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Client 1

Client Name *

Preferred Name *

Date of Birth *

Gender *

Marital Status *

Occupation *

Street Address *

Suburb *

State *

Postcode *

Is the postal address different than the above? *

No
Yes

Postal Street Address *

Postal Suburb *

Postal State *

Postal Postcode *

Phone

Mobile

Email Address *

Client 2

Name

Preferred Name

Date of Birth

Gender

Marital Status

Occupation

Street Address

Suburb

State

Postcode

Is the postal address different than the above?

Yes
No

Postal Street Address

Postal Suburb

Postal State

Postal Postcode

Phone

Mobile

Email

Is the client seeking advice on the suitability of an Elston Investment Service?

Yes
No

Investment Service

Scaled investment advice is limited to the suitability of an Elston investment service

Is the client seeking advice on establishing a new SMSF?

Yes
No

New Self-Managed Super Fund Establishment *

This advice includes the recommendations on establishing a fund, rollover advice, death nominations advice and the formulation of the fund Investment Strategy document (including insurance considerations)

Is the client seeking advice on strategies for an existing SMSF?

Yes
No

Type of SMSF

Is the client seeking advice on insurances?

Yes
No

Insurance Advice

This may include; review of existing Life, Trauma, Income Protection, and Total & Permanent Disability both inside and outside of Super as well as new recommendations

Is the client seeking advice from Elston on any other topic or any other matter?

Yes
No

Advice from Elston

Assets

File Upload

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Annual Gross Income

Approximate Annual Expenses

Annual Gross Income

Approximate Annual Expenses

Lifestyle Assets

(non-income producing assets)

Owner

Current Value

Insured Value

Centrelink Value

Motor Vehicle 1 Owner

Motor Vehicle 1 Current Value

Motor Vehicle 1 Insured Value

Motor Vehicle 1 Centrelink Value

Motor Vehicle 2 Owner

Motor Vehicle 2 Current Value

Motor Vehicle 2 Insured Value

Motor Vehicle 2 Centrelink Value

Other 1 Owner

Other 1 Current Value

Other 1 Insured Value

Other 1 Centrelink Value

Other 2 Owner

Other 2 Current Value

Other 2 Insured Value

Other 2 Centrelink Value

Investment Assets

(income producing assets)

Asset 1

Asset Description

Owner

Value

Cost

Date

Income

Asset 2

Asset Descript

Owner

Value

Cost

Date

Income

Asset 3

Asset Description

Owner

Value

Cost

Date

Income

Asset 4

Asset Description

Owner

Value

Cost

Date

Income

Superannuation Fund 1

Superannuation

Owner

Value

Insurance

Currently Receiving Contributions?

Superannuation Fund 2

Fund Name 2

Fund Owner 2

Fund Value 2

Fund Insurance 2

Fund Receiving Contributions 2

Superannuation Fund 3

Fund Name 3

Fund Owner 3

Fund Value 3

Fund Insurance 3

Fund Receiving Contributions 3

Additional Asset Information

(include contingent assets)

Liabilities

Liability

Liability

Owner

Security For Loan

Value

Description

Liability 2

Liability

Owner

Security For Loan

Value

Description

Liability 3

Liability

Owner

Security For Loan

Value

Description

Additional Liability Information

(include contingent liabilities)

Referrer Information

Your Name *

Your Email *

Name

Phone 1300Elston

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Complaints Warnings and Disclaimers

Warnings and disclosures

This material has been prepared for general information purposes only and not as specific advice to any particular person. Any advice contained in this material is General Advice and does not take into account any person’s individual investment objectives, financial situation or needs. Before making an investment decision based on this advice you should consider whether it is appropriate to your particular circumstances, alternatively seek professional advice. Where the General Advice relates to the acquisition or possible acquisition of a financial product, you should obtain a Product Disclosure Statement (“PDS”) relating to the product and consider the PDS before making any decision about whether to acquire the product. You will find further details of the service we provide and any cost to you within the Financial Services Guide. Any references to past investment performance are not an indication of future investment returns. Prepared by EP Financial Service Pty Ltd ABN 52 130 772 495 AFSL 325 252 (“Elston”). Although every effort has been made to verify the accuracy of the information contained in this material, Elston, its officers, representatives, employees and agents disclaim all liability (except for any liability which by law cannot be excluded), for any error, inaccuracy in, or omission from the information contained in this material or any loss or damage suffered by any person directly or indirectly through relying on this information.

Elston Group - ACN 130 771 523

EP Financial Services Pty Ltd - ABN 52 130 772 495 / AFSL 325 252

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