CORE FINANCIAL PLANNING QUESTIONNAIRE

Client(s) Name
Adviser Name / Quentin Cooke
Date Completed

16 Low Road

Burwell

Cambridge

CB25 0EJ

T: 01638 615343

F: 01638 615342

E:

The Tenet Financial Planning Questionnaires are designed to be modular in nature, dependent on the advice being given to the client.

For all cases, the Core Financial Planning Questionnaire should be completed fully where possible, with the additional advice specific information gathered in the relevant modules, as indicated below. Where advice is being ‘limited’ to specific areas of need, please indicate the area of need by ticking the end column and ensure that you complete the additional fact find:

Supplementary Questionnaires
Need Area / Required for advice on:
Estate Planning / Required in addition to all other modules for clients who wish to address Estate Planning issues. / ☐
Planning for Retirement / Required where clients are planning for retirement and may be making capital or income contributions, have inherited pension funds or making decisions that involve switches or transfers of existing pension funds. / ☐
Living in Retirement / Required where clients are immediately prior to (e.g. within 6 months), at or in retirement. / ☐
Protection / Required for all recommendations for protection contracts, with the exception of those made as part of Estate Planning. / ☐
Adviser Note
Please complete all the appropriate sections. If a section is not applicable, then please strike this through and write N/A. For the avoidance of doubt within this questionnaire, and all supplementary questionnaires, N/A means not applicable.

Contents

Section 1: Aims & Objectives 3

Section 2: Personal & Family Details 4

Section 3: Health, Power of Attorney & Wills 5

Section 4: Employment Details 7

Section 5: Earnings & Income 9

Section 6: Expenditure & Affordability 11

Section 7: Protection Plans 13

Section 8: Pensions Plans 16

Section 9: Savings & Investments 18

Section 10: Mortgages & Other Debt 20

Section 11: Other Assets 21

Section 12: Risk Profile 22

Section 13: Taxation and Investment Allowances 24

Section 14: Investment Preferences 24

Section 15: Other Professional Advisers 26

Section 16: Current Financial Priorities 27

Section 17: Additional Notes 28

Section 18: Declaration 29

Letter of Authority 30

Section 1: Aims & Objectives

The key to successful financial planning is to have clearly defined aims and objectives to work towards. Aims may best be considered as long term aspirations or ambitions without a clearly defined date or ‘someday maybe’ projects and goals. Objectives are more specific and would generally have a defined timeline linked to them. So an aim might be to leave a current employer, to retrain and then to set up my own business at some time in the future whilst my objective is to have a pension of (the equivalent of) £30,000 a year in today’s terms.

The best objectives to plan against are Specific, Measurable, Achievable, Realistic and Time bound. An example might be to achieve an annual pension income of the equivalent of £30,000 a year in today’s terms, payable for life from age 60.

Please describe your aims and objectives below.

Section 2: Personal & Family Details

/ Client 1 / Client 2 /
Title / Mr / Mrs / Miss / Ms / Dr / Mr / Mrs / Miss / Ms / Dr
First Name(s)
Surname
Marital Status / Married / ☐ / Married / ☐
Single / ☐ / Single / ☐
Divorced / ☐ / Divorced / ☐
Widower / ☐ / Widower / ☐
Co-habiting / ☐ / Co-habiting / ☐
Civil Partnership / ☐ / Civil Partnership / ☐
Date of Birth / Age / / / / / /
Gender
Nationality / British / ☐ / British / ☐
Other: / ☐ / Other: / ☐
Country of Residence / United Kingdom / ☐ / United Kingdom / ☐
Other: / ☐ / Other: / ☐
Domicile / United Kingdom / ☐ / United Kingdom / ☐
Other: / ☐ / Other: / ☐
Address
Postcode
Home Telephone
Mobile Telephone
Work Telephone
Home Email Address
Work Email Address

Dependant’s Details

Name / Dependent Upon
(J=Joint, C1=Client 1, C2 = Client 2) / DOB / Relationship to Client(s) / Financially
Dependent? / Anticipated length of dependency /
J ☐ / C1 ☐ / C2 ☐ / Y ☐ N ☐
J ☐ / C1 ☐ / C2 ☐ / Y ☐ N ☐
J ☐ / C1 ☐ / C2 ☐ / Y ☐ N ☐
J ☐ / C1 ☐ / C2 ☐ / Y ☐ N ☐
Additional Notes /

Section 3: Health, Power of Attorney & Wills

Your health can have a significant impact on our advice. It can impact the cost of protection and also the level of benefits that you may be entitled to. For example, annuity rates are increased for smokers and individuals with certain lifestyle factors, whereas life cover costs are can increase. Please complete the details below so that we can ensure that any quotations we obtain are specific to your circumstances.

/ Client 1 / Client 2 /
How would you describe your general health? / Excellent / ☐ / Excellent / ☐
Good / ☐ / Good / ☐
Average / ☐ / Average / ☐
Poor / ☐ / Poor / ☐
Do you suffer from any medical condition that may affect your ability fulfil your current role?
(If ‘yes’ please provide additional details in Notes) / Yes ☐ No ☐ / Yes ☐ No ☐
Do you suffer from any medical condition that might mean you have to consider retiring early?
(If ‘yes’ please provide additional details in Notes) / Yes ☐ No ☐ / Yes ☐ No ☐
Height (ft/ins or cm)
Weight (st/lbs or kg)
If retired, occupation prior to retirement
Have you ever been diagnosed with any of the following?[1] / Hypertension / Yes ☐ No ☐ / Yes ☐ No ☐
High Cholesterol / Yes ☐ No ☐ / Yes ☐ No ☐
Heart condition / Yes ☐ No ☐ / Yes ☐ No ☐
Diabetes / Yes ☐ No ☐ / Yes ☐ No ☐
Cancer, leukaemia, lymphoma, growth, or tumour / Yes ☐ No ☐ / Yes ☐ No ☐
Stroke / Yes ☐ No ☐ / Yes ☐ No ☐
Respiratory/lung disease / Yes ☐ No ☐ / Yes ☐ No ☐
Multiple sclerosis / Yes ☐ No ☐ / Yes ☐ No ☐
Neurological disease / Yes ☐ No ☐ / Yes ☐ No ☐
Other serious illness
(please detail in notes) / Yes ☐ No ☐ / Yes ☐ No ☐
Are you a smoker?
(This includes cigarettes, cigars, pipes, or any nicotine replacement products) / Yes ☐ No ☐ / Yes ☐ No ☐
If you have smoked in the past, please state when you stopped
How many cigarettes / cigars per day do you smoke? (or ounces/grams of pipe tobacco)
Notes

3.1 Power of Attorney

/ Client 1 / Client 2 /
Do you have a Power of Attorney? / Yes ☐ No ☐ / Yes ☐ No ☐
What type of Power of Attorney is it? / Enduring / ☐ / Enduring / ☐
Lasting / ☐ / Lasting / ☐
What does it cover? / Financial / ☐ / Financial / ☐
Health & Wellbeing / ☐ / Health & Wellbeing / ☐
Both / ☐ / Both / ☐
When was it made?
Who has the Power of Attorney?

3.2 Wills

Please ensure that you provide a copy of your will.

/ Client 1 / Client 2 /
Have you made a will? / Yes ☐ No ☐ / Yes ☐ No ☐
When was it made?
When was it last reviewed?
Does it reflect your current wishes? / Yes ☐ No ☐ / Yes ☐ No ☐
Name(s) of Executors:
Name(s) of children’s guardians:
Details of Beneficiaries:
Additional Notes /

Section 4: Employment Details

4.1 Employment Details

/ Client 1 / Client 2 /
Employment Status / Employed / ☐ / Employed / ☐
Self – Employed / ☐ / Self – Employed / ☐
Retired / ☐ / Retired / ☐
Not Employed / ☐ / Not Employed / ☐
National Insurance No

4.2 Employer Details

/ Client 1 / Client 2 /
Current Employer
Basis of Employment / Full Time / ☐ / Full Time / ☐
Part time ( ) hrs per wk / ☐ / Part time ( ) hrs per wk / ☐
Temporary / ☐ / Temporary / ☐
Contract / ☐ / Contract / ☐
Employer Address
Employer Post Code
Telephone Number
Industry
Occupation / Job Title
Start Date / / / / / /
Are you on probation? / Yes ☐ No ☐ / Yes ☐ No ☐
Probation End Date / / / / / /
Do you have access to an Employer Sharesave Scheme or other long term incentive scheme?
(If yes, please provide further details in notes section) / Yes ☐ No ☐ / Yes ☐ No ☐
Do you have any additional occupation(s)?
(If yes, please provide further details in notes section) / Yes ☐ No ☐ / Yes ☐ No ☐

4.3 Self Employed Business Details

/ Client 1 / Client 2 /
Name of Business
Address
Postcode
Telephone Number
Email Address
Type of Business
Occupation / Job Title
Date Business Started /
Holding Acquired / / / / / /
Business Status / Sole Trader / ☐ / Sole Trader / ☐
Limited Company / ☐ / Limited Company / ☐
Partnership / ☐ / Partnership / ☐
Limited Liability Partnership / ☐ / Limited Liability Partnership / ☐
Shareholding in Business / % / %
Are you a contractor? / Yes ☐ No ☐ / Yes ☐ No ☐
Do you have an accountant?
(If yes, please complete section 16) / Yes ☐ No ☐ / Yes ☐ No ☐

4.4 Future Changes to Employment

/ Client 1 / Client 2 /
Do you expect your employment circumstances to change, either in the short term or longer term?
(If yes please provide details in Notes) / Yes ☐ No ☐ / Yes ☐ No ☐
Planned Retirement Date
Additional Notes /

Section 5: Earnings & Income

5.1 Gross Employment Income (Annual)

/ Client 1 / Client 2 /
Basic Salary / £ p.a. / £ p.a.
Car Allowance / £ p.a. / £ p.a.
Bonus / £ p.a. / £ p.a.
Overtime / £ p.a. / £ p.a.
Shift Allowance / £ p.a. / £ p.a.
Other / £ p.a. / £ p.a.
Value of Benefits in Kind (P11D) / £ p.a. / £ p.a.
Other Earned Income
(e.g. 2nd Job – provide details Notes) / £ p.a. / £ p.a.
Total Employment Income / £ p.a. / £ p.a.

5.2 Self-Employment Income (Annual)

/ Client 1 / Client 2 /
Number of Years’ Accounts / Self-Assessment Available
Latest Year (1)
Year End
Net Profit (before taxation) / £ p.a. / £ p.a.
Net Dividend (if Ltd) / £ p.a. / £ p.a.
Director’s Remuneration (if Ltd) / £ p.a. / £ p.a.
Previous Year (2)
Year End
Net Profit (before taxation) / £ p.a. / £ p.a.
Previous Year (3)
Year End
Net Profit (before taxation) / £ p.a. / £ p.a.
Total Self Employed Income / £ p.a. / £ p.a.

5.3 Other Gross Income (Annual)

/ Client 1 / Client 2 /
Tax Free Income (e.g. ISA) / £ p.a. / £ p.a.
Deposit Interest / £ p.a. / £ p.a.
Investment Income (Interest) / £ p.a. / £ p.a.
Investment Income (Dividend) / £ p.a. / £ p.a.
Rental Income / £ p.a. / £ p.a.
Pension (State) / £ p.a. / £ p.a.
Pension (Private) / £ p.a. / £ p.a.
Child Benefit / £ p.a. / £ p.a.
Working Tax Credit / £ p.a. / £ p.a.
Child Tax Credit / £ p.a. / £ p.a.
Disability Benefits (e.g. DLA, PIP etc) / £ p.a. / £ p.a.
Other:(please provide details in Notes) / £ p.a. / £ p.a.
Total Other Gross Income / £ p.a. / £ p.a.

5.4 Tax Rate

/ Client 1 / Client 2 /
Tax Rate / Non Tax Payer (0%) / ☐ / Non Tax Payer (0%) / ☐
Basic Rate (20%) / ☐ / Basic Rate (20%) / ☐
Higher Rate (40%) / ☐ / Higher Rate (40%) / ☐
Additional Rate (45%) / ☐ / Additional Rate (45%) / ☐
Additional Notes /

Section 6: Expenditure & Affordability

6.1 Expenditure Analysis

Please complete the details below as accurately as possible so that we can obtain a full understanding of your current circumstances. If you do not wish to provide this information, please go to Section 6.2.

/ Client 1 / Client 2 / Joint /
Essential Expenditure / Mortgage / £ / £ / £
Loans / £ / £ / £
Life/Pension Policies / £ / £ / £
Council Tax / £ / £ / £
Gas/Electric/Water / £ / £ / £
Telephone / £ / £ / £
TV/Subscriptions / £ / £ / £
Car Ins./Road Tax / £ / £ / £
Petrol/Travel Expenses / £ / £ / £
Food & Housekeeping / £ / £ / £
Clothes / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Total Essential Expenditure / £ / £ / £
Desirable / Socialising / £ / £ / £
Holidays / £ / £ / £
Interests & Hobbies / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Other ( ) / £ / £ / £
Total Desirable Expenditure / £ / £ / £
Total Expenditure / £ / £ / £
Net Income per month / £ / £ / £
Surplus per month / £ / £ / £
Will any of the above financial commitments cease in the future? / Yes ☐ No ☐
(if yes, please provide details below) / Yes ☐ No ☐
(if yes, please provide details below)
How much money would you need as an emergency fund? / £
Is this available in an immediately accessible account? / Yes ☐ No ☐
Details:
Notes

6.2 Statement of Affordability

If you do not wish to complete the full Expenditure Analysis in Section 6.1 (which we strongly recommend that you do), then provide confirmation of your overall position below.