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Financial Planning Questionnaire and Risk Profile


Thank you for taking time to fill out this Client Questionnaire and Risk Profile, the information given in
this
questionnaire will remain confidential and will only be used by xyz to provide financial planning advice for
you.
The quality of our analysis given will depend upon the quality of the information that you provide.
Therefore, we
would appreciate you entering full and accurate information. If you have any queries during this process,
please
note these and they can be discussed more with your advisor.

To achieve your goals, Sr. Sarabjit Singh Chahal will …


• Where are you today
• Where do you want to get to
• How can you get there
• Review your progress regularly and to help you stay on track

CONTENTS
Page
Checklist of what to bring
A. YOUR PERSONAL INFORMATION
A.1 Personal Information
A.2 Employment Details
A.3 Family members
B. YOUR GOALS
B.1 Retirement Goal
B.2 Children Education Goals
B.3 Children Marriage Goals
B.4 Asset Building Goals
B.5 Other Goals
C. YOUR INCOME
D. YOUR EXPENSES
E. YOUR POLICIES
E.1 Life Insurance
E.2 Health Insurance
E.3 Motor Insurance
E.4 Home and content Insurance
E.5 Other Insurances
F. YOUR ASSETS
F.1 Personal Assets
F.2 Saving Bank Accounts
F.3 PPF Accounts
F.4 Deposits- Banks, Bonds
F.5 Recurring Deposits
F.6 Shares / Mutual Funds
F.7 Mutual Fund SIPS
G. YOUR LIABILITIES
H. YOUR TAX PLANNING
I. YOUR ESTATE PLANNING
J. YOUR RISK LEVEL
Annexure: 1 LIVING EXPENSES WORKSHEET
DECLARATION
2
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3
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5
6
6
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9
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10
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11
1. Latest CTC provided by the employer
2. Most recent 1 payslip
3. Most recent Income tax return
4. Loan and mortgage statement
5. Brokerage and mutual fund statement
6. Life insurance policies and annual statements
7. Health insurance policies
8. Home insurance policies
9. Motor insurance policies
10. Pan Card
11. Stock Options
Proposed Activities
Filled form received by xyz
Analysis of information
Complete information received
Draft plan to be sent to you
Discussion with you if needed
Final plan sent to you
Next steps and implementation
OUR PRIVACY POLICY
xyz will provide you with financial services in a secure and confidential manner. As a financial services
company, we believe that the
privacy and security of your data are essential. We take reasonable steps to preserve the security of the
personal information we collect. All
stored personal information is protected from unauthorised access.
Copyright 2007. All Rights Reserved. No part of this document may be reproduced without the
express consent of xyz.

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A.
YOUR PERSONAL INFORMATION
A.1 Personal Information
Self Spouse
Surname Chahal Chahal
First Names Sarabjit Singh Amarjit
Date of Birth 20th Feb 1959 th
8 Dec 1962
Gender Male Female
Martial Status Married Married
Telephone (home)
Telephone (mobile) 9899709468
Fax
E-mail ssinghchahal@yahoo.com
PAN Number BILPK8849R
Residential Address House No. 90, Street No 5 Phase II Model Town,
Bathinda, Punjab

A.2 Employment Details


Self Spouse
Employment Status Employed House Wife
Employer Name Sh. Sukhwinder Singh
Employer Address Irrigation Department,
Canal Division, Bathinda
Telephone (office) 01642246160

A.3 Family members

Examples include: Children or parents; any other persons who are financially
dependant upon you.

Name Relationship status Date of Birth Dependant (Yes/No) If


Dependent
status is
“Yes” then
at what age
you expect
to be self
supported
(member’s
age)
Navpreet Kaur Unmarried 25th July 1987 No
Gurpreet Singh Unmarried 04th June 1989 No

Copyright 2007. All Rights Reserved. No part of this document may be reproduced without the
express consent of xyz.

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B. YOUR GOALS
B.1

Retirement Goal
Please specify your retirement goals
Self Spouse
At what age do you want to retire? 58 -
Amount (Rs.)

Monthly pension after retirement (today's value) Ideal Rs. 25000


(our estimate is based on percentage of your
present household living expenses) Min Rs. 25000

Any lump sum amount required at retirement age No

B.2 Children Education Goals N/A


B.2.1 School and College Education

B.2.2 Higher Education N/A


How much will be required in which year for higher education (in today's value)

B.3 Children Marriage Goals


How much will be required in which year for marriage (in today's value).
Name of Child Year Amount (Rs.) Any other
information or
comment you wish
to make
Navneet Kaur 26 (2014) Rs. 15 lakh
Gurpreet Singh 26 (2016) Rs. 10 lakh

B.4 Asset Building Goals


Description Amount (Rs.) Are you open to take home loan - No

Real estate:Primary home Already staying in own house


Real estate:Vacation home Not required
Real estate:Rental property No
Real estate:Vacant land No
Purchase of car Already have a car
Jewellery Worth Rs. 10 lakh
Any other information or comment (Aleady having jewellery Rs. 5 lakh)
you wish to make
B.5 Other Goals

Description Year Today's Value Amount (Rs.)


Vacation: International 2015 Rs. 2 lakh (Trip to Australia)
Vacation: domestic 2013 Rs. 50000 (Trip to Hajur Sahib)
Charity N/A
Gift N/A
Upgradation of house 2018 Rs. 500000

C.
YOUR INCOME
Sources Self What is the expected rate % of growth Per
Annum?
Salary (Gross) Rs. 50000 8%
-Fixed Rs. 50000
-Variable or Bonus N/A
House Property Own House
Other Sources Rs. 1 lakh from ancestral land

Retirement assets

Scheme Self
Current Balance Your contribution Employer’s
per month Contribution
per month
GPF Rs. 10 lakh Rs. 7000
Superannuation
Gratuity

Amount of retirement benefits you expect to receive


Self
-Provident Fund Rs. 18 lakh
-Superannuation -
-Gratuity Rs. 5 lakh (on retirement)
-Leave Encashment Rs. 3 lakh

D. YOUR EXPENSES

Description Amount (Rs.)

A. Housing Rs. 1 lakh per year


(rent and maintenance expenses)

B. Utilities Rs. 7000 per month


(Electricity, Gas, Water, Telephone, Mobile Phone, Internet, Cable TV)

C. Food,Clothing,Transport Rs. 10000 per month


(Fruit/Vegetable/Groceries, Takeaway food/restaurants, Pet Food,
Clothing, Petrol, Vehicle Maintenance, Vehicle Taxes/License)

D. Education N/A
(School Fees, Tutoring/Books, Sports/out of school activities, School
Bus/transport)

E. Other expenses Rs. 2500 per month


(Medical cost, Personal care, Dependant care, Entertainment,
Recreation, Club membership, Hobbies, Gift/donation to Charities, Gift to
family and others, Subscriptions -newspapers and magazines, Pocket
Money children, Wine/spirits/alcohol, Cigarette/tobacco, Gardening
expenses, Servants, Drivers)

Total Expenses (A+B+C+D+E) Rs. 27500 (Approx)


What is the expected rate % of growth Per Annum? 8%

E. YOUR POLICIES
Here we find out whether you are under insured or over insured. So provide details
of all insurance policies including that provided by the employer.
Please include copies of any existing insurance policies that you may have so that
this can be properly reviewed.
E.1 Life Insurance (including provided by employer)
Sl No.

Insurance Company LIC Life Insurance


Who is Insured? Self
Term of the Policy 25 years
Sum Assured Rs. 5 lakh
Date of Commencement
Type of policy Endowment Policy
Policy Owner Self
Premium Rs. 1000 per month
Paying Term Monthly
Annual
Premium
Date of Maturity Cash Value/surrender value of the policy as on the date

E.2
Health Insurance
Sl No.
Insurance
Company
Type of
policy
Life
Insured
Sum
Assured
Annual
Premium
Date of
Commencement
Renewal Date

E.3
Motor Insurance Bike and Car Insurance apne aap details dal lena plz
Sl No.
Insurance
Company
Type of
policy
Value
Insured
Annual
Premium
Date of
Commencement
Renewal Date

E.4
Home and content Insurance N/A
Sl No.
Insurance
Company
Type of
policy
Value
Insured
Annual
Premium
Date of
Commencement
Renewal Date

E.5
Other Insurances N/A

F. YOUR ASSETS

F.1 Personal Assets


Sl No Description Cost of Acquisition Date of Acquisition Current Value
Real estate:Primary home Rs. 10 lakh April 2003 Rs. 60 Lakh
Real estate:Vacation home N/A
Real estate:Rental property N/A
Real estate:Vacant land Rs. 1 crore
Jewellery Rs. 5 lakhs
F.2
Saving Bank Accounts
Sl No
Name of the Bank/ Post Office State Bank of India
Type of Account Saving Account
Holder Name Self
Present Balance Rs. 1lakh

F.3
PPF Accounts N/A
Sl No
Name of the Bank/
Post Office
Type of Account
Holder Name
Present Balance

F.4
Deposits- Bank FD
Sl No
Name of the Bank/Post Office/ Company State Bank of India
Holder Name Self
Deposit Amount Rs. 5 lakh
Date of Deposit 2005
Period of Deposit 10 years
Interest Rate 8.5%
Maturity Date 2015
Maturity Calculate kr lena

F.5
Recurring Deposits N/A
Sl No
Name of the
Bank/Post
Office
Holder
Name
Start Date
Installment
Amount
Frequency Interest
Rate
Maturity
Date
Maturity
Amount
%
%
%
%

F.6
Shares / Mutual Funds N/A
Sl No
Name of the Scripts
Holder Name
No of
shares/Units
Current Value

F.7 N/A
Mutual Fund SIPS
Sl No Name of Scheme
Holder Name
Start Date
Installment
Amount
Frequency
Total No of
Installments paid

G.
YOUR LIABILITIES N/A

H.
YOUR TAX PLANNING
Description
Amount (Rs.)
Documents needed
Interest paid on housing loan for
self occupied house
Interest statement from lender
Deductions under section 80C
Proof of the following-
National Saving Certificate(NSC),
Public Provident Fund, Pension Plans, 5 year
Fixed Deposit, Mutual Fund ELSS, Amount spend
on any two children's education, Repayment of
principal of home loan, Accrued interest from NSC
Deductions under section 80 D
Health Insurance Premium slip
Deductions under section 80 E
Proof of interest paid on higher education for self
Deductions under section 80 G
Proof of charitable donation

I.
YOUR ESTATE PLANNING
Do you have a Will?
Yes/No No

J.
YOUR RISK PROFILE
Questions/Answer
1. I plan to begin withdrawing money from my investment within
Ans. 6-10 years

2. I intend to spend all my investments after withdrawal within


Ans. 6-10 years

3. My knowledge of investments is
Ans. Good
4. When I invest my money, I am
Ans. Equally concerned about my investment losing or gaining value

5. What investments have your owned in the past


Ans. Money market funds or cash equivalent
6. Imagine that the sensex has dropped by 25%. You owned a Reliance stock which also
fell by 25%, What would you do?
Ans. Sell some of my shares

7. Average, best case and worst case scenarios for hypothetical investment portfolio has
been given below. Which is most acceptable to you ?

Ans. Average 9%
Best Case 25%
Worst Case -13%

Annexure 1: Living Expenses Worksheet

Items
Monthly Amount (Rs.)
A. Housing
Rent
House repairs Rs. 1lakh per annum

B. Utilities
Electricity Rs. 3000 per month
Gas Rs. 500 per month
Water Rs. 200 per month
Telephone
Mobile Phone Rs. 2000 per month
Internet Rs. 1000 per month
Cable TV Rs. 300 per month

C. Food,Clothing,Transport
Fruit/Vegetable/Groceries Rs. 2000 per month
Takeaway food/restaurants Rs. 2000 per month
Clothing Rs. 2500 per month
Petrol Rs. 2000 per month
Vehicle Maintenance Rs. 1000 per month
Vehicle Taxes/License Rs. 500 per month

D. Education N/A
School Fees
Tutoring/Books
Sports/out of school activities
School Bus/transport

E. Other expenses
Medical cost Rs. 1000 per month
Personal care (hair care, dry cleaning etc) Rs. 500 per month
Subscriptions (newspapers and magazines) Rs. 300 per month

Servants Rs. 500 per month


Other expenses Rs. 200 per month
Total Expenses (A+B+C+D+E) Rs. 2500 per month

Copyright 2007. All Rights Reserved. No part of this document may be reproduced
without the express consent of xyz.

- Confidential -
Page: 12

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 financial plan. 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 financial
planning advice will only remain valid while my situation does not change or
while I am progressing on
a recommended course of action.
I agree to a charge of Rs.
for the preparation of a financial plan by xyz for my given
situation and objectives.
Signed:
Date:
The statutory environment in this country may change from time to time therefore
it is important that a
client should review any financial planning recommendations made to ensure that
these remain valid.
A client should also review their plans from time to time to ensure that their
objectives or situation
have not changed dramatically necessitating an alteration of their plans.