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26 Nov
2019

Financial Needs Analysis | Good Grade Guarantee!

Financial Needs Analysis
Strictly Confidential
Australian Institute of Financial Services and Accounting Level 5, 97 Pacific Highway, North Sydney, 2060
D ate
N ame
S urname
N ame
Surname
A dvisor
R eferred by
Important Notice regarding provision of personal information and privacy
In order for an Advisor to make a sound financial recommendation, the advisor must conduct an appropriate investigation of your particular needs and financial situation. The information requested in this form is necessary to enable a recommendation to be made on a reasonable basis. If you do not provide complete and accurate information as requested in this form, the adviser may not be able to give you an appropriate recommendation.
All AIFA advisers will adhere to the ten National Privacy Principles under the Privacy Act 1988 when collecting, using, storing and disclosing the information contained in this form and will now unlawfully disclose this information.
You are entitled to gain access to this information.
Main Reasons for Seeking Advice

Goals and Objectives
Do you have any specific needs, expenses or objectives you would like to achieve? For example cash flow monitoring, debt reduction, wealth accumulation, retirement, asset protection

Time Frame and Importance (H,M,L)
Short Term

Medium Term

Long Term

Personal Summary Details

Title
Mr
Mrs
Miss
Ms

Mr
Mrs
Miss
Ms
Dr
Other:

Dr
Other:
Surname

Given Names

Preferred Name

Maiden Name

Sex
Male
Female

Male
Female
Date of Birth

Marital Status
Single
Married
Divorced
Separated
Defacto
Widowed
Other:
Permission to discuss matters with client/partner
Yes
No

Yes
No

Plan focus
Individual
Both clients

Contact Information
Home Address

Town/Suburb

State

Postcode

Postal Address If different from Home

Town/Suburb

State

Postcode

Phone (H)

Phone (W)

Mobile

Fax

Email – Client 1

Send Email
Yes
No
Email – Client 2

Send Email
Yes
No
Health Issues
Do you Smoke
Yes
No

Yes
No

Do you have Private Health Cover?
Yes
No

Yes
No

Name of Fund

Any Major Health Issues?

Child / Dependant / Other Details
Name
DOB
Sex
School/Occupation
Dependant Until

Do you receive a family tax Benefit?
Yes
No

Employment Details

Occupation

Work Status
Full Time Employed

Full Time Employed
Self Employed

Self Employed
Casual

Casual
Part Time Employed

Part Time Employed
Not Working or Retired

Not Working or Retired
Position Title

Employer Name

Retirement Age

Retirement Date

Do you have a Self Managed Super Fund (SMSF)?
Yes No

Yes No
If so, please provide details

Trustee Name

Fund Name

Administrator

Notes

Tax Status
Personal Company Trust Super Fund Other

If Company / Trust / Super Fund ticked, please describe structure:

Present Estate Planning Situation
Not Disclosed
Not Applicable
Nil

Do you have a valid Will?
Yes
No

Yes
No
Date of Will

Last Reviewed

Will Location

Power of Attorney?
Yes
No

Yes
No
Enduring?
Yes
No

Yes
No
Enduring Guardianship?
Yes
No

Yes
No
Funeral Plan and amount paid?
Yes
$
No

Yes
$
No
Notes

Financial Data Section
Not Disclosed
Not Applicable
Nil
Current Income
Income description

($pa)

($pa)
Salary or wages income

Reportable Fringe Benefits Taxable Value

Annuity or allocated

Rental Income

Share / investment income

Foreign pension income

Maintenance income

Current Centrelink or Department of Veterans’ Affairs (DVA) benefit amount

TOTAL INCOME

$

$

You receive no Centrelink payments at this time

You choose not to provide these details at this time
Capital Gains Tax Liability

Assessable capital gain

Emergency Funds

Emergency funds available

Notes

Current Expenditure
Not Disclosed
Not applicable
Nil
Budget Calculations
Weekly
Monthly
Annually
Expenses
Amount

Expenses
Amount
Household

Transport

Rent
$

Car Registration
$
Repairs
$

Parking
$
Gas
$

Fuel
$
Electricity
$

Repairs / Maintenance
$
Water
$

Public Transport
$
Telephone
$

$
Furniture
$

$
Appliances
$

SUB TOTAL
$
Maintenance
$

Medical

$

Doctor
$

$

Medicines
$

$

Dentist
$
SUB TOTAL
$

$
Children

$
School Fees
$

SUB TOTAL
$
University / TAFE Fees
$

Insurance

Tuition
$

Home & Contents
$
Books & Uniforms
$

Car
$
Camps / Excursions
$

Health
$

$

Income Protection
$

$

Life Insurance
$
SUB TOTAL
$

$

$

SUB TOTAL
$

EXPENSES PAGE TOTAL
$
Expenses
Amount

Expenses
Amount
Debt Repayment

Other

Mortgage
$

Child Care
$
Personal Loans
$

Child Support
$
Car Loan
$

Gifts
$
HECS/HELP payments
$

Donations
$
Credit Card
$

Hobbies / Sport
$
Store Cards
$

Subscriptions
$
Lay-bys
$

Newspapers etc.
$

$

DVD’s
$

$

Eating Out
$
SUB TOTAL
$

Alcohol & Cigarettes
$
Savings

Pet Food
$
Super Contribution
$

Other Pet Costs
$
Regular Savings
$

Groceries
$
Regular Investment
$

Holidays
$

$

Clothes & Shoes
$

$

Hair and Beauty
$
SUB TOTALS
$

$

$

SUB TOTAL
$

TOTAL INCOME
$

LESS DEDUCTIONS e.g. Salary Sacrifice
$

LESS INCOME TAX & Medicare
$

TOTAL INCOME AFTER TAX
$

EXPENSES PREVIOUS PAGE
$

EXPENSES THIS PAGE
$

TOTAL EXPENSES
$

SURPLUS
$
Fixed Assets
Personal assets (excluding assets which generate income)
You choose not to provide these details at this time
You have no personal assets at this time
Description
Date Purchased & Cost if known
Owner (Client Name, Joint, Other Entity)
Estimated market value ($)
Existing liability ($)
Disposable on:
Retain
Home and principle residence

Home contents

Motor vehicle 1

Motor vehicle 2

Caravan

Boat / Marine craft

Notes

Investment Property Assets
You have no investment property at this time
You choose not to provide these details at this time
Property Address
Owner (Client Name, Joint, Other Entity)
Estimated market value ($)
Existing liability
Net income ($) pa
Disposable
Retain

Where relevant, please include acquisition details for Capital Gains Tax implications in the notes section that follows
Cash / Fixed Interest Assets
You have no cash / fixed interest assets at this time
You choose not to provide these details at this time
Description
Owner (Client Name, Joint, Other Entity)
Market value ($)
Interest rate / return %
Maturity Date
Disposable
Retain

Liabilities (including credit cards)
Loan type and lender
Owner (Client Name, Joint, Other Entity
Original amount ($)
Credit limit ($)
Balance O/S ($)
Interest (% pa)
Repayment amount ($) & Frequency
Tax deduction

Would you be prepared to borrow against any of these assets? Yes No (if yes please specify below)

Notes

Current Investment and Superannuation Portfolio
Investment Name/Type (include, managed funds, superannuation & direct shares)
Owner (Client Name, Joint, Other Entity)
Original amount / purchase price invested (if applicable)
Current Value
Insurance Attached to Super

Please provide copies of your latest statements in relation to the above investments
Notes

Current Life Insurance and General Insurance Policies
Insurance Company Name
Insured
Policy Owner
Type of Policy: Life, Income Protection, Trauma
Inside Super Y / N Which fund
Sum Insured
Annual Premium
Retain Y / N

Where you have indicated that you may consider replacing an above policy/policies we will require further information such as costs associated with cancelling the policy etc.
Are you unhappy with any of your current investment or insurance policies? If yes please explain:

Notes

Risk and Investment Profile
In order to recommended investments that are suitable to your goals and needs, we need to find out more about how you feel about certain aspects of investments and returns. We use a tool called a risk profile to assist in recommending the right mix of assets for you.
1. How familiar are you with investment markets?

Score
Client Name
Client Name
Very little understanding or interest
1

Not very familiar
2

Have enough experience to understand the importance of diversification
3

Understand that markets may fluctuate and that different market sectors offer different income, growth and taxation characteristics
4

Experienced with all investment sectors and understand the various factors which may influence performance
5

2. When you think of the term “investment markets”, which of the following words comes to mind

Score
Client Name
Client Name
Risky
1

Complicated
2

Unsure
3

Potential
4

Possibilities
5

3. What level of risk or periods of poor returns would you be prepared to take in arranging your financial affairs?

Score
Client Name
Client Name
Very Conservative, I will not take any risk of losing capital for any period of time
1

Fairly conservative, preferring not to have a negative return but with a view to consistent returns
2

Willing to take some risk of short term negative performance to improve returns
3

Willing to take reasonable amount of risk of short term negative performance to improve returns
4

Willing to take more risk of short term performance than most to improve long term returns
5

4. The greatest returns are generally obtained from more volatile investments. Which statement do you feel more comfortable with?

Score
Client Name
Client Name
Preferably guaranteed returns
1

Stable, reliable returns
2

Some unpredictability in returns
3

Moderate unpredictability in returns
4

Greatest unpredictability but potentially higher returns
5

5. How long are you likely to continue with an investment strategy that is not meeting your expectations

Score
Client Name
Client Name
I would change it immediately
1

Up to 6 months
2

Up to 18 months after discussing concerns with my advisor
3

Up to 3 years after discussing concerns with my advisor
4

More than 3 years after discussing concerns with my advisor
5

6. Generally, when seeking higher long term returns from your investments, from time to time, you will also increase the likelihood of poor performance from time to time. Which of the following best describes your investment priorities?

Score
Client Name
Client Name
Preservation of my current capital is my only objective
1

Security of capital and consistent returns are more important than capital growth
2

A balance of both investment income and capital growth returns are expected over long term, accepting the possibility of short periods of poor performance from time to time
3

Capital growth is more important than investment income returns over the longer term. I am comfortable with poor performance in the value of my investments over short periods
4

Growing my assets substantially over the long term. I do require income returns to support my living needs and accept that the value of my investment may fluctuate materially from year to year.
5

7. Historically, the share market has experienced rapid rises and falls in value. What do you think you would do if your investment experienced a fall by as much as 30% in value in a very short period of time i.e. a year or less.

Score
Client Name
Client Name
Sell the investment immediately
1

Reduce holdings in the investment to limit the loss
2

Do nothing
3

Buy more of the investment
4

Borrow money to buy more of the investment
5

8. Choose the most appropriate response to the following statement. I am willing to experience the ups and downs of the market for the potential of greater returns.

Score
Client Name
Client Name
Strongly disagree
1

Disagree
2

Neither agree nor disagree
3

Agree
4

Strongly agree
5

9. Choose the most appropriate response to the following statement. My main concern is security. Keeping money sage is more important than earning higher returns.

Score
Client Name
Client Name
Strongly disagree
1

Disagree
2

Neither agree nor disagree
3

Agree
4

Strongly agree
5

10. When it comes to investing, you would describe yourself as…

Score
Client Name
Client Name
Inexperienced; investing is a new experience for me
1

Somewhat inexperienced; investing is fairly new to me
2

Somewhat experienced; knowledgeable
3

Experienced; knowledgeable of the factors that make investments go up and down
4

Very experienced; knowledgeable of the factors that make investments go up and down
5

11. How do you feel if your investments go down in value?

Score
Client Name
Client Name
Extremely concerned; it becomes the thing I think about most
1

Very concerned; it becomes something I think about a lot
2

Concerned; it comes to mind when I see or hear media
3

Not very concerned; it crosses my mind on occasion
4

Indifferent
5

12. Choose the most appropriate response to the following statement. My main concern is the effect of taxation on my investment.

Score
Client Name
Client Name
Not a major concern
1

Tax effectiveness is good but not if I need to take higher risks
2

Neither agree nor disagree
3

Agree taxation effects on investments are important
4

Strongly agree taxation effects on investments are extremely important
5

SCORE TOTAL

Score 12 – 19
Conservative
Score 45 – 52
Growth
Score 20 -27
Moderately Conservative
Score 53 – 60
High Growth
Score 28 – 44
Balanced

Client Investment Profiles
Conservative – Score 12 – 19 You are a conservative investor to whom security of capital is a major importance, however, you may seek higher returns from investing in longer term fixed interest securities and may consider investing a minor portion of your funds into growth investments. Your profile will generally give rise to high income and some capital growth. Your return will be low and consistent compared with other portfolios. Your ideal asset allocation would fall within the range of your risk profile listed below, depending on your score. A low score would be at the bottom end of the Conservative range whilst a high score ideally would be at the bottom of the Moderately Conservative range.
Moderately Conservative – Score 20-27 You are a Moderately Conservative investor who cautiously desires capital stability and are willing to increase your investment potential by investing in some growth assets such as shares. You accept the low possibility of a negative annual return, which may occur approximately once every seven to ten years. Your ideal asset allocation would fall within the range of your risk profile listed below, depending on your score. A low score would be at the top end of the conservative range, whilst a high score ideally would be at the bottom of the Balanced range.
Balanced – Score 28-44 You are a Balanced investor who desires a prudent balance of income and growth. You do not wish to see all of your capital eaten away by tax and inflation and are prepared to take a small short term risk in order to gain longer term capital growth and accept a higher possibility of a negative annual return, that may occur once in every six to seven years. Your ideal asset allocation would fall within the range of your risk profile listed below, depending on your score. A low score would be at the top end of the Moderately Conservative range, whilst a high score ideally would be at the bottom end of the Growth range.
Growth – Score 45-52 You are a Growth investor who aggressively seeks to maximise long term capital growth investing mostly in growth assets. You remain cautious towards taking high levels of long term risks. However your general understanding of the investment market enables you to feel comfortable with short term risk. You accept the possibility of a negative annual return that may occur once every four to five years. Your ideal asset allocation would fall within the range of your risk profile listed below, depending on your score. A low score would be at the top end of the Balanced range, whilst a high score ideally would be at the bottom of the High Growth range.
High Growth – Score 52-60 You are a High Growth investor who aggressively seeks to maximise long term capital growth, by investing predominantly in growth assets. You are well aware of the heightened potential for capital loss in the short term and accept the higher risk of a negative return, that may occur once every three to four years. Your ideal asset allocation would fall within the range of your risk profile listed below, depending on you score. A low score would be at the top end of the Growth range, whilst a high score ideally would be at the top of the High Growth range.
A suggested asset allocation for each risk profile is as follows:
Asset Class
Conservative
Moderately Conservative (Cautious)
Balanced (Prudent)
Growth (Assertive)
High Growth (Aggressive)
Range of Annual Returns 1 year
-7% to 28%
-16% to 27%
-23% to 39%
-29% to 44%
-34% to 49%
2 years
4% to 9.7%
4.8% to 13.3%
5.3% to 16%
5.7% to 18.4%
5.9% to 20.2%
3 years
4% to 8.7%
4.4% to 11.6%
4.7% to 13.7%
4.9% to 15.5%
5% to 16.9%
Expect Negative Returns
Rarely
Once in 7 to 10 yrs
Once in 6 to 7 yrs
Once in 4 to 5 yrs
Once in 3 to 4 yrs
General Characteristics of Portfolio
Stable portfolio, value may be lessened by inflation. Provides income but no capital growth, generally no tax advantages, quick access to investment monies for short investment terms
Conservative but with some tolerance to risk, small exposure to growth, consists of mostly income and some capital growth, may keep better pace with inflation than conservative portfolio and provide minimal tax effectiveness
Will accept some exposure to growth to increase potential returns. Will achieve greater tax effectiveness due to spread of assets and will provide minimum amount of income from assets. Capital less likely to be eaten away by inflation
Will accept short term volatility for higher returns long term. Provides more tax effectiveness than Balanced portfolio. Portfolio will have more growth than income. Suitable for longer term investing
Will accept high short term volatility for higher returns long term. Provides more tax effectiveness than growth portfolio. Portfolio will have mostly growth with little income. Suitable for longer term investing

Benchmark
Benchmark
Benchmark
Benchmark
Benchmark
Cash
21
10
5
2
0
Australian Fixed Interest
26
24
17
9
0
International Fixed Interest
23
14
8
3
0
Australian Shares
12
24
35
45
50
International Shares
10
19
25
31
40
Property
8
9
10
10
10
Client’s Tested Profile

Agreed Risk Profile / Asset Allocation

Sourced from Bloomberg Van Eyk Research January 1971 to August 2008. Actual allocation may be 10% either side of this benchmark depending on the current, economic and personal circumstances.
Investment Concerns
Fund Preferences – Please tick if any of the following are important to you
Website Access
Ability to invest in Shares directly
Wholesale managed funds
Want to consolidate Super / Investments
Insurance to age 65 & beyond
Wide variety of fund options
Want to roll over Super
Ability to convert to income stream
UK Pension transfer
Portable
BPay / Direct Debit
Advice on investment options
Accepts all types of contributions i.e. personal and employer

Adviser Notes Area
Would you like your superannuation money and non superannuation investment money invested in the same manner? Or would you like different investment time frames and / or assets for non super money?

Record any specific discussions regarding client preference surrounding Inflation, Tax advantages, Security of Capital, Liquidity and Income Needs.

Did you discuss any changes to the risk profile, if yes what? (e.g. was there any concern that the client’s financial objective may not be reached with their existing profile). Note any relevant discussions regarding Investment preferences.

Have you ever dealt with Financial Advisers in the past? How would you describe your experience?

What matters are most important to you?

Superannuation and Retirement Income Planning
Not Disclosed
Not applicable
Nil
If you retired today and all your principle debts were paid and you only had to meet your usual living and preferred lifestyle expenses, how much income would you need?
Plans

Retirement Income in today’s dollars

Expected Retirement Age

Estimated Years of Retirement funding

Emergency Funds

Present Super Contributions details
Per annum

Per annum
Personal (after tax) Superannuation contributions

Employer (SG)

Additional Salary Sacrifice arrangement

TOTAL

Have you made any lump sum contributions to super in the last 2 years?

Estate Planning Objectives
Are there any special estate planning issues which should be considered when providing my recommendations (e.g. special needs of beneficiaries, potential for estate disputes, capital gains tax issues, etc.)

Insurance Planning
Not Disclosed
Not applicable
Nil
Term / Life
Your most important financial asset is YOU and your ability to earn income. As part of your financial plan, you should consider whether you have sufficient resources to cover the possibility of loss of income.
Our analysis of your risk needs depends upon the answers you provide to us on the questions following.
To evaluate your level of risk, we must estimate some of the lump sum needs that would exist at the time of your death.

Life Cover Needs

Liabilities to be paid out (e.g. mortgage, personal loans $)

Emergency fund ($)

Funeral expenses ($)

Income to be replaced ($ pa)

For how long would you want your income to be replaced?

Children’s education expenses ($ pa)

Other expenses ($)

TOTAL

TPD Needs

Liabilities to be paid out (e.g. mortgage, personal loans $)

Emergency fund ($)

Income to be replaced ($ pa)

For how long would you want your income to be replaced?

Children’s education expenses ($ pa)

Other expenses ($)

TOTAL

For TPD is Any / Own occupation Important
Yes No
Yes No
Trauma / Crisis Cover Needs

Liabilities to be paid out (e.g. mortgage, personal loans $)

Emergency fund ($)

Income to be replaced ($ pa)

For how long would you want your income to be replaced?

Children’s education expenses ($ pa)

Other expenses ($)

TOTAL

Buy backs
Yes No
Yes No
Comprehensive benefits
Yes No
Yes No
Trauma reinstatement
Yes No
Yes No

Income Protection Needs

Amount of income to be covered ($)

Waiting period
30 / 60 / 90 days
30 / 60 / 90 days
Benefit period
2, 5, age 65
2, 5, age 65
Other (e.g. super contribution option)

Is Any / Own occupation
Any / Own
Any / Own
Notes

Professional Advisers
Do you want us to contact any other professional advisers and seek input un relation to your financial plans (e.g. Accountant, Lawyer, etc)
Name

Address

Town/Suburb

State

Postcode

Firm

Phone

Fax

Authority to contact for information?

Name

Address

Town/Suburb

State

Postcode

Firm

Phone

Fax

Authority to contact for information

Name

Address

Town/Suburb

State

Postcode

Firm

Phone

Fax

Authority to contact for information

Referrals
Who referred you to us?

Any Other Additional Notes

Privacy Acknowledgment and Consent
In this Document ‘We’, ‘Us’ and ‘Our’ refer to: Australian Institute of Financial Services and Accounting (AIFA), and its representatives. AIFA can be contacted by writing to Level 5, 97 Pacific Highway, North Sydney, 2060 or by telephone on 1300 785 775.‘You’ and ‘Your’ refer to: the person whose information we collect and hold in order to give advice about financial products and services.Collection of Personal Information We collect personal information about you so we can advise you about financial products and services, administer our relationship with you and to provide you with information on other services we provide. The personal information we collect from you will depend on the advice involved, but includes your name, address, contact details, business details, financial information, and in the case of an application for life insurance, medical and lifestyle information.The law can also require us to collect personal information, e.g. Commonwealth legislation requires us to identify persons who open or operate accounts, or we may be required to collect your tax file number.Other Members of AIFA Solutions We are permitted by the Privacy Act to disclose personal information (other than sensitive information) to our related body corporate. This enables AIFA to have an integrated view of its customers. Any related body corporate of ours to which personal information is properly disclosed, will also be bound by the Privacy Act, in relation to the use and disclosure of such information.Other Disclosures Personal information may be disclosed to: If you have life insurance: the insurer, claims investigators, medical practitioners, reinsurers, and insurance reference agencies. If sensitive information about you (including health information) is collected for the purpose of an application for life insurance, that sensitive information will only be used for that purpose or with your consent; If you have superannuation or managed investments: external product providers into which you might direct some of your investment, other product providers to which your investment might be transferred, fund administrators and fund trustees; Austrack the government agency who oversees Anti Money Laundering and Counter Terrorism: we are required to provide details of certain transactions and entities where we hold reasonable suspicion of suspect nature.In all circumstances where we contract with others to provide services to us, and these contractors have access to your personal information, confidentiality agreements will apply. Personal information may only be used by our contractors for our purposes.We may be allowed or obliged to disclose information by law. e.g. under Court Orders or Statutory Notices pursuant to taxation or social security laws.You Need to Provide us with Accurate and Relevant Information If you provide us with incomplete or inaccurate information, the advice we give you may be incomplete or inappropriate or we may not be able to arrange the products or services you are seeking.Sending of Personal Information Overseas We may send information overseas if we outsource functions using overseas agents or contractors.Access You may (subject to permitted exceptions) access your information by contacting the Compliance Manager in writing: Level 5, 97 Pacific Highway, North Sydney, 2060. We may charge you for providing this service..
Client Acknowledgement and Consent
Privacy and Consent
I/We acknowledge and consent to the use, storage and disclosure of your personal information as indicated above.
Risk Profile
I/We have completed my/our Risk Profile Questionnaire with the assistance of my/our Adviser. My/Our profile has been fully explained and I/we have understood the volatility and exposure to more Growth and High Growth strategies.
Limited Personal Information Warning
If you have chosen not to provide all information requested by the Financial Planner, you must understand that appropriate advice may not be able to be given and you risk making a financial commitment to a life product or investment product that may not be appropriate for your needs.
Acknowledgement
I/We confirm that the details recorded in this Financial Needs Analysis are correct and reflect my/our true financial position. Please prepare a financial plan for my/our consideration.
Electronic Receipt of Information
I/ We confirm that we have access to a computer and the internet and would like to receive material in an electronic format.
Tax File Number (TFN) Consent
TFN

TFN

I/ We give permission to retain my Tax File Number for financial planning purposes
I/We agree to a plan fee of

Including GST
Signature:

Date:

Signature:

Date:

Power of Attorney (if applicable

Date:

Adviser Signature

Date

Adviser Name:

Review of Financial Information
Reviews
I/ We have provided updated personal information for the purposes of reviewing my financial situation.
Are you happy with your current asset allocation/ risk profile?
Yes, I am happy with my risk profile
No, I am not happy with my risk profile (we will need to complete a new risk profile)
Signature

Date

Signature

Date

Power of Attorney (if applicable)

Date

Adviser Signature

Date

Adviser Name

Additional Review Notes

Notes

Notes

To Whom It May Concern:I / We__________________________________________________________________________________ hereby request and instruct that all relevant information on my / our investments, insurances, superannuation or other financial information be released to ______________________________________________and their staff, Authorised Representative of Australian Institute of Financial Services and Accounting.I / We request that all relevant documentation to act on my / our behalf be sent to ______________________________________________________________________ – including superannuation release forms.I / We request that the servicing adviser on my accounts be transferred to __________________________________ I/We wish for this alteration to occur immediately.Please also accept a photocopy scanned or facsimile copy of this letter as authority, as the original will stay on file.Yours faithfullyName: ……………………………………………………………………………… Name:……………………………………………………………………………Signed: ……………………………………………………………………………. Signed: …………………………………………………………………………..Date: ……………………………………………………………………………….. Date: …………………………………………………………………………….
To Whom It May Concern:I / We__________________________________________________________________________________ hereby request and instruct that all relevant information on my / our investments, insurances, superannuation or other financial information be released to ______________________________________________and their staff, Authorised Representative of Australian Institute of Financial Services and Accounting.I / We request that all relevant documentation to act on my / our behalf be sent to ______________________________________________________________________ – including superannuation release forms.I / We request that the servicing adviser on my accounts be transferred to __________________________________ I/We wish for this alteration to occur immediately.Please also accept a photocopy scanned or facsimile copy of this letter as authority, as the original will stay on file.Yours faithfullyName: ……………………………………………………………………………… Name:……………………………………………………………………………Signed: ……………………………………………………………………………. Signed: …………………………………………………………………………..Date: ……………………………………………………………………………….. Date: …………………………………………………………………………….
Level 5, 97 Pacific Highway, North Sydney, 2060
Phone: 1300 785 775
Fax: 1300 785 776
Website: www.aifa.edu.au
April 2011

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