Referred By___________________________________ No.

_____________________________
Occupation____________________________________________________________________
Address__________________________________________ Near By ______________________

Name _______________________________________________ M

;F

Education __________________________ DOB __________________ Percentage ___________

Present Address ________________________________________________________________
______________________________________________________________________________
Near By _______________________________________________________________________
Contact No ________________________________, ___________________________________
No. Of 2 Wheelers _______________________ No. Of 4 Wheelers ________________________
S.No

Child Name

DOB

Higher Education
Year
CC

Marriage / SC
Year
CC

1
2
3

S.No

No. Of Years for GOAL

Goal 1

Goal 2

Goal 3

Higher

Marriage /

Education

Life
Settlement

1
2
3

Others

Total No of Departments

Approximate
Monthly saving Per Month

Monthly Income per Month

Other Income per Annum

Total Income per Annum

Total Expenses per Annum

Total Personal Expenses per Annum :

Approximate Expenses
Tea

Coffee

Water Bottle

Cool drinks

Smoking

Guttka

Alcohol

Soda

Late payment fee

Unnecessary Outside food

Unnecessary Shopping

Have you planned for your childs higher education?

Yes

No

Have you planned for your childs marriage / life settlement?

Yes

No

Have you planned for your retirement?

Yes

No

Child Higher Education?

Present Cast =

Future Cast =

Present Age

Duration =

Saving / Investments = PM/PA

Goal Age

Future Cast =

Marriage / Life settlement ?

Present Cast =

Future Cast =

Present Age

Duration =

Saving / Investments = PM/PA

Goal Age

Future Cast =

Seek / Accidents ( 2 to 3 Months rest)?

X

( What About your Personal Income)

Child Education / Family Income?

X

(if Unfortunate event to Earner)

(Child is ready for marriage )

Hospitalization
X

Retirement
X

60 years

100 Years

20 25 years age is best age to start investing

(Rs 5,000 @12% PA X 40 Year = Rs.5, 15,48,543/-)

Starting at 20 year

60 years
(Rs 5,000 @12% PA X 30 Year = Rs.1, 62,17,556/-)

Starting at 30 year

60 years
(Rs 5,000 @12% PA X 20 Year = Rs.48,41,924/-)

Starting at 40 year

60 years
(Rs 5,000 @12% PA X 10 Year = Rs.11, 72, 274/-)

Starting at 50 year

60 years

Savings / Investments
Investment + Extra saved Money

Present Age =

N=

60 Years

N=

60 Years

Investment

Present Age =

_____________________________
Difference = _____________________________

Bank + Extra saved Money

Present Age =

N=

60 Years

N=

60 Years

Bank

Present Age =

_____________________________
Difference = _____________________________

Investment

Bank

=
________________________________

Deference

=
________________________________

PERSONAL FINACEAL STATUS

Name _________________________________________________________M / F _________
Fathers / Husbands Name ______________________________________________________
DOB _______________________Present age __________ Retirement Age ________________
Present address _______________________________________________________________
____________________________________________________________________________
Near By______________________________________________________________________
Personal Contact No. ___________________________, _______________________________
Occupation___________________________________________________________________
Total Annual Income ___________________________________________________________
Total Personal Expenses per Annum _______________________________________________
Last 3 year TAX fileing Copies

Yes

No

Total Investments
Bank Savings
Mutual Funds
Shares
FDS / RDS
Insurances
Physical Gold / Silver
Real Estate

To fill the form takes 1 to 2 Hours

7 to 10 working days to give Suggestion
Signature