Financial Needs Analysis Your name(s): Your adviser: Date completed: / / Mulcahy & Co Financial Planning ABN 33 114 922 271 Australian Financial Services License 340094 300B Gillies Street, Wendouree VIC 3355 Tel: (03) 5330 7200
Mulcahy & Co Financial Planning and your privacy The privacy of your personal information 1. Why are we asking so many questions? We collect your personal information to ensure we are able to provide you with products and services appropriate to your needs. The financial planning process involves the following steps: a) understanding a client s financial goals b) gathering all the details of a client s financial position c) analysing all the issues and options which will form the basis of any recommendations d) the adviser providing advice and recommendations, while making all the required disclosures e) the client agreeing with the advice and giving the adviser permission to implement all actions required to achieve the client s financial goals f) the adviser and the client agreeing to the level of further review and action required to ensure the advice and recommendations continue to achieve the client s identified financial goals. Effective financial planning is the result of carefully gathering the right information to enable a thorough assessment of your financial goals. This can be achieved by completing or updating a Financial Needs Analysis. A Financial Needs Analysis will help identify what is relevant and assist in prioritising any actions required. We aim to ensure that the personal information we retain about you, is accurate, complete and up to date. If you provide us with incomplete or inaccurate information, we may not be able to provide you with the products or services you are seeking. The law also requires us to collect personal information. For example, The Corporations Act 2001 requires us to identify a person s needs, objectives and financial circumstances to be able to provide advice, and the Anti Money Laundering and Counter Terrorism Financing Act 2006 (Cth) requires us to identify all clients and to conduct identity verification checks. 2. Access to your personal information Subject to permitted exceptions, you can access your personal information at any time by contacting your financial adviser. 3. Communicating your personal information At times, we may need to communicate your personal information to other parties, including: a) your adviser b) external product providers c) organisations (bound by strict confidentiality) to whom we outsource certain functions, such as our auditors. In these circumstances, information will only be used for our purposes d) other professionals such as solicitors, accountants and stockbrokers when a referral is required e) third parties when required by law (eg under a court order) f) government departments or agencies such as ASIC or AUSTRAC. Page 2 of 22
Part A Personal details * Mandatory fields Client 1 Client 2 Title Mr Mrs Ms Miss Dr Mr Mrs Ms Miss Dr Last name * Other Other Given names * Preferred name Gender Male Female Male Female Date of birth * / / / / Age Marital status Preferred contact details * Mandatory fields Primary contact Client 1 Client 2 Preferred method of contact Mail Phone Email Home address * Postal address ( same as above) Home phone ( preferred) Work phone ( preferred) Mobile ( preferred) Fax Home e-mail ( preferred) Work e-mail ( preferred) Children / dependants Do you have any dependants? Yes complete table below. No, Not disclosed by client Name Date of birth Gender / / Male Female / / Male Female / / Male Female Page 3 of 22
Employment Client 1 Client 2 Employment status Employee Self-employed Unemployed Homemaker Full time Part time Casual Contract On leave Retired Student Other Employee Self-employed Unemployed Homemaker Full time Part time Casual Contract On leave Retired Student Other Occupation details Are you gainfully employed? Yes complete the table below. No, Not disclosed by client, Not applicable Primary occupation Employer s name / trading name Number of hours worked per week Client 1 Client 2 Salary / wages (net of tax) $ pw / pf / pm $ pw / pf / pm Social security Are you in receipt of Centrelink / DVA / overseas pension benefits? Yes complete the table below. No, Not disclosed by client, Not applicable Benefit details Client 1 Client 2 Source Centrelink DVA O/S Centrelink DVA O/S Name / type of payment Payment amount $ pf $ pf Other payments / entitlements Reference number Have you gifted assets in the last five years? If yes, how much and when? Yes No $ on / / Yes No $ on / / $ on / / $ on / / $ on / / $ on / / Page 4 of 22
Income summary Not disclosed by client, Not applicable Gross income (pa) Client 1 Client 2 Salary / wages $ pa $ pa $ pa $ pa $ pa $ pa Total $ pa $ pa Notes Expenditure details Not disclosed by client What is your annual cost of living? $ pa How much do you or your household save each year? $ pa Do you expect any changes to your current savings pattern? Yes No If yes, provide details Do you anticipate any one-off expenses? Yes No If yes, provide details Professional advisers None, Not disclosed by client Type Name Company Phone Solicitor Accountant Insurance adviser Doctor Other Page 5 of 22
Part B Why are you 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, etc. Short term (less than 2 years) Medium term (2 to 5 years) Long term (more than 5 years) Special interests / hobbies Additional questions relating to your objectives Superannuation Not applicable, Not disclosed by client Concessional contributions cap applicable to you $25,000 $50,000 Client 1 Client 2 Total concessional contributions made this financial year $ $ Remaining concessional cap this financial year $ $ $25,000 $50,000 Total non-concessional contributions made in the past 3 financial years $ $ Remaining non-concessional cap $ $ Retirement Not applicable, At what age do you plan to retire? Not disclosed by client Client 1 Client 2 How much income per year do you think you will need in retirement? $ pa Page 6 of 22
Part C Assets and liabilities Lifestyle assets None, Not disclosed by client, Not in scope Description Owner Current value Purchase amount Purchase date Family home C1 C2 Joint $ $ / / Contents C1 C2 Joint $ $ / / Motor vehicle 1 C1 C2 Joint $ $ / / Motor vehicle 2 C1 C2 Joint $ $ / / Holiday home C1 C2 Joint $ $ / / Boat / caravan C1 C2 Joint $ $ / / Other C1 C2 Joint $ $ / / Investment assets Cash / fixed interest None, Not disclosed by client, Not in scope Description Owner Current value Income pa Maturity date C1 C2 Joint $ $ / % / / C1 C2 Joint $ $ / % / / C1 C2 Joint $ $ / % / / C1 C2 Joint $ $ / % / / Managed funds / shares / other None, Not disclosed by client, Not in scope Description Owner Current value Units / shares Regular investment Reinvest income C1 C2 Joint $ $ pa Yes No C1 C2 Joint $ $ pa Yes No C1 C2 Joint $ $ pa Yes No C1 C2 Joint $ $ pa Yes No Direct property None, Not disclosed by client, Not in scope Description Owner Current value Purchase amount Purchase date Annual rent Property type C1 C2 Joint $ $ / / $ C1 C2 Joint $ $ / / $ C1 C2 Joint $ $ / / $ C1 C2 Joint $ $ / / $ Page 7 of 22
Superannuation assets Superannuation Funds None, Not disclosed by client, Not in scope Description Owner Current value Member number Insurance via fund C1 C2 $ Yes No C1 C2 $ Yes No C1 C2 $ Yes No C1 C2 $ Yes No Liabilities None, Not disclosed by client, Not in scope Type Lender Borrower Balance Interest rate Principal or interest only Loan term Monthly repayment Home mortgage C1 C2 Joint $ % P&I IO $ Investment loan C1 C2 Joint $ % P&I IO $ Personal loan C1 C2 Joint $ % P&I IO $ Credit cards C1 C2 Joint $ % P&I IO $ Lease / HP C1 C2 Joint $ % P&I IO $ Reverse mortgage C1 C2 Joint $ % P&I IO $ Line of credit C1 C2 Joint $ % P&I IO $ Margin loan C1 C2 Joint $ % P&I IO $ Other C1 C2 Joint $ % P&I IO $ Estate details Not disclosed by client, Not in scope Client 1 Client 2 Do you have a Will? Yes No Yes No Does it reflect your current wishes? Yes No Not sure Yes No Not sure Date prepared / / / / Personal insurance Current policy details None, Not disclosed by client Insurance company name Insured Policy Owner Type of policy Sum insured Annual premium Inside Super Yes Yes Yes Yes No No No No Page 8 of 22
Part D Risk profile questionnaire Not in scope Your personal investment style The amount of risk an investor is willing to accept is known as their risk profile. Assessing a client's tolerance to investment risk is a key aspect of portfolio construction and is critical to determining appropriate asset allocation, the recommended investments and expected returns. The following questions are designed to help me determine your risk profile. Investigating your financial needs, circumstances and objectives will assist us in developing an investment strategy and recommendations to suit your specific requirements. Question 1 (Your liquidity requirements, ie having access to your funds) Apart from any short-term and ongoing needs for access to cash, how long do you envisage it will be before you require access to most of your funds? 1. 1 year or less. 2. 2 to 3 years. 3. 3 to 5 years. 4. 5 years or more. Score Client 1: Client 2: Joint: Other: Question 2 (Your investment experience) How familiar are you with investment markets? 1. I have no experience at all. 2. I have a basic understanding of investment markets. 3. I have a strong understanding of investment markets. 4. I am an experienced investor. Score Client 1: Client 2: Joint: Other: Question 3 (Your attitude to risk) How comfortable are you with putting your initial investment at risk to achieve a higher level of return? 1. I am not prepared to accept any loss of my initial investment. 2. I am prepared to accept minor losses to my initial investment. 3. I understand that in seeking higher returns I may have to accept some loss of my initial investment. 4. In seeking a higher return, I am prepared to accept a loss of my initial investment. Score Client 1: Client 2: Joint: Other: Question 4 (Your investment objectives) What do you want to achieve from your investments? 1. I want a source of income. I am not particularly concerned about my initial investment growing in value. 2. My priority is to generate income. However, I would like to see my initial investment grow over time. 3. My priority is the capital growth of my initial investment. However, I would like to generate some income. 4. My focus is on investment growth. I am not interested in generating income. Score Client 1: Client 2: Joint: Other: Page 9 of 22
Question 5 (Your concerns about inflation) How important is it to you that the value of your initial investment keeps pace with or exceeds the rate of inflation over your investment time frame? 1. Not important. 3. Important. 5. Extremely important. Score Client 1: Client 2: Joint: Other: Question 6 (Your concerns about taxation) When investing, how important is it for you to minimise your income tax? Bear in mind that tax-minimisation strategies may involve taking some risk with your initial investment. 1. Not at all. 2. Slightly important. 3. Important. 4. Very important. Score Client 1: Client 2: Joint: Other: Question 7 (Your attitude to capital loss) How would you react if the value of your portfolio fell by more than 20% in any year? 1. I would consider redeeming all my assets and transferring them to cash. 2. I would be concerned and consider changing my investment strategy. 3. I would be confident that my strategy remains appropriate for my time horizon and would make no changes. 4. I would consider investing more to take advantage of the lower entry prices. Score Client 1: Client 2: Joint: Other: Question 8 (Your investment preferences) Which one of the following best describes your attitude to market volatility when choosing an investment? 1. I prefer investments that are not affected by market volatility so the value of my capital will not fluctuate. 2. I prefer investments with a low risk of volatility; however, I am happy to have a small portion of my portfolio invested in assets with potentially higher levels of short-term capital fluctuation. 3. I prefer to spread my investments across the different asset classes and accept that some capital fluctuation will occur as a result. 4. I am comfortable including investments with a higher degree of capital fluctuation in my portfolio, but like to maintain a small amount of stable investments to smooth returns over time. 5. I am comfortable investing the majority of my portfolio in assets with higher levels of capital fluctuation. Score Client 1: Client 2: Joint: Other: Question 9 (Your attitude to gearing please tick the appropriate box) Gearing strategies can magnify your gains, but also your losses. Would you be prepared to borrow to invest? I would not consider borrowing to invest. I would be prepared to borrow up to 25% of my total investment. I would be prepared to borrow up to 50% of my total investment. I would be prepared to borrow up to 70% of my total investment. Page 10 of 22
Add up the scores to these questions and write the total into the appropriate box below. Final score Client 1: Client 2: Joint: Other: Refer to the client risk profiles below and write the corresponding risk profile into the appropriate box below. Client 1: Client 2: Joint: Risk profile Other: Notes Client risk profiles Defensive (8 to 11) Your investment style suggests you do not wish to take on any investment risk. Your main priority is safeguarding your investment capital, and you are prepared to sacrifice higher returns for peace of mind. Generally, the most appropriate strategy for someone with a defensive risk profile is to invest 90% in income and 10% in growth assets. Defensive investors should be prepared to accept negative returns approximately one year in every 20. A defensive approach is usually appropriate for investment terms of one to two years. Conservative (12 to 17) Your investment style suggests you are prepared to accept a small amount of risk; however, your priority remains preserving your capital over the medium to long term. Generally, the most appropriate strategy for someone with a conservative risk profile is to invest 70% in income and 30% in growth assets. Conservative investors should be prepared to accept negative returns approximately one year in every eight. A conservative approach is usually appropriate for investment terms of two to three years. Moderate (18 to 25) Your investment style suggests you have some understanding of investment markets and their behavior, and are prepared to take short-term risks to gain long-term capital growth. Generally, the most appropriate strategy for someone with a moderate risk profile is to invest 40% in income and 60% in growth assets. Moderate investors should be prepared to accept negative returns approximately one year in every six. A moderate approach is usually appropriate for investment terms of three to four years. Growth (26 to 30) Your investment style suggests you are seeking a greater growth component in your investment portfolio, with some income to smooth volatility in your returns. Although you remain cautious of taking on extreme levels of risk, your general understanding of investment markets enables you to feel comfortable with short-term risk. Generally, the most appropriate strategy for someone with a growth risk profile is to invest 20% in income and 80% in growth assets. Growth investors should be prepared to accept negative returns approximately one year in every five. A growth approach is usually appropriate for investment terms of four to five years. Aggressive (31 to 34) Your investment style suggests you are prepared to sacrifice short-term safety to maximise the value of your investments through long-term capital growth. However, you do not wish to make unbalanced investment decisions. Generally, the most appropriate strategy for someone with an aggressive risk profile is to invest 100% in growth assets. Aggressive investors should be prepared to accept negative returns approximately one year in every four. An aggressive approach is usually appropriate for investment terms of five to seven years. High alpha (31 to 34) A sub-class of the aggressive investment style is high alpha. While the recommendation for high alpha investors is also to invest 100% in growth assets, a high alpha investment portfolio typically has a larger exposure to Australian shares than a purely aggressive investment strategy. As high alpha portfolios are likely to experience more volatility than aggressive portfolios, high alpha investors should be prepared to accept negative returns approximately one year in every three. A high alpha approach is usually appropriate for a term of investment of more than seven years. Page 11 of 22
Asset classes Each investment risk profile is supported by asset allocation guidelines designed to match your investment experience and risk tolerance with your expectations for investment returns. The asset allocation for each risk profile is shown in the table below. Asset class Defensive (90/10) Conservative (70/30) Strategic asset allocation Moderate (40/60) Growth (20/80) Aggressive (0/100) High alpha (0/100) Income Cash 30% 30% 5% 5% 0% 0% Fixed interest 60% 40% 35% 15% 0% 0% Growth Australian shares 5% 15% 30% 40% 50% 55% International shares 3% 10% 20% 25% 40% 40% Income and growth Property / infrastructure 2% 5% 10% 15% 10% 5% Total 100% 100% 100% 100% 100% 100% As client circumstances differ, and portfolio values vary over time, an acceptable portfolio recommendation must remain within ten points of the strategic asset allocation for each asset class. For example, if the target asset allocation for Australian shares is 30%, the recommended allocation should be between 20% and 40%. In addition, the portfolio must remain within ten points of the strategic asset allocation benchmark (ie the growth to income ratio). Minor variations in your asset allocation will occur from time to time and, if appropriately managed, will not generally have a material effect on the long-term performance of your investment portfolio. Significant variations from these benchmarks may also occur for a variety of reasons, and will be addressed in your Statement of Advice or other documentation. Risk profile The relationship between risk and return Return Higher Return Moderate X Growth X 26 to 30 points Aggressive X 31 to 34 points Medium Return Conservative X 18 to 25 points Defensive 12 to 17 points Lower Return X 8 to 11 points Risk This table is for illustrative purposes only. If your adviser identifies that you appear to be unable to reach your stated financial goals because they conflict with your risk tolerance, do you want to make 'Reaching your financial planning objectives' the priority? If yes, provide details. Yes No Page 12 of 22
Notes Page 13 of 22
Part E Declarations Client declaration I declare that: The advice I am seeking from my adviser is: The information I have marked as being Not in scope in this document and the matters detailed in the table below are to be excluded from the advice. If I have not disclosed any information in this document or declined to provide full personal information, I understand that my adviser may not be able to fully assess my financial needs, circumstances and objectives. As a result, any recommendation/s may not be appropriate to my particular financial situation. All the information provided to my adviser in this document is true, current and correct. I have received a copy of my adviser s Financial Services Guide. My adviser explained that a detailed breakdown of all fees and/or fee-for-service charges related to the placement of my investments will be included in the Statement of Advice that will be prepared for me. I have read and understood the statements about my privacy. I consent to the uses described and the disclosures set out in this document. I wish to proceed with the preparation and presentation of a Statement of Advice based on the above, at a fee of $ 0 payable to Mulcahy & Co Financial Planning. I understand that this fee is non-refundable. Any fees incurred for establishing my investments and the provision of ongoing service in relation to regular reviews of my portfolio will be agreed to after I have signed the Agreement to Proceed section within the Statement of Advice. / / / / Client 1 signature Date Client 2 signature Date Adviser declaration I declare that: The information contained in this financial needs analysis is an accurate and complete record of the information provided by the client, and acknowledged by the client signing and dating above. The client was given a copy of the Financial Services Guide before any investment advice or service was provided. The preparation of the client s Statement of Advice will be based on the above information and any other documentation provided. / / Adviser s signature Date Page 14 of 22
Forms Identification form for individual and sole traders GUIDE TO COMPLETING THIS FORM o o o Complete all applicable sections of this form in BLOCK LETTERS. Provision of this information is required by law. The individual s identity must be verified before the product / service can be provided. Complete one form for each individual. Contact Risk Management and Compliance if the individual is unable to provide either the Primary or Secondary ID documents. SECTION 1: PERSONAL DETAILS Surname Date of Birth dd/mm/yyyy Full Given Name(s) Residential Address (PO Box is not acceptable) Street Suburb State Postcode Country COMPLETE THIS PART IF INDIVIDUAL IS A SOLE TRADER Full Business Name (if any) ABN (if any) Principal Place of Business (if any) (PO Box is not acceptable) Street Suburb State Postcode Country SECTION 2: IDENTIFICATION PROCEDURE o o Verify the individual s full name; and EITHER their date of birth or residential address. Complete EITHER Part A or Part B. (Note: Part B should only be completed if the individual does not own a document from Part A.) PART A ACCEPTABLE PRIMARY ID DOCUMENTS Tick Select ONE valid option from this section only Australian State / Territory driver s licence containing a photograph of the person Australian passport (a passport that has expired within the preceding 2 years is acceptable) Card issued under a State or Territory for the purpose of proving a person s age containing a photograph of the person Foreign passport or similar travel document containing a photograph and the signature of the person * Page 15 of 22
PART B ACCEPTABLE SECONDARY ID DOCUMENTS Tick Select ONE valid option from this section Australian birth certificate Australian citizenship certificate Pension card issued by Centrelink Health card issued by Centrelink Tick National identity card issued by a foreign government containing a photograph of the person in whose name the card was issued * AND ONE valid option from this section A document issued by the Commonwealth or a State or Territory within the preceding 12 months that records the provision of financial benefits and contains the individuals name and residential address A document issued by the Australian Taxation Office within the preceding 12 months which contains the individuals name and residential address A document issued by a local government body or utilities provider within the preceding 3 months which records the provision of services to that address or to that person (the document must contain the individuals name and residential address) Foreign driver's licence that contains a photograph of the person in whose name it issued and the individuals date of birth * If under the age of 18, a notice that: o was issued to the customer by a school principal within the preceding 3 months; and o contains the customers name and residential address; and o records the period of time that the customer attended at that school * Documents that are written in a language that is not English, must be accompanied by an English translation prepared by an accredited translator. ID RECORD Document 1 Document 2 Verified From Original Certified Copy Original Certified Copy Copy of ID Document (copy must be legible) Attached (go to Section 3) Alternative Agreed (complete ID Document Details below) Attached (go to Section 3) Alternative Agreed (complete ID Document Details below) ID DOCUMENT DETAILS Document 1 Document 2 Document Issuer Issued Date Expiry Date Document Number English Translation N/A Attached N/A Attached SECTION 3: FINANCIAL PLANNER DETAILS identification and verification conducted by: Date Verified (dd/mm/yyyy) Financial Planner s Name JAMIE MULCAHY Phone No. 03 5330 7200 AFS Licensee Name Mulcahy & Co Financial Planning AFSL No. 340094 Page 16 of 22
Identification form for individual and sole traders GUIDE TO COMPLETING THIS FORM o o o Complete all applicable sections of this form in BLOCK LETTERS. Provision of this information is required by law. The individual s identity must be verified before the product / service can be provided. Complete one form for each individual. Contact Risk Management and Compliance if the individual is unable to provide either the Primary or Secondary ID documents. SECTION 1: PERSONAL DETAILS Surname Date of Birth dd/mm/yyyy Full Given Name(s) Residential Address (PO Box is not acceptable) Street Suburb State Postcode Country COMPLETE THIS PART IF INDIVIDUAL IS A SOLE TRADER Full Business Name (if any) ABN (if any) Principal Place of Business (if any) (PO Box is not acceptable) Street Suburb State Postcode Country SECTION 2: IDENTIFICATION PROCEDURE o o Verify the individual s full name; and EITHER their date of birth or residential address. Complete EITHER Part A or Part B. (Note: Part B should only be completed if the individual does not own a document from Part A.) PART A ACCEPTABLE PRIMARY ID DOCUMENTS Tick Select ONE valid option from this section only Australian State / Territory driver s licence containing a photograph of the person Australian passport (a passport that has expired within the preceding 2 years is acceptable) Card issued under a State or Territory for the purpose of proving a person s age containing a photograph of the person Foreign passport or similar travel document containing a photograph and the signature of the person * Page 17 of 22
PART B ACCEPTABLE SECONDARY ID DOCUMENTS Tick Select ONE valid option from this section Australian birth certificate Australian citizenship certificate Pension card issued by Centrelink Health card issued by Centrelink Tick National identity card issued by a foreign government containing a photograph of the person in whose name the card was issued * AND ONE valid option from this section A document issued by the Commonwealth or a State or Territory within the preceding 12 months that records the provision of financial benefits and contains the individuals name and residential address A document issued by the Australian Taxation Office within the preceding 12 months which contains the individuals name and residential address A document issued by a local government body or utilities provider within the preceding 3 months which records the provision of services to that address or to that person (the document must contain the individuals name and residential address) Foreign driver's licence that contains a photograph of the person in whose name it issued and the individuals date of birth * If under the age of 18, a notice that: o was issued to the customer by a school principal within the preceding 3 months; and o contains the customers name and residential address; and o records the period of time that the customer attended at that school * Documents that are written in a language that is not English, must be accompanied by an English translation prepared by an accredited translator. ID RECORD Document 1 Document 2 Verified From Original Certified Copy Original Certified Copy Copy of ID Document (copy must be legible) Attached (go to Section 3) Alternative Agreed (complete ID Document Details below) Attached (go to Section 3) Alternative Agreed (complete ID Document Details below) ID DOCUMENT DETAILS Document 1 Document 2 Document Issuer Issued Date Expiry Date Document Number English Translation N/A Attached N/A Attached SECTION 3: FINANCIAL PLANNER DETAILS identification and verification conducted by: Date Verified (dd/mm/yyyy) Financial Planner s Name JAMIE MULCAHY Phone No. 03 5330 7200 AFS Licensee Name Mulcahy & Co Financial Planning AFSL No. 340094 Page 18 of 22
Client authorisation The financial adviser can use this form to request additional information from other institutions. To whom it may concern I, whose date of birth is / / Client 1 name Client 1 date of birth of (insert full address) Request that all relevant information about my investments, insurance, superannuation, bank accounts, Centrelink entitlements or other financial information be released on request to my adviser listed below: Mulcahy & Co Financial Planning Pty Ltd. Address: 300B Gillies Street, WENDOUREE VIC 3355. Telephone: (03) 5330 7200 Fax: (03) 5330 7250 Mulcahy & Co Financial Planning is an Australian Financial Services Licensee; ABN 33 114 922 271 AFSL No. 340094 Please also accept a photocopy or facsimile copy of this letter as authority. The original will stay on file at 300B Gillies Street Wendouree, Vic 3355. Please also release information to the following support staff as listed below: Yours faithfully Client 1 signature / / Date Page 19 of 22
Client authorisation The financial adviser can use this form to request additional information from other institutions. To whom it may concern I, whose date of birth is / / Client 2 name Client 2 date of birth of (insert full address) Request that all relevant information about my investments, insurance, superannuation, bank accounts, Centrelink entitlements or other financial information be released on request to my adviser listed below: Mulcahy & Co Financial Planning Pty Ltd. Address: 300B Gillies Street, WENDOUREE VIC 3355. Telephone: (03) 5330 7200 Fax: (03) 5330 7250 Mulcahy & Co Financial Planning is an Australian Financial Services Licensee; ABN 33 114 922 271 AFSL No. 340094 Please also accept a photocopy or facsimile copy of this letter as authority. The original will stay on file at 300B Gillies Street Wendouree, Vic 3355. Please also release information to the following support staff as listed below: Yours faithfully Client 2 signature / / Date Page 20 of 22
Tax file number collection The collection of tax file numbers (TFNs) by an Australian Financial Services Licence (AFSL) holder and its authorised representatives is authorised under tax and privacy laws and the use and disclosure of this information is strictly regulated under those laws. Providing your TFN to an investment body or regulated superannuation fund is not compulsory, but there may be tax implications for your dividends, interest, distributions and superannuation contributions if you do not provide your TFN to an investment body or regulated superannuation fund or claim an exemption. For more information about the use of TFNs, please phone your nearest Australian Tax Office. I I Client 1 (print name) Client 2 (print name) permit Mulcahy & Co Financial Planning and its authorised representative to retain my TFN, subject to the following conditions: 1. That Mulcahy & Co Financial Planning and its authorised representatives agrees to use and/or disclose my TFN for tax-related purposes only, specifically for quoting on current and future investment and superannuation applications, unless otherwise indicated by me. 2. That Mulcahy & Co Financial Planning and its authorised representatives maintain the necessary security to ensure that my TFN information is protected, by such safeguards as are reasonable in the circumstances to prevent loss, unauthorised access, use, modification or disclosure, and any other misuse. 3. That Mulcahy & Co Financial Planning and its authorised representatives will remove and destroy all records of my TFN should I so instruct and immediately upon my ceasing to be a client of Mulcahy & Co Financial Planning. I acknowledge that Mulcahy & Co Financial Planning and its authorised representatives are acting on my behalf in the conduct of my affairs. TFN Signature Client 1 Client 2 Date / / / / Adviser name JAMIE MULCAHY Signature Date / / Mulcahy & Co Financial Planning is an Australian Financial Services Licensee, ABN 33 114 922 271, AFSL 340094. Mulcahy & Co Financial Planning s address is 300B Gillies Street, Wendouree, VIC, 3355. Page 21 of 22
Notes Page 22 of 22