JR00912-01 ER Fact Find March 2013 · Web viewIt is vital that when you are using any form of fact...

Customer 1 Name:

Customer 2 Name:

Adviser Name:

1

Your company name and details hereYour logo here

Equity Release

Fact Find

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Basic details

Address:

Postcode:

Address (if different):

Postcode:

Date & Time completed:

Telephone Home visit

Others present at the meeting & their relationship to customer

2

This questionnaire is designed to provide your adviser with the information required in order to review your circumstances.

Periodically your adviser may need to confirm that the information is correct.

To ensure that the advice provided to you is appropriate, and any recommendations based on sound information, it is important that the questions are answered as fully as possible.

Please ensure that you read the Data Protection section of our terms of business.

Full nameTitleTelephone numberAddressEmail addressRelationship to clientActing in a professional capacity?

Yes / No Yes / No Yes / No

If acting in a professional capacity, please describe

Personal details

Customer 1 Customer 2

Title: Surname: Title: Surname: Sex: Forename(s): Sex: Forename(s):

Date of birth: Age: Date of birth: Age:

Marital status Marital status Home Home Mobile Mobile Email Email

Relationship to customer 1

Notes(Please include details of any Power of Attorney, if applicable)

Family and DependantsNameRelationshipDependant? Yes No Yes No Yes No

3

If yes, To age?Date of birth

Does the customer involve anyone Yes Who?else in their financial decisions? No

Employment Details

Details of Employment Customer 1 Customer 2Occupation

Employment status Employed Self Employed Retired Unemployed

Employed Self Employed Retired Unemployed

Employer’s name

UK resident Yes No Yes NoWork or live abroad Yes No Yes No

Notes, including hours worked

4

Financial Details

IncomeCustomer 1 Customer 2 pa pm Net Gross

pa pm Net Gross

Earned income £ £ Pension (state) £ £ Pension (other) £ £ Investment – regular withdrawals

£ £

Investment – adhoc withdrawalsOther (specify in notes section) £ £ State benefits (inc £ £ Disability Allowance (DLA)/ Attendance Allowance (AA)/Guaranteed Pension Credit (GPC)/ Savings Pension Credit (SPC) &Other (Not Council Tax Reduction (CTR))

Monthly Income £ pm pm

Joint Monthly Income £ pm

Tax Rate Nil Lower Nil Lower

Basic Higher Basic Higher

Detail benefits received due to disability

Disability Living Allowance Care Low Med High Amount £ pw

Disability Living Allowance Mobility Low Med High Amount £ pw

Attendance Allowance Low Med High Amount £ pw

Detail means tested benefits

GPCAmount

£ pw SPC Amount

£ pw CTB Amount

£ pw

Is customer in Assessed Income Period? If yes, next review date:Please note, equity release may have an impact on the benefits your client receives. For more information please visit https://www.gov.uk/browse/benefits

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What is the clients FULL council tax bill? £

Is the customer in receipt of other benefits? Yes No If yes, provide details inc amount

Expenditure

Breakdown

Amount Frequency Amount FrequencyMortgage/Rent £ Car Expenses £ Loans/Credit Card £ Domestic insurances £ Council Tax (Inc Benefits) £ Other insurances £ Utilities £ Leisure / holiday £ Food/household £ Other £ Children/Grandchildren £

Other (please specify:_______________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ____________________

Total Outgoings £ Net Monthly Income £ Net Surplus/Shortfall £

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Where there is a net surplus:

What does the customer do with this amount? Potential to service Interest Only Mortgage?

Where there is a net shortfall:

How does the customer deal with on-going income shortfalls?

Notes including impact on death of either customer

Is Customer expected to receive any future pensions inc state pension? Yes No If yes, provide details below:

Have you lost touch with a personal/private pension scheme? Yes No If yes, provide details below:

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Existing Investments

Deposit Based

Banks/Building Societies (including savings bonds)

Company Type/Rate Restrictions Balance Purpose Encashment Penalties

If income taken, amount?

Frequency Cust 1/2/J

ISA Cash

Company Latest Valuation Rate % Purpose If income taken, amount

Frequency Cust 1/2

National Savings

Account Type Latest Valuation

Purpose Rate % Maturity Date If income taken, amount


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Total Value of Deposit Based Accounts

Customer 1 Customer 2 Joint

Investment Based

Investment Bonds (not including savings bonds)Company Latest

ValuationPurpose Encashment

penalties (if applicable)

If income taken, amount


Unit trusts / ITs / OEICs / PEPs / ISAsCompany Latest

ValuationPurpose Encashment

penalties (if applicable)

If income taken, amount


Stocks & SharesCompany Latest Valuation Purpose If income taken,

amountFrequency Cust

1/2/J

Other InvestmentsCompany Latest Valuation Purpose If income taken,

amountFrequency Cust

1/2/J

Total Value of Investment Based AccountsCustomer 1 Customer 2 Joint

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Endowment / Savings Plan

Company Type WP UL ISA Start date Term Estimated Maturity Date

Other policies such as critical illness, term assurance, whole of live and hospital plan policies

Company Type of policy Start date Term Estimated Maturity Date

Estimated value at maturity

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Care Funding (Basic Details)

Customer(s) requiring care: Yes NoHas individual(s) undergone an NHS Continuing Care Assessment?

Yes NoIf so, please obtain an original or certified copy.

If not provide any additional health information required:(For example, ADLs: Mobility, washing, dressing, feeding, toileting, continence, mental impairment, transferring (moving from chair to bed and vice versa)

Is individual already in care home? Yes NoCare Home Contact Name:

Care Home Contact Name Position:

Care Home Contact Telephone Number:

Care Home Address line 1:





Care Home Postcode:

Type of existing care?

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Hours Frequency

Equivalent p.m.

Existing care (Hours):Existing care (Cost): £ £ What type of care is now required?

If living in own home, how long does individual wish to remain in own home?

How likely is this?

How likely are they to move back and forth from home to care?

What are the timescales?

Additional care-related Expenditure: Total FrequencyEquivalent

p.m.Care costs (estimated): £ £ Care costs (actual): £ £ When is next review due – please detail date:

__ / __ / ____

If not accounted for in the main Expenditure section, any additional Personal Expenditure of the individual(s) in care (for example, hairdresser, chiropody, pocket money etc.): £ £

Is expenditure likely to increase? Yes NoIf yes, please give details, including likely time if known:

Total Monthly Initial Additional Care related Expenditure: £ Total Monthly Expenditure from earlier Expenditure section in Fact Find: £

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Is this expenditure likely to change? Yes NoBy how much? £ £

Why?

ADJUSTED TOTAL MONTHLY EXPENDITURE: £ NET MONTHLY INCOME: £ NET MONTHLY SURPLUS / SHORTFALL: £

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Assets & Liabilities

AssetsCustomer 1 Customer 2 Joint

Home (primary residence) £ £ £ Other properties £ £ £ Contents £ £ £ Vehicles £ £ £ Value of deposit accts £ £ £ Value of investments accts £ £ £ Business interestsplease describe below in notes

£ £ £

Other assetsplease describe below in notes

£ £ £

Totals £ £ £

Total Assets (Cust 1,2 & Joint) £

Notes including details of other assets not covered above, e.g. Other properties, business interests.

Emergency Fund

In the event of an emergency do you have immediate access to funds?

Yes No

Where would the funds come from?

How much is available? £

If applicable, how has any previous ‘emergency money’ been funded & spent? (Including amounts & dates)

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For what future purpose, including timescales are future emergency money likely to be used?

Likely event:

Future timescales:

Estimated amount required:

Estimated time before repeat expenditure:

Likely event:

Future timescales:



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Likely event:

Future timescales:



Liabilities

Outstanding Mortgages

Mortgage type Interest only Repayment Flexible Lifetime Mortgage

Mortgage on this property? Yes No

If mortgage not on this property, please enter address of mortgaged property

Amount outstanding £ Monthly Payment £

Expiry date or remaining term £ Interest rate %Lender

Details of any early repayment charges

Does the customer have sufficient provision to repay the mortgage?

Yes No

Is the mortgage protected in the event of death/critical illness, or long term sickness?

Yes No

Unsecured Loans Customer 1 Customer 2 JointLoan amounts £ £ £

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Term length Monthly Payment £ £ £

Other Liabilities Customer 1 Customer 2 JointOther Loan amounts £ £ £ Credit Card balances £ £ £ Store card balances £ £ £ Overdraft £ £ £ Other £ £ £ Total Liabilities £ £ £

Details of other liabilities including payment details

Summary of assets and liabilitiesTotal assets £ Total liabilities £ Net assets/liabilities £

If the total value of your estate including investments, property and other assets exceeds “the nil rate Band”, you may have a potential IHT liability. We recommend you seek specialist Inheritance Tax advice to correctly plan for any potential liability you may have.

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Inheritance

Is leaving an inheritance to beneficiaries important? Yes NoIf yes, details including preferences for their estate

Equity Release will potentially impact on the value left to your beneficiaries. How do you feel about this?

Has the customer discussed their plans for Equity Release with their family/beneficiaries? Yes No

If they have not, please record why:

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If they have, please record whom they have discussed it with and their views. Please include names, relationship to client(s) and view of each respondent.

Wills

Does the customer have a will that reflects their current wishes? Yes NoIf Yes, give details below

Who are the beneficiaries?

Does the customer have a LPOA or CPOA (Scotland)? Yes NoNotes (if required)

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Has the customer made any gifts in the last 7 years or 14 years in the case of Chargeable Lifetime Transfers

If Yes, give details below

Yes No

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Property Details

Is the property Joint Tenancy Yes Noor Is the property Tenancy in Common Yes NoType of property House Bungalow Flat

Maisonette Detached Semi Terraced

Construction type Brick Stone Other Is the property? Freehold Leasehold Commonhold

If leasehold, when does the lease expire? Number of bedrooms Estimated Property value £

Customers’ Main Residence? Yes NoIs There a mortgage outstanding on the property (details in liability section)?

Yes No

Is the customer the sole occupant? Yes No please give details

Is the property used for purposes other than residential?

Yes No please give details

Was the property previously owned by a Local Authority?

Yes No If large estate, rough proportion in private ownership? Possible issue if less than 50%

When was the property built?

Is the property part of a sheltered housing development? Yes NoAre there any age restrictions placed on occupants of the property? Yes No

If the property is a flat or maisonette, please answer the following questions:

Is the property: Purpose built ConversionIs it over a retail or business premises? Yes NoIs the block wholly privately owned? Yes No

How many storeys? (e.g. Ground floor = 1)

If more than 7 storeys, is it served by lifts? Yes No

Where are the deeds to the property kept? Notes (including comment on condition of property)

What is the customers view of House Price movement over the medium to long term?

Construction Questionnaire / Property Considerations

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Is there anything about the property that might concern a lender? i.e. Is it:

Timber framed? Yes No

Metal Framed? Yes No

Construction Type Single Skin Brick Double Skin Brick Cavity Stone Lath/Plaster Wooden Clad Laing-Easi Form concrete Cornish Wimpey No Fines Hawkesley

Notes

If the property is terraced or semi detached, is there a ‘fire-break’ or wall in the attic separating your property from your neighbours?

Roof Type Slate Tile Flat Bitumen Part Flat / Part Apexed Over 25% Flat Roof Thatched

Notes

Signs of Damp, Cracks or structural movement?

Is the property listed? Yes NoIs there any history of Subsidence, Flooding or Japanese Knotweed at the property?

Is property used for commercial purposes, i.e. B&B or holiday lets? Yes No

If the property is tenanted, is there a proper 6 month Assured Shorthold Agreement in place?

Yes No

Is there electricity pylon within 50 meters of the property Yes No

Buildings insurance

Does the customer have buildings insurance? Yes No

What is the renewal date?

Your health and lifestyle

If you are a smoker and/or have certain health conditions, you may be eligible for Enhanced LTV terms. By filling in the medical questions at the end you will enable us to take into account your health and lifestyle conditions when calculating the maximum amount you can borrow.

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Customer 1 Customer 2Attitudes to Life Expectancy? Attitudes to Life Expectancy?

Explore the customers attitude towards making provision and discuss financial plans and requirements for Long Term care. Views on the impact of releasing equity on LTC plans?

Customer 1 Customer 2

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Customer Objectives

What are you hoping Equity Release will help you achieve?

Priorities

Rate the importance of the following factors to the customer:

Not important Neutral Important

RANK the top 3

PrioritiesInterest RateFacility to drawdown future fundsAbility to make monthly repaymentsA guaranteed income for lifeProviding an incomeTo add fees to the loanAbility to increase the loan in futureRetaining ownership of their propertyInheritance for beneficiariesMaximum possible cash release*Speed of completionFinancial strength of providerNo investment risk in funding for care Protecting against any increase in care support costsProtecting capital / income against inflation

*Does the customer qualify for enhanced?

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Reason why customer has ranked certain features, including the cost/benefit of each.

Rank Reasons why priority1

2

3

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Explore the following alternatives to Equity Release

Use of existing assets / maturing life policiesCould the customers existing assets be restructured or sold to meet the customer needs?

Remortgage / Extending existing termHave you considered a standard remortgage or extending the term of your existing mortgage

Financial help from family / inheritanceThe likelihood of this occurring now and in the foreseeable future?

Local authority grants eligibilityIf the customer wants to do home improvements, is a grant available? Indicate which of the three outcomes apply: 1. Customer established/establishing, 2. Adviser will establish, 3. Adviser to inform based on knowledge

Moving to a cheaper propertyConsidered moving to a less expensive property? What if your personal circumstances change?

State BenefitsDoes any unclaimed benefit entitlement potentially meet the customers objectives?

Rent a room

Budgeting

Do nothing

Employment

Other

Equity release solution

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Having provided a balanced overview of the pros & cons of Lifetime Mortgages and Home Reversion plans, what are the product features that the customer is drawn to and why?

Record Details of the Lump sum required

Purpose Amount Date Required

Total Release Amount £

Is the customer prepared to utilize their existing savings to meet their objectives?

Yes No

If not, why?

If the release amount creates a post completion monthly income surplus, explain how this would be spent. Could it go towards an Interest Only payment?

Apart from death or long term care, does the customer expect to repay the Equity Release plan early?

Yes No

If Yes, give details including the reason, timescales, amounts & where funds will come from.

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Credit history

Has the customer ever had a mortgage or loan application refused? Yes No

Has the customer ever had a judgement for a debt or a loan default registered against them?

Yes No

Has the customer ever been declared bankrupt or made an arrangement with their creditors?

Yes No

Has the customer ever failed to keep up their payments under any previous or current mortgage, rental or loan agreement?

Yes No

If yes, give details

Other NeedsDoes the customer need to make provision for Retirement Planning/Savings/Investments/IHT?

Yes No

If yes to any of the above, provide details

Cancelled policiesWill any policies be cancelled or made paid up (within the next 6 months) as a result of this advice?

Yes No

Details

SolicitorDoes the customer have a Solicitor? If yes, include details on back page. If No, recommend specialist.

Yes No

Solicitor Contact Name:

Solicitor Practice Name:

Solicitor Address line 1:





Solicitor Postcode:

Released FundsWhere will any funds released be held (e.g. cash ISA, high interest savings account)?

Changes to circumstancesDoes the customer anticipate that there will be any changes to their circumstances in the future?

Yes No

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If yes, give details including timescales, amounts, loan repayments etc

Non DisclosureHas any information not been disclosed? Yes No

If yes, give details, including reasons why

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Your health and lifestyle

If you are a smoker and/or have certain health conditions, you may be eligible for Enhanced LTV terms. By filling in the questions in this section you will enable us to take into account your health and lifestyle conditions when calculating the maximum amount you can borrow.

Please be as honest and open as possible in disclosing your health and lifestyle factors – the more we know about you, the more likely we are to be able to offer you a higher LTV based on your individual circumstances.

We rely on the information provided by you in this application form to calculate the amount of the lump sum cash advance that we are able to offer you and if the information provided by you is found to be inaccurate then we may be entitled to cancel the Lump Sum Plus Lifetime Mortgage/reject your application or adjust the amount of the lump sum cash advance agreed..

Your age

Your height

Your weight

Alcohol consumption per week

0-49 units

50-69 units

70+ units

Have you smoked 10 or more cigarettes per day or 2.5 ounces (71 grams) or more of rolling tobacco per week for the last 10 years?

Yes No Yes No

Have you been diagnosed with high blood pressure?

Yes No Yes No

If yes, please enter your most recent reading:

Systolic Diastolic

Was this reading:

With medication? Yes No Yes NoWithout medication? Yes No Yes No

Have you been diagnosed with Coronary Artery Disease/Ischaemic Heart Disease/Angina and are prescribed medication (not including aspirin or

Yes No Yes No

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Customer 1 Customer 2 (if applicable)

sprays)?

If yes, please enter your date of diagnosis:

Less than 1 year 1-5 years More than 5 years

Have you been diagnosed as having suffered a heart attack which required hospital admission?

Yes No Yes No



Have you received surgery for a heart condition? Yes No Yes No

If yes, please indicate the nature of the surgery:

Heart bypass, stent or angioplasty

Valve replacement Pacemaker or ICD



Have you been diagnosed with Diabetes Mellitus, controlled with tablets or insulin?

Yes No Yes No



Have you been diagnosed as having suffered a

Yes No Yes No

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stroke (CVA)?



Have you been diagnosed as having suffereda mini-stroke (TIA)?

Yes No Yes No



Have you been diagnosed with malignant cancer (excluding skin cancer), requiring radiotherapy or chemotherapy?

Yes No Yes No



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Have you been diagnosed with any of the following :

Parkinson’s Disease requiring medication? Yes No Yes No



Multiple Sclerosis requiring the use of mobility aids? Yes No Yes No



Dementia (including Alzheimer’s Disease)? Yes No Yes No



Chronic kidney failure? Yes No Yes No



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Chronic respiratory disease requiring daily medication or inhalers?

Yes No Yes No



Heart, kidney, liver or lung transplant? Yes No Yes No



Cirrhosis of the liver? Yes No Yes No



Motor Neuron Disease? Yes No Yes No



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Peripheral vascular disease (including Intermittent Claudication)?

Yes No Yes No



Hepatitis C? Yes No Yes No



HIV Yes No Yes No



Any other medical conditions or medications

Continuation Sheet / Additional Notes

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Lines are open Monday to Friday, <0:00 to 0:00>, and Saturday <0:00 to 0:00.> <website address> <Firm Name>. Registered Office:<A House, Any Road, Any Town, Any County AB1 2CD>. Registered in England Number <000000000>. <Firm Name> is authorised and regulated by the Financial Conduct Authority. >

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JR00912-01 ER Fact Find March 2013 · Web viewIt is vital that when you are using any form of fact...

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Transcript of JR00912-01 ER Fact Find March 2013 · Web viewIt is vital that when you are using any form of fact...