Data Collection Form

Kindly complete the data collection form below to help us prepare for our upcoming meeting. Once we receive your information, a member of our team will be in touch. Thank you!

First Name *

Last Name *

Email *

Phone *

Address

Street Address *

State *

Postal code *

Annual Salary *

Age Next Birthday *

Employment Status *

Self Employed

Employed

Contractor

Retired

On Leave

Student

Other

If Self Employed is income via

Drawings

Wages (Pay Slip)

Ref-Id

Financial and Lifestyle Goals

For example: to pay off home mortgage within 5 years, save a deposit for first home, upgrade existing car within 12 months, assist 2 kids with their tertiary education costs, explore genuine crypto investment opportunities, within 3 years have saved up for our 4-week European holiday for our family of 5 ($25K), started the renovation of our bathroom ($11K), be self-funded retirees by age 60, allocate $15K for each of our children’s weddings.

Goals & Objectives 1 Year

Goals & Objectives 2 to 3 Years

Goals & Objectives 5 years and beyond

Partners Details

Partner First Name

Partner State

Partner Last Name

Partner Email Address

Partner Phone

Partner Annual Income

Partner Age Next Birthday

Is Partner an employee in receipt of pay slips

Yes I am

No I am not

Private Vehicle's

Your Private Motor Vehicle's *

No Vehicle (Go to Next Section)

1 Vehicle

2 Vehicles

3 Vehicles

Is finance attached to any private vehicles

Yes Finance

No Finance

Would you like a tax deduction for your private vehicle

Yes

More Info

Do you already have a Novated Lease

Yes I do

No I dont

More Info

Home Status

Home Status *

Homeowner (mortgage paid)

Homeowner (with mortgage)

Renting

Boarding / Lodging

No Fixed Address

Weekly Rent or Lodgings

Home Value

Home Debt

Investment Property's

Total Properties Value

Partner Properties Value

Total Properties Debt

Partner Total Properties Debt

Share Portfolios

Total of Share Portfolio

Partner Total of Share Portfolio

Superannuation

Do you have Superannuation *

Yes

Unsure

Does your partner have Superannuation

Yes

Unsure

Super Fund Value

Partner Super Fund Value

If yes, have you nominated your beneficiary's

Yes

Unsure

If Yes, have you nominated partner beneficiary's

Yes

Unsure

Superannuation Documents (Recommended for Prompt Submission)

Super Statements Upload

Upload up to 3 x statements

Please ensure these are your latest documents

Partner Super Statements

Upload up to 3 x statments

Please ensure these are your latest documents

Insurance Policies

Your Death Cover Insured Amount

Partner Death Cover Insured Amount

Your TPD Insured Amount

Partner TPD Insured Amount

Your Salary Continuance Amount(SCI)

Partner Salary Continuance Amount

Cash at Bank

Cash at Bank *

Includes Mortgage Offset Account

Partner Cash at Bank

Includes Mortgage Offset Account

Digital Investments

My digital investment portfolio includes: *

Tokenised Assets

Other

Blue Chip Crypto

Not Sure

Memes

N/A

What level of security do you use for your digital assets?

Licensed Custody

Self Custody

Platform Custody

If you selected "SELF CUSTODY" please answer question below

Would you consider a more secure option?

Yes

Tell me more

N/A

Crypto Assets Value

Partner Crypto Assets Value

Other Significant Assets

If you have any other assets of value, please list below.
For example: vintage car, rare painting, collectables.

Please list asset and approximate value

Wills / Estate Planning

Do you currently have a Will *

Yes

Partner Yes

Partner No

Unsure

Is your Will up to date *

Yes

Partner Yes

Partner No

Unsure

Do you have a Power of Attorney *

Yes

Partner Yes

Partner No

Unsure

Do you have a Testamentary Trust *

Yes

Partner Yes

Partner No

Unsure

Any Other Comments?

Any Comments

Bridging the Gap

How did you find us? *

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Other
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Service Interest

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