Client Information Sheet

CLIENT INFORMATION SHEET

(A) PARTIES MY DETAILS MY PARTNER’S DETAILS SURNAME: SURNAME: FIRST NAMES: FIRST NAMES: HOME ADDRESS: HOME ADDRESS:

POSTAL ADDRESS: POSTAL ADDRESS:

HOME PHONE: HOME PHONE: WORK PHONE: WORK PHONE: MOBILE NUMBER: MOBILE NUMBER: HOME FAX: HOME FAX: WORK FAX: WORK FAX: EMAIL ADDRESS: EMAIL ADDRESS: DATE OF BIRTH: DATE OF BIRTH: PLACE OF BIRTH: PLACE OF BIRTH: CITIZENSHIP: CITIZENSHIP: AN AUSTRALIAN CITIZEN: YES / NO AN AUSTRALIAN CITIZEN: YES / NO AT PRESENT LIVING IN AUSTRALIA?: YES / NO AT PRESENT LIVING IN AUSTRALIA?: YES / NO ORDINARILY LIVE IN AUSTRALIA? YES / NO ORDINARILY LIVE IN AUSTRALIA? YES / NO

OCCUPATION: OCCUPATION: EMPLOYER: EMPLOYER:

1 (A) PARTIES (cont) MY DETAILS MY PARTNER’S DETAILS MARITAL / PARENTAL STATUS: MARITAL / PARENTAL STATUS: FATHER / MOTHER FATHER / MOTHER HUSBAND / WIFE HUSBAND / WIFE DE FACTO PARTNER DE FACTO PARTNER OTHER OTHER MARITAL STATUS BEFORE MARRIAGE?: MARITAL STATUS BEFORE MARRIAGE?: NOT PREVIOUSLY MARRIED NOT PREVIOUSLY MARRIED WIDOWED WIDOWED DIVORCED DIVORCED

(B) OUR RELATIONSHIP DETAILS Date we began living together: Date of marriage: Place of marriage: Date of separation: Location of Marriage Certificate: Location of Birth Certificate: Date of decree absolute: Place decree granted:

2 (C) OUR CHILDREN CHILD 1 CHILD 2 SURNAME: SURNAME: FIRST NAMES: FIRST NAMES: DATE OF BIRTH: DATE OF BIRTH: FULL NAME OF PARENT 1: FULL NAME OF PARENT 1: FULL NAME OF PARENT 2: FULL NAME OF PARENT 2: CHILD 3 CHILD 4 SURNAME: SURNAME: FIRST NAMES: FIRST NAMES: DATE OF BIRTH: DATE OF BIRTH: FULL NAME OF PARENT 1: FULL NAME OF PARENT 1: FULL NAME OF PARENT 2: FULL NAME OF PARENT 2:

(D) PREVIOUS COURT ORDER, PENDING PROCEEDINGS OR AGREEMENTS DATE COURT SUMMARY OF ORDER / AGREEMENT / PROCEEDINGS

3 NOTE: If no property or maintenance issues, leave Sections E to J blank

(E) ASSETS AND DEBTS WHEN WE BEGAN LIVING TOGETHER MY ASSETS AT THAT TIME MY PARTNER’S ASSETS AT THAT TIME Asset Value Asset Value a) $ a) $ b) $ b) $ c) $ c) $ d) $ d) $ e) $ e) $ f) $ f) $ MY DEBTS AT THAT TIME MY PARTNER’S DEBTS AT THAT TIME Liability Value Liability Value a) $ a) $ b) $ b) $ c) $ c) $ d) $ d) $ e) $ e) $ f) $ f) $

4 (F) ASSETS AND DEBTS AS AT DATE OF SEPARATION MY ASSETS AT separation MY PARTNER’S ASSETS AT separation Asset Value Asset Value g) $ g) $ h) $ h) $ i) $ i) $ j) $ j) $ k) $ k) $ l) $ l) $ MY DEBTS AT SEPARATION MY PARTNER’S DEBTS AT SEPARATION Liability Value Liability Value g) $ g) $ h) $ h) $ i) $ i) $ j) $ j) $ k) $ k) $ l) $ l) $

5 (G) ASSETS AND DEBTS NOW MY ASSETS NOW MY PARTNER’S ASSETS NOW Asset Value Asset Value a) $ a) $ b) $ b) $ c) $ c) $ d) $ d) $ e) $ e) $ f) $ f) $ MY DEBTS NOW MY PARTNER’S DEBTS NOW Name of Creditor Value Name of Creditor Value a) $ a) $ b) $ b) $ c) $ c) $ d) $ d) $ e) $ e) $ f) $ f) $

6 (H) OUR FINANCIAL RESOURCES MINE MY PARTNER’S GROSS ANNUAL INCOME: $ GROSS ANNUAL INCOME: $ as at 30 June as at 30 June PRESENT GROSS WEEKLY INCOME: $ PRESENT GROSS WEEKLY INCOME: $ EMPLOYED BY: EMPLOYED BY: SUPERANNUATION: SUPERANNUATION: Fund Name: Fund Name: Address: Address:

Telephone: Telephone: LONG SERVICE LEAVE: LONG SERVICE LEAVE: HOLIDAY PAY: HOLIDAY PAY: LIFE POLICIES: LIFE POLICIES: Fund Name: Fund Name: Address: Address:

Telephone: Telephone: Amount of Cover: $ Amount of Cover: $ Whose life is insured: Whose life is insured: COMPANIES: COMPANIES: Name: Name: Director/s: Director/s: Shareholder/s: Shareholder/s: TRUSTS: TRUSTS: Name: Name: Trustees: Trustees: Beneficiaries: Beneficiaries:

7 (I) PAID EMPLOYMENT DURING OUR TIME TOGETHER MYSELF MY PARTNER PERIOD: PERIOD: OCCUPATION: OCCUPATION: FULL/PART-TIME: FULL/PART-TIME:

(J) FINANCIAL CONTRIBUTIONS FROM EACH OF US DURING OUR RELATIONSHIP ITEM DATE ME MY PARTNER Gifts from parents/others $ $ Inheritances $ $ Personal injury/compensation awards $ $ Retrenchment/termination packages $ $ Windfalls $ $ Payments for welfare other party/children $ $ Other $ $

(K) OTHER RELEVANT INFORMATION (please summarise below) MYSELF MY PARTNER

8 (L) MY WILL LOCATED AT: WHO BENEFITS FROM YOUR WILL? I HAVE NO WILL:

(M) MY POWER OF ATTORNEY LOCATED AT: WHO ARE MY ATTORNEYS? I HAVE NO POWER OF ATTORNEY:

(N) MY ACCOUNTANT NAME: ADDRESS:

TELEPHONE:

(O) MY OTHER TRUSTED ADVISERS