Fact Finding Sheet as at 26 September 2012

7/29/2019 Fact Finding Sheet as at 26 September 2012

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Private & Confidential

FACT FINDING SHEET

FOR :

COMPLETED BY :

DATE :

IMPORTANT NOTICE

Your financial advisor must have sufficient relevant information before he can make a

suitable recommendation. The information that you provide on your investment objective,financial situation and your particular needs will be the basis of the advice given.

A POINT TO NOTE:A product purchased without completing this Fact Finding Form, or following partial or

accurate completion, may not be appropriate to your needs.

Some of the advantages that you would have of completing this form are that this form

enables your advisor to

Assess your financial health more accurately Cater for your total financial needs Ensure that there is no duplication in the recommendations proposed Provide you some form of financial planning to try to realize your financial goals

As such, the recommendations given can only be as accurate as the information that is

provided.


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Fact Finding Sheet September 2012

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1. CLIENT PARTICULARS

What is your main reason for seeking advices?

Personal Information Client

Name: NRIC: DOB:

Address:

Tel: (H) : (O) (Mobile): Fax:

E-mail: Marital Status:

Residential Status: Malaysian Others

Personal Information Spouse

Name: NRIC: DOB:

Address:

Tel: (H) : (O) (Mobile): Fax:

E-mail: Marital Status:

Residential Status: Malaysian Others

Children / Dependants:

Name 1: DOB: Dependant: Y N






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1. CLIENT PARTICULARS

Employment Details - SELF:

Occupation : Employment status:

Business name : Retirement Age:

Address: Retirement Date

Employment Details - SPOUSE:

Occupation : Employment status:

Business name : Retirement Age:

Address: Retirement Date

Health:

SELF:

Are you in good health? Y N (If no, give details on last page) Smoker? Y N

SPOUSE:

Are you in good health? Y N (If no, give details on last page) Smoker? Y N

Are there any histories of medical hereditary problems?

Estate Details - SELF:WILL: Last updated: Held by:

Do you have a Testamentary Trust Setup? Y N

Do you have a Power of Attorney? Y N Name of Attorney:Do you have a Living Trust Setup? Y N

Estate Details - SPOUSE:

WILL: Last updated: Held by:

Do you have a Testamentary Trust Setup? Y N

Do you have a Power of Attorney? Y N Name of Attorney:Do you have a Living Trust Setup? Y N


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2. YOUR CASH FLOW STATEMENT

A.CASH INFLOW YOU SPOUSE COMBINED

Gross Annual Employment Income

Gross Annual Employment Bonus

EPF from Employer

Sub total

(less EPF of employee)

(less EPF of employer)

Net annual income and bonus

Annual Interest Income

Annual Rental Income

Annual Dividends

Sale of Assets

Borrowings

Other Income

TOTAL INFLOW


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B. CASH OUTFLOW YOU SPOUSE COMBINED

Home Utilities (e.g. water, gas,rental, TV license, others)

Vehicles (e.g. Vehicle installment,

insurance, road tax & others)

Family & personal Life (e.g. Food,clothing, domestic help, child

expenses, medical & dental, Income

tax)

Luxury (e.g. Holidays, clubs)

Loan Repayment (e.g. Homemortgage, personal/student loans)

Savings & Investment (e.g. Cashsavings, Insurance premiums,

investment)

Tax Payable

Other Expenses

TOTAL OUTFLOW

C. NET CASH FLOW YOU SPOUSE COMBINEDTOTAL INFLOW less OUTFLOW

Do you plan or are there factors within 12 months, which may significantly increase or decreaseyour current income and expenditure position. (E.g. An inheritance or borrowing money for

investment or purchase of a holiday home. etc.)


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3. YOUR NET WORTH STATEMENT

ASSETS YOU SPOUSE COMBINED

Cash Assets:

Savings Accounts

Current Account

Fixed Deposit

Life Insurances Cash Value

Others

Total Cash Assets

Invested Assets:

Equities (Stocks & Shares)

Bonds/Fixed income Securities

Unit Trust

Investment-linked policies

EPF

Other Retirement Account Balance

Others

Total Invested Assets

Personal Use Assets:

Owner occupied Residential

property

Home Furnishings

Cars

Jewelry/Collections

Others

Total personal Use Assets

TOTAL ASSETS


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3. YOUR NET WORTH STATEMENT

LIABILITIESInterest

%

YOU

(RM)

Spouse

(RM)

Joint

(RM)

Mthly

Repayment (RM)

Currentoutstandi

ngBalance

(RM)

Current Liabilities:

Credit Cards

Overdraft

Income tax payable

Other Bank Loans

Others

Total Current liabilities

Long-Term Liabilities:

Residential HomeLoan

Investment Property

Car loan Repayment

Hire purchase

Home renovation Loan

Family/Personal Loan

Others

Total long-term

Liabilities

TOTAL LIABILITIES

Net Worth


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4. YOUR FINANCIAL GOALS AND OBJECTIVES


Short Term (Less Than 3 years) Estimated Costs

Medium Term (3 7 years) Estimated Costs

Long Term (More Than 7 years) Estimated Costs


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YOUR PERSONAL PRIORITIES

Rank your personal priorities starting from 1 as top most priority

PERSONAL PRIORITIESYOU SPOUSE

Ranking Ranking

Providing for family in the event of death

Providing for you and your family in the event ofdisability

Providing for long-term medical care (major illness)

Providing for hospital and surgical benefits

Debt management / loan cancellation

Saving for short term (e.g. deposit for home, car)

Saving for medium term (e.g. early mortgagerepayment)

Funding your childrens tertiary education

Funding for a comfortable retirement

Planning for possible Estate Duty Taxes


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YOUR FINANCIAL GOALS AND OBJECTIVES

YOUR RISK PROFILE

1. What is your Investment time horizon?a. I plan to hold my investment portfolio for the next 1 year

b. I plan to hold my investment portfolio for the next 5 yearsc. I plan to leave my money for 10 years or more

2. When you hear unexpected, adverse or bad financial news, youa. Never over react

b. Rarely over reactc. Always over react

3. If you have invested in a stock that rose 25% within 3 months after you bough it, you woulda. Do nothing or buy more shares

b. Sell some sharesc. Sell all your shares

4. In case of an emergency, you would have available savings to pay for.a. Less than 3 months living expenses

b. 3 to 6 months living expensesc. More than 6 months living expenses

5. Choose the statement that best describes your investment savings goal in relation to inflationa. My savings should be very safe, even if my investment returns do not keep up with

inflation

b. It is important that the value of my investment grow at the same rate as inflationc. It is important that my investment grow faster than inflation

6. What is the maximum loss of value you could accept in any one-year period on yourinvestment portfolio?a. 0%

b. 10%c. 25%

Total Score:


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SCORING

a. = 1 pointsb. = 2 pointsc. = 3 points

Total Score Investor profile

6 10 points Low risk

11 -15 points Medium risks

16 18 points High risks


DISCLAIMER

We accept no responsibility for giving any recommendation or advice based on the Risk Profile

Analysis. The Risk Profile Analysis is structured for hypothetical investors whose characteristics,

circumstances and requirement may differ from your own. The Risk profile Analysis is BUT a

useful guide.


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RETIREMENT PLANNING

Retirement PlanYou

(RM)

Spouse

(RM)

What is your desired annual retirement income (in todays

Ringgit)?

Planned retirement Age?

Estimated Life Expectancy

FINANCIAL GOALS AND OBJECTIVES

TERTIARY PLANNING

Estimated Cost of Education (in todays Ringgit):

1st Child RM in years Local / Overseas for years

2nd

Child RM in years Local / Overseas for years

3rd


4th Child RM in years Local / Overseas for years

5th


Available Resource for Tertiary Education

1st

Child RM

2ndChild RM

3rd

Child RM

4th Child RM

5th Child RM


OTHERS

1. Do you, your spouse or children expect to receive an inheritance in the near future? Y N

If yes, please provide details:

2. Other information for consideration (e.g. expected changes to your income or debt level,

proposed sales of assets, capital gains tax liability, etc.)


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ECONOMIC INDEX

REQUIRED ASSUMPTIONS: YOU SPOUSE

What do you feel is a fair rate of inflation?

What is your expected wage (including bonus) growth rate?

Either: What % of your current annual income would you need

at retirement?

Or: What amount, in todays Ringgit would you require during

retirement?

What would you consider a fair rate of return for the following

before retirement?

Savings/Current Account Fixed Deposit Traditional Insurance Polices Investment-linked Insurance Policies Stocks/Shares Unit trusts Real Estate EPF Other Retirement Account

What would you consider a fair of return on investment during

retirement?

What would you consider a fair education inflation rate?


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EXISTING INSURANCE POLICIES

Lets review your existing insurance program (All forms of insurance policies owned by you orprovided by the company, e.g. Group benefits, motor car, Mortgage, household contents,

investment Linked, Disability, Income protection, hospital. Surgical benefits, including 3rd

partychild education policies)

YOU:

Policy type

Incep

tiondate

Basic

SumAssured

Riders/

Age

Other

Benefits

Maturi

ty date/ Age

Maturity

Amount

Cash

Value

Outsta

ndingloans

Premium/

Annum

SPOUSE:

Policy typeInception

date

BasicSum

Assured

Riders/Age

OtherBenefits

Maturity date

/ Age

MaturityAmount

CashValue

Outstanding

loans

Premium/Annum


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GENERAL INFORMATION

We need to know of any circumstances that may or may not have in the past affected anapplication for insurance on your life. Things to consider may include your health, any conditions,

any participation in hazardous sports, previous illnesses or accidents, or if you have ever beendeclined or rated for insurance cover.


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F

INANCIAL GOALS AND OBJECTIVES

TAX PLANNING

Tax Relief for Resident Individual for Year Assessment 2010

No. Individual Relief Types Amount

(RM)

You

(RM)

Spouse

(RM)

1 Self and Dependent 9,000

2 Medical expenses for parents 5,000

(Limited)

3 Basic supporting equipment 5,000

(Limited)

4 Disabled Individual 6,000

5 Education Fees (Individual) 5,000

(Limited)

6 Medical expenses for serious diseases 5,000

(Limited)

7 Complete medical examination 500(Limited)

8 Purchase of books, journals, magazines and publications 1,000(Limited)

9 Purchase of personal computer 3,000(Limited)

10 Net saving in SSPN's scheme 3,000(Limited)

11 Purchase of sport equipment for sport activities 300

(Limited)

12 Subscription fees for broadband registered in the name

of the individual

500

(Limited)

13 Interest expended to finance purchase of residential

property. Relief of up to RM10,000 a year for threeconsecutive years from the first year the interest is paid.Subject to the following conditions:

(i) the taxpayer is a Malaysian citizen and a resident;

(ii) limited to one residential unit;(iii) the sale and purchase agreement is signed between10th March 2009

and 31st December 2010; and(iv) the residential property is not rented out.

Where:(a) 2 or more individuals are eligible to claim relief forthe same property ; and

(b) total interest expended by those individuals exceedsthe allowable amount for that year. Each individual is

allowed an amount of relief for each year based on the

following formula:

10,000

(Limited)


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No. Individual Relief Types Amount

(RM)

You

(RM)

Spouse

(RM)

A x B

Cwhere;

A = total interest allowable in the relevant year;B = total interest expended by the relevant individual in

the relevant year;

C = total interest expended by all the individuals.

14 Husband/Wife/Alimony Payments 3,000(Limited)

15 Disable Wife/Husband 3,500

16 Ordinary Child relief 1,000

17 Each unmarried child of 18 years and above who isreceiving full-time education ("A-Level", certificate,matriculation or preparatory courses).

1,000

18 Each unmarried child of 18 years and above that:

(i) receiving further education in Malaysia in respect ofan award of diploma or higher (excludingmatriculation/preparatory courses).

(ii) receiving further education outside Malaysia inrespect of an award of degree or its equivalent (includingMaster or Doctorate).(iii) the instruction and educational establishment shall

be approved by the relevant government authority.

4,000

19 Disabled child

Additional exemption of RM4,000 disable child age 18years old and above, not married and pursuing diplomasor above qualification in Malaysia @ bachelor degree or

above outside Malaysia in program and in HigherEducation Institute that is accredited by related

Government authorities

5,000

20 Life insurance and EPF 6,000

(Limited)

21 Premium on new annuity scheme or additional premium

paid on existing annuity scheme commencing payment

from 01/01/2010 (amount exceeding RM1,000 can beclaimed together with life insurance premium)

1,000

(Limited)

22 Insurance premium for education or medical benefit 3,000(Limited)

* For latest tax relief schedule, kindly refer to Inland Revenue Board of Malaysia

(www.hasil.org.my).


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CLIENT ACKNOWLEDGEMENT

Yes(initial Please)

No(Initial Please)

The information provided in this form is

COMPLETE & ACCURATE to the BEST OFMY KNOWLEDGE

Or

I have chosen to ONLY DISCLOSE a LIMITED

AMOUNT of information shown in this form

Or

I have CHOSEN & REQUESTED that NOFORMAL ANALYSIS is to be conducted for my

circumstance

I understand and acknowledge that by not completing a FACT FINDER, the recommendations

given MAY not be accurate and appropriate to my needs and objectives.

Client Signature & name: Spouse signature & name:

NRIC No.: NRIC No.:

Date: Dates


ADVISORS DECLARATION

I declare that the information provided by me in this Fact Find is confidential and is only to be

used for the purpose of fact finding in the process of recommending suitable products and shallnot be used for any other purposes.


ADDITIONAL INFORMATION


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DISCLAIMER

All information, particulars and data contained herein is confidential and privileged to theintended recipient and/or user only. Such information, particulars and data shall not be

used by the intended recipient otherwise than for the purpose expressly and/or impliedly

stated by The Malaysian Insurance Institute (MII) and mutually agreed upon by allparties who are privy to the same.

If you are not the intended recipient and/or user, you are notified that any use,

dissemination, distribution or copying of such information, particulars and data is strictly

prohibited. If you have received such information, particulars and data in error, pleasenotify the MII immediately and return the original forthwith.

Clients Signature & Name Advisors Signature & Name

NRIC No : NRIC No :Date : Date :

Fact Finding Sheet as at 26 September 2012

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Transcript of Fact Finding Sheet as at 26 September 2012