WEALTH PLANNING DATA GATHERING SHEET
A. PERSONAL INFORMATION
A.1 Personal Information
Self Spouse
Surname
First Name
Age
Gender
Marital Status
A.2 Employment Details
Self Spouse
Employment Status (Employed /
Self employed /Retired)
A.3 Family members
Examples Include: Children or parents; any other persons who are financially dependent upon you.
Marital If Dependent status is "Yes" then at
Relationshi Current Male / Dependen
Name Status of what age you expect them to be self
p Age Female t
Children (Yes/No) supporting (member's age)
Mother
Father
Child 1
Child2
Child 3
Any other relative
Any other information:
B. GOALS
B.1 Retirement Goal
Retirement Age (Your targeted age to
retire)
Monthly pension required
Any lump sum amount required
B.2 School and College Education
How much will be required and for which year towards school and college education (in today's value)
Name of Child Age School College
Age to Age to
Age to Age to start
Finish/ Annual Finish/ Annual
start / Year / Year to
Year to Expenses Year to Expenses
to Start Start
Finish Finish
B.3 Children Marriage Goals
How much will be required in which year for marriage (in today\s value)
Name of Child Year Amount
B.4 Asset Building Goals
Today's
Are you
Value
Description Year open to
Amount
take a loan
(Rs.)
Real Estate: Primary Home
Real Estate: Rental Property
Real Estate: Vacant Land
Purchase of Car
Jewellery
B.5 Other Goals
Today's
Value
Description Year
Amount
(Rs.)
Vacation: International
Vacation: Domestic Annual
Charity
Gift
Up gradation of house
Medical Corpus
Others
Any other information
For Reference
Illustrative higher education costs in India
ENGINEERING (Four-year BE/B-Tech) per annum cost
- IITs: Rs. 3.50-4.50 lakh
- Private colleges: Rs. 5.50-7 lakh
MEDICINE (Five-year MBBS)
- Govt-funded colleges: Rs. 7-8 lakh
- Private colleges: Rs. 25-35 lakh
BUSINESS MANAGEMENT (Two-year
course)
- IIMs: Rs. 6-7.5 lakh
- Private institutes: Rs. 7-16 lakh
Illustrative higher education costs in Abroad
- Annual tuition Rs. 18-21 lakh
- Annual living Rs. 12-14 lakh
C. INCOME
Expected Growth Rate
Self (p.m.) Spouse
(% p.a)
Salary (Gross)
Business or profession
House Property (Rental)
Other sources
Retirement Assets
Amount of Retirement Benefits you expect to receive on your & your spouse's retirement
Self Nominee
-Provident Fund
-Superannuation
-Gratuity
-Others
D. EXPENSES/OUTFLOWS
Description Monthly (Rs.)
A. Housing
(rent and maintenance expenses)
B. Utilities
(Electricity, Gas, Water, Telephone, Mobile Phone, Internet, Cable TV)
C. Food, Clothing, Transport
(Fruit/Vegetable/Groceries, Takeaway food/restaurants, Pet Food, Clothing,
Petrol, Vehicle Maintenance, Vehicle Taxes/License)
D. Education
(School Fees, Tutoring / Books, Sports / out of school activities, School Bus/transport)
E. Other expenses
(Medical cost, Personal care, Dependent care, Entertainment, Club membership,
Hobbies, Gift/donation to Charities, Gift to family and others,
Subscriptions - newspapers and magazines, Gardening expenses, Servants,
Drivers, Pocket Money children
F. Investments/Savings
Loan EMIs
Insurance Premiums
Other regular saving obligations
Total Expenses (A+B+C+D+E+F)
Any other information:
Expected Growth Rate
(% p.a)
Annual (Rs.)
E. POLICIES
E.1 Life Insurance (Specify if provided by employer)
Who is Insured? Premium Paying
Sl No. Type of Policy Nominee Survival/Maturity Benefit
(Policy Owner) Term/ Term of policy
E.2 Motor Insurance
Sl No. Insurance Company Type of Policy Value Insured Annual Premium Term of policy
1
2
E.3 Health Insurance (Specify if provided by employer)
Sl No. Insurance Company Type of Policy Life Insured Sum Assured Annual Premium
1
2
E.4 Home Insurance
Sl No. Insurance Company Term of the Policy Value Insured Annual Premium Commencement Date
1
2
Any other information:
Annual Date
Premium Sum Assured
Maturity
Commencement Date Renewal Date
Term of Policy Commencement Date Renewal Date
Renewal Date
F. ASSETS
F.1 Personal Assets
Ownership (Single or Joint) If
Sl No Description Cost of Acquisition Date of Acquisition
joint specify the co-owner
1 Real Estate
Primary Home
Vacant Land
Secondary Home
Any other property
2 Jewellery
F.2 Saving Bank Accounts (Banks, Post Office)
Holding (Single
Sl No Type of Account Holder Name /Joint) If joint specify Nominee
the Co-Holder
1
2
F.3 PPF Accounts
Sl No Type of Account Holder Name Nominee Present Balance
1
2
F.4 Deposits- Banks, Post Office, Bonds, company (Excluding Mutual Funds, Shares )
Holding (Single
Sl No Type of Account Holder Name /Joint) If joint specify Nominee
the Co-Holder
1
2
F.5 Recurring Deposits
Holding (Single
Sl No Type of Account Holder Name /Joint) If joint specify Nominee
the Co-Holder
1
2
F.6 Demat Accounts / Mutual Funds Folios
Holding (Single
SI No Description Holder Name /Joint) If joint specify Nominee
the Co-Holder
1
2
3
F.7 Mutual Funds SIP's
Holding (Single
SI No Description Holder Name /Joint) If joint specify Nominee
the Co-Holder
1
2
3
Any other Information
Current Value
Present Balance
Maturity
Deposit Amount Period of Deposit Interest Rate
Amount
Period of Deposit/ Maturity
Installment Amount Interest Rate
Frequency Amount
Current Value
Installment Amount Frequency
G. LIABILITIES
Examples Include: Any loans related to your personal assets and additional liabilities
Origination Original Interest Amount Monthly
Sl No Description Original Balance
Date Term Rate Outstanding Payment
1 Home Mortgage
2 Car Loan
3 Loan Against Policies
4 Loan Against Investments
5 Personal Loan
6 Credit Cards
7 Others
H. TAX PLANNING
Description Amount (Rs)
Interest paid on housing loan
for self occupied house
Deduction u/s 80C
Deduction u/s 80D
Deduction u/s 80E
Deduction u/s 80G
Others
Any other information:
Insured
(Yes/No)
Estate & Succession Planning Questionaire- Need Analysis Questions
1
3
4
5
ESTATE PLANNING CONCERNS QUESTIONS
Read each statement and choose the level of Concern this is for you i.e. what is the chance
of this occurring in your life or after your death?
1
2
3,
6
7
8
9
10
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2
3
4
5
I. ESTATE PLANNING
Estate & Succession Planning Questionaire- Need Analysis Questions
Do you want to retain control over your assets till you are alive?
Do you want that your assets & properties post your death are distributed as per your wishes and
desires?
Only to people you want them to go at the time you want, in the manner you want and in the
propotion you want.
In case you become incapicitated or disabled have you made provisions for someone to operate
your singly owned bank accounts, mutual fund investements, fixed deposits etc.
Do you want to ensure and easy peaceful transfer of your wealth post your death?
Is the nominee in all your financial holdings same person who you would like to inherit those assets
after you?
Do you know your legal heirs? i.e. in case you pass away without creating a "WILL" who all will get
your property and in what proporation
ESTATE PLANNING CONCERNS QUESTIONS
Read each statement and choose the level of Concern this is for you i.e. what is the chance
of this occurring in your life or after your death?
Risk that Your Assets after your Death, might not fully pass on to your spouse, because if you die
without a ‘Will’ other people apart from your spouse are your legal heirs.
Risk that after you pass away your children or other Legal Heirs might fight over your Assets
Risk that if you and your spouse pass away while your children are ‘Minor’ someone other than your
choice might become their Guardian.
Risks of one of you child or other beneficiary losing his or her inheritance to creditors, lawsuits or to
a divorcing spouse or to mismanagement of the money.
Risk that an inheritance passing to a minor child or grandchild might be misspent or stolen by the
person in charge of managing the money for that child or grandchild.
Risk of loss of information that dies with you such as details of your assets, debtors, creditors,
information about passwords to your email id etc.
Risk that your Business might not run smoothly after you pass away?
Risk of Creditors where you have stood Guarantor taking your Assets to pay the loan.
Risk that your ‘Incapacitated Child’ ‘Special Child’ might not be looked after properly once both you
and your spouse pass away.
Risk of unwanted efforts made to save your life if you feel that it’s best to cease such efforts and die
peaceably and without pain. For Ex. Suppose you become brain dead with no chance of recovering
and Doctors keep you artificially alive. In this case your Wealth goes to a Doctor or Hospital and also
you have to bear lots of Pain.
Your Current State of Estate Planning
Answer the below questions to help us understand your current state of Estate Planning
Do you presently have a will?
Do you have a Financial Durable Power of Attorney?
Have you created a Letter of Guardianship for your minor child?
Do you have a 'Living Will" i.e Advanced Health Care Power of Attorney?
Have you created an " Asset Information Sheet" for your next generation?
YES NO
HIGH MEDIUM LOW NO/NA
SELF SPOUSE
YES NO YES NO
J. YOUR RISK PROFILE
Questions Answer A B
I plan to begin withdrawing money from
Less than 3 years 3-5 years
my investment within
I intend to spend all my investments after
Less than 2 years 2-5 years
withdrawal within
My knowledge of investments is None Limited
When I invest my money, I am Most concerned about my Equally concerned about my
investment losing value investment losing or gaining value
What investments have you owned in Money market funds or
Bonds and/ or bond funds
the past cash equivalent
Imagine that the NIFTY has dropped by
25%.You owned a Reliance stock which
also fell by 25%. Sell all my shares Sell some of my shares
What would you do?
Average, best case and worst case
scenarios for hypothetical investment Average: 7.2% Average: 9%
portfolio has been given below. Best Case: 15% Best Case: 25%
Which is most acceptable to you? Worst Case: -5% Worst Case: -13%
Any other information:
C D
6-10 years More than 10 years
6-10 years More than 10 years
Good Extensive
Most concerned about my
investment gaining value
Stocks and/ or stocks funds
Do nothing Buy more shares
Average: 10.5% Average: 12%
Best Case: 33% Best Case: 50%
Worst Case:18% Worst Case: 28%
DECLARATION
I hereby declare that any information supplied in this questionnaire is correct and I understand that this
information will be used towards creating my Wealth Plan and for academic purposes by AAFM India.
I indemnify the company from any liability that may arise from this information being incorrect, or my
failure to implement any recommendations, which are made from this information. I understand that it is my
responsibility to choose to or not to implement any recommendations made as a result of this plan, or to
formally engage the company to implement these recommendations for me. I understand that any
Wealth Management advice will only remain valid while my situation does not change or while I am progressing
on a recommended course of action.
I am aware that AAFM India may use the data obtained from me for academic purposes.
Signed: YES
Date:
The statutory environment in this country may change from time to time therefore it is important that a client
should review any Wealth Management recommendations made to ensure that these remain valid. A client
should review any Wealth Management recommendations made to ensure that these remain valid. A client
dramatically necessitating an alteration of their plans
.
