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Client Profile
Strictly Confidential
  1. Please complete all relevant sections with as much detail as possible.
  2. Once completed, please submit to us for our personal report and recommendations on the strategy required for us to help you achieve your financial objectives.
  3. Alternately, you can print off a hard copy and send it to us by fax :
    Japan            +81  344 964 281
    UK                +44  20 7900 3046
    USA              +1    708 810 8723

Section One - Personal Details
Title Surname
First Name Date of Birth
Nationality Company
Office Address Home Address
To which address should correspondence be sent? Office Home


Code Number Ext.
Office Telephone
Office Fax
Home Telephone
Home Fax
Mobile
Telephone for Clarification? Yes No
E-mail
Notes
Marital Status Spouse Name
Spouse's Age Spouse's Nationality

Children's Name Sex Date of Birth
Notes

Section Two - Planning Details
In case of an Emergency, how much liquid cash would you always want available immediately?
In which currency are you paid?
On average, what is your surplus monthly income? p/m
What is your attitude towards risk?
If you utilised a spread, what split would you use?
%
Cautious%
Balanced%
Aggressive %
100 %
What would you assume as the rate of inflation? 5%pa 7.5% 10% Other
In any programme that is put in place, what are the important factors?
Flexibility Access Offshore
Security Tax Efficiency Discipline
Portability Easy to Administer
What Currency US$ Other (Please state)
Notes

Section Three - Current Investment, Please complete the asset summary below
Fixed Assets Current Value
1. Main Home
2. Other Property/Land
3. Other (Please Specify)
Fixed Assets
Financial Assets Current Value
1. Bank Deposits
2. Equities
3. Bonds
4. Mutual Funds
5. Unit Trusts
6. Regular Saving Plan
7. Other (Please Specify)
8. Other (Please Specify)
Notes

Section Four - The Future
Please list all major financial goals in the Short Term (up to 3 years), Medium Term (3 to 10 years) and Long Term(10 years or more).

Reminder Lists
- Retirement
- College / University Education Fees
- Children's Trust Fund
- Property Purchase
- Wedding Costs
- Set up own business
- Create Capital

Please complete with:
1. What is required?
2. By when?
3. How much is required in today's terms?

Short Term
0-3 Years

 Medium Term
3-9 Years		 Long Term
10 Years +
Emergency Fund in Place?

Section Five - SUMMARY OF GOALS and OBJECTIVES
I want to : Priority
Please tick as appropriate 1
High		 2
Medium		 3
Low
Increase or create capital
Improve capital growth of investments
Reduce Estate/Inheritance tax
Diversify existing investments
Simplify investments
Secure early financial independence
Provide for children's education fees
Provide for a comfortable retirement
Provide funds for my children's future
Provide further insurance upon death
Provide insurance for serious illness
Other (Please Specify)
Other (Please Specify)

The information provided will be treated in the strictest of confidence
and used to make recommendations in relation to your financial goals.
It is important that the "Client Profile" (including any other information) is an accurate account of your circumstances and noted that any withheld information could affect the advice given.
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