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CONFIDENTIAL CLIENT FACTFIND.

We provide advice to clients on protection insurances and mortgages. The purpose of this questionnaire is to clarify your financial needs and to assist us in advising you in relation to certain financial protection insurance products including – life assurance, specified serious illness cover and income protection cover. However, if you wish to focus on certain financial products only, please tick the relevant area:

SERVICES REQUESTED:*

Section 1 – About you

Name*
Address
DD slash MM slash YYYY
Smoker?
Your dependents

Section 2 – Your work, income & investments

Manual work / Driving / Work @ heights? If yes, please provide full details:
Self Manual work / Driving / Work @ heights? If yes, details:

Assets & Liabilities

Approximates are fine – This is just about gauging an overall view.

Section 3 - Existing financial cover

If you are unsure of what cover you currently have in place, please complete a Letter of Authority. This will allow your advisor to get accurate information directly from the life assurance company (ies).

Current mortgage details

DD slash MM slash YYYY

Section 4 - Advice on Mortgage Protection only

Complete this section if you are just looking for a price for a mortgage protection policy to satisfy your lenders requirements for your new mortgage.

(Interest-only / Ordinary repayment)
Specified serious illness cover required?

Section 5 - Additional details

Do you need any business protection insurance?
Have you made a will?

Next Review Date

It is recommended that an annual review of your cover take place to ensure that all your needs are monitored for changing circumstances. I will diary forward a note to contact you by your preferred contact method in 1 years’ time.

Consent*
*
Consent*
*
Consent*
*

Client(s)

Print name
DD slash MM slash YYYY
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