General Form – Cmme FWR

About you

First name

Last name

D.O.B

E-mail

Telephone number

Marital status Single Married Living with partner Prefer not to say

Partner employment status Umbrella Contractor PAYE

Your Employment status Umbrella Contractor PAYE Other

Do you have dependents? Yes No

How Many?

Do you own a limited company Yes No

Have you changed employment status in last 12 months? Yes No

Explain

Are you planning to change in next 12 months? Yes No

Explain

Do you reside in the UK Yes No

General finances

With regards to income

what is your annual income?

With regards to income:

What is your combined household income (if applicable)

Could you manage without borrowing e.g.via a credit card or loan (not inc mortgage) Yes No Don't know

Do you have savings/access to emergency funds if you had to pay for something unexpected like a medical bill or for home/car maintenance? Yes No Don't know

How often to you pay interest on any debt you have Monthly Quarterly Annually Other

Explain

Do you have an Independent Financial Advisor Yes No

How do you feel about your current financial situation, on a scale of 1-10, where 1 is very worried/concerned and 10 is very confident/happy

Currently, do you have any specific areas of concern regarding your overall financial situation

Home & property

Do you have a mortgage Yes no

Do you know the mortgage type (types if more than one) Fixed Variable Other

Explain

When is your mortgage due for renewal

Have you reviewed your mortgage/s in the last 12 months - to check you're still on the best rate for example? Yes No

How satisfied are you with your current mortgage arrangements, on a scale of 1-10, where 1 is very unsatisfied and 10 is very satisfied

Any plans to buy, move, remortgage or invest in a buy to let in the next 12 months? Yes No Don't know

Explain

Currently, do you have any specific mortgage or property related needs

Financial protection

Do you have any of the following in place

Income cover

Yes No

Do you have any of the following in place

Life cover

Yes No

Do you have any of the following in place

Critical Illness cover

Yes No

If you were off work for a year due to ill heath, would you be able to cope financially i.e. cover the monthly outgoings Yes No Don't know

Have you reviewed your protection policies in the last 12 months - to check you still have the right level of cover for your needs Yes No

How satisfied are you that your current protection arrangements provide adequate financial cover for you & your family - on a scale of 1-10, where 1 is very unsatisfied and 10 is very satisfied

Currently, do you have any specific income or health protection needs

Long term planning

Do you have a pension Yes No

What type of pension Private Auto-enrol Other

Explain

How many pension pots do you have

Estimated total value of your pension pot/s

Are you currently paying into your pension Yes No

How long until you retire 1-10 years 10-20 years 20+ years

Have you reviewed your pension/long term panning arrangements in the last 12 months - to check you are still on track meet your lifestyle objectives in later life Yes No

How satisfied are you that you will have enough money to lead the life you want in retirement, on a scale of 1-10, where 1 is very unsatisfied and 10 is very satisfied

Currently, do you have any specific areas of concern or need regarding your pension or long term planning

Close

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