicant
Life Protection/Term Required? / <FFINSURANCE.LIFE1> / <FFINSURANCE.LIFE2>
Who is the protection for? / <FFINSURANCE.LIFECOVERFOR> / <FFINSURANCE.LIFECOVERFOR>
What is the cover required to protect? / <FFINSURANCE.LIFEPROTECTWHAT1> / <FFINSURANCE.LIFEPROTECTWHAT2>
Protection required for? / <FFINSURANCE.LIFEDEATH1> / <FFINSURANCE.LIFEDEATH2>
What level of cover would be required, amount and type
(Annual or Lump Sum)? / <FFINSURANCE.LIFETERMCOVER1> <FFINSURANCE.LIFECOVERTYPE1> / <FFINSURANCE.LIFETERMCOVER2> <FFINSURANCE.LIFECOVERTYPE2>
Over what period is cover required? / <FFINSURANCE.LIFETERM1> Years / <FFINSURANCE.LIFETERM2> Years
Have you smoked in the last 12 months? / <CLIENT.SMOKER_1> / <CLIENT.SMOKER_2>
Are you in good health? / <CLIENT.GOODHEALTH_1> / <CLIENT.GOODHEALTH_2>
What basis of cover? / <FFINSURANCE.LIFEBASIS1> / <FFINSURANCE.LIFEBASIS2>
If cover required is Increasing by how much?
If % by how much? / <FFINSURANCE.LIFEINCREASE1> / <FFINSURANCE.LIFEINCREASE2>
Do you want the certainty of knowing the cost of cover does
not change throughout the term? (Guaranteed Premiums) / <FFINSURANCE.LIFEGURA1> / <FFINSURANCE.LIFEGURA2>
If NO to certainty of premium do you understand that premiums
may increase when they are reviewed? / <FFINSURANCE.LIFEPREMIUMINCREASE1> / <FFINSURANCE.LIFEPREMIUMINCREASE2>
Do you require Waiver of Premium? / <FFINSURANCE.LIFEWAIVER1> / <FFINSURANCE.LIFEWAIVER2>
Do you require Terminal Illness Benefit? / <FFINSURANCE.LIFETERMINALILLNESS1> / <FFINSURANCE.LIFETERMINALILLNESS2>
Do you require the contract to be assigned or written under
trust? / <FFINSURANCE.LIFETRUST1> / <FFINSURANCE.LIFETRUST2>
Are there any material facts that should be disclosed relating to
any medical conditions, claims history etc? / <FFINSURANCE.LIFEMATERIALFACTS1> / <FFINSURANCE.LIFEMATERIALFACTS2>

CRITICAL ILLNESS PROTECTION

You have indicated that you require Critical Illness protection in the event of Applicant 1/Applicant 2 suffering a
Critical Illness
1st Applicant / 2nd Applicant
Critical Illness Required? / <FFINSURANCE.CIC1> / <FFINSURANCE.CIC2>
Who is the protection for? / <FFINSURANCE.CICOVERFOR> / <FFINSURANCE.CICOVERFOR>
What is the cover required to protect? / <FFINSURANCE.CIPROTECTWHAT1> / <FFINSURANCE.CIPROTECTWHAT2>
What level of cover would be required? / <FFINSURANCE.CITERMCOVER1> / <FFINSURANCE.CITERMCOVER2>
Over what period is cover required? / <FFINSURANCE.CITERM1> Years / <FFINSURANCE.CITERM2> Years
What basis of cover? / <FFINSURANCE.CIBASIS1> / <FFINSURANCE.CIBASIS2>
If cover required is Increasing by how much?
If % by how much? / <FFINSURANCE.CIINCREASE1> / <FFINSURANCE.CIINCREASE2>
Do you want the certainty of knowing the cost of cover does not
change throughout the term? (Guaranteed Premiums) / <FFINSURANCE.CIGURA1> / <FFINSURANCE.CIGURA2>
If NO to certainty of premium do you understand that premiums
may increase when they are reviewed? / <FFINSURANCE.CIPREMIUMINCREASE1> / <FFINSURANCE.CIPREMIUMINCREASE2>
Do you require Waiver of Premium? / <FFINSURANCE.CIWAIVER1> / <FFINSURANCE.CIWAIVER2>
Do you require Terminal Illness Benefit? / <FFINSURANCE.CITERMINALILLNESS1> / <FFINSURANCE.CITERMINALILLNESS2>
Do you require Limited Benefits (core only definitions)? / <FFINSURANCE.CILIMITEDBENEFIT1> / <FFINSURANCE.CILIMITEDBENEFIT2>
Do you require Extended Benefits (core plus definitions)? / <FFINSURANCE.CIEXTBENEFIT1> / <FFINSURANCE.CIEXTBENEFIT2>
Do you require a buy back option? / <FFINSURANCE.CIBUYBACK1> / <FFINSURANCE.CIBUYBACK2>
Are children CI benefits required? / <FFINSURANCE.CICHILDREN1> / <FFINSURANCE.CICHILDREN2>
Do you require Permanent total disability? / <FFINSURANCE.CIPERMDIS1> / <FFINSURANCE.CIPERMDIS2>
Have you smoked in the last 12 months? / <CLIENT.SMOKER_1> / <CLIENT.SMOKER_2>
Are you in good health? / <CLIENT.GOODHEALTH_1> / <CLIENT.GOODHEALTH_2>
Are there any material facts that should be disclosed relating to
any medical conditions, claims history etc?
(If yes please refer to notes section) / <FFINSURANCE.CIMATERIALFACTS1> / <FFINSURANCE.CIMATERIALFACTS2>

INCOME PROTECTION