Heart Client Fact Find

Client Fact Find
MAIN APPLICANT'S PERSONAL DETAILS
Name

PrefixFirst NameMiddle NameLast Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Contact Details

Area CodePhone Number
Email
example@example.com
Marital Status
Citizenship Status
Tax File Number (TFN)
Mother's maiden name
Current Will
Date of will

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Private Health Insurance

Main Applicant Address History
Residential Address

Street Address

Street Address Line 2

CityState

Post Code
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Residential Status
Postal Address (if different from above)

Street Address

Street Address Line 2

CityState

Post Code
Previous Address

Street Address

Street Address Line 2

CityState

Post Code
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
End Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

Main Applicant Employment History
Current Employer
Name of current employer
Occupation
Employment Status
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Income amount
Net or Gross
Frequency
Employer Address

Street Address

Street Address Line 2

CityState

Post Code
Employer contact name

First NameLast Name
Employer contact number

Area CodePhone Number
Employer email
example@example.com
Previous Employer
Occupation
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
End Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

SECOND APPLICANT'S PERSONAL DETAILS
Name

PrefixFirst NameMiddle NameLast Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Contact Details

Area CodePhone Number
Email
example@example.com
Marital Status
Citizenship Status
Tax File Number
Mother's maiden name
Current Will
Date of will

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Private Health Insurance

Second Applicant Address History
Residential Address

Street Address

Street Address Line 2

CityState

Post Code
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Residential Status
Postal Address (if different from above)

Street Address

Street Address Line 2

CityState

Post Code
Previous Address

Street Address

Street Address Line 2

CityState

Post Code
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
End Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

Second Applicant Employment History
Current Employer
Occupation
Employment Status
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Income amount
Net or Gross
Frequency
Employer Address

Street Address

Street Address Line 2

CityState

Post Code
Employer Contact Name

First NameLast Name
Employer Contact Number

Area CodePhone Number
Employer Contact Email
example@example.com
Previous Employer
Occupation
Start Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
End Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

Dependents
Dependent #1
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent
Dependent #2
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent
Dependent #3
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent
Dependent #4
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent
Dependent #5
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent
Dependent #6
Name
DOB

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Financial Dependent

Assets - Real Estate

If you already own any properties please enter their details below
Property 1

Street Address

Street Address Line 2

CityState

Post Code
Value
Current Lender
Loan Balance
Rental Income per month
Property 2

Street Address

Street Address Line 2

CityState

Post Code
Value
Current Lender
Loan Balance
Rental Income per month
Property 3

Street Address

Street Address Line 2

CityState

Post Code
Value
Current Lender
Loan Balance
Rental Income per month
Property 4

Street Address

Street Address Line 2

CityState

Post Code
Value
Current Lender
Loan Balance
Rental Income per month

ASSETS - Superannuation & Insurance

Please enter details of your Superannuation & Insurance Policies
SUPERANNUATION
Superannuation Fund
Ownership
Value
Superannuation Fund
Ownership
Value
Superannuation Fund
Ownership
Value
Superannuation Fund
Ownership
Value
Superannuation Fund
Ownership
Value
Superannuation Fund
Ownership
Value
INSURANCE
Insurer
Ownership
Value
Type
Insurer
Ownership
Value
Type
Insurer
Ownership
Value
Type
Insurer
Ownership
Value
Type
Insurer
Ownership
Value
Type
Insurer
Ownership
Value
Type

ASSETS - Home Contents & Motor Vehicles, Boats & Caravans
HOME CONTENTS
Value
MOTOR VEHICLES, BOATS & CARAVANS
Make/Model/Year
Ownership
Value
Make/Model/Year
Ownership
Value
Make/Model/Year
Ownership
Value
Make/Model/Year
Ownership
Value
Make/Model/Year
Ownership
Value
Ownership
Make/Model/Year
Value

ASSETS - Bank Accounts
BANK ACCOUNTS
Financial Institution
Balance
Type of account
Ownership
Financial Institution
Balance
Type of account
Ownership
Financial Institution
Balance
Type of account
Ownership
Financial Institution
Balance
Type of account
Ownership
Financial Institution
Balance
Type of account
Ownership

ASSETS - Other

Any other assets not previously listed
Asset
Detail of asset
Value
Ownership
Asset
Detail of asset
Value
Ownership
Asset
Detail of asset
Value
Ownership
Asset
Detail of asset
Value
Ownership
Asset
Detail of asset
Value
Ownership
Asset
Detail of asset
Value
Ownership

LIABILITIES - Home Loans & Personal Loans

If you have any current home loans, personal loans, car loans etc please enter the details here
Creditor
Name of financial institution
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Name of financial institution
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Name of financial institution
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Name of financial institution
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Name of financial institution
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount

LIABILITIES - Credit Cards or Store Cards

If you have any current credit cards, store cards etc please enter the details here
Creditor
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount
Creditor
Type of credit
Balance
Ownership
Interest Rate
Limit
Monthly repayment amount

OTHER INCOMES

If you have any additional income (not related to your employment, assets or properties) please enter here. For example family assistance, child support etc
Type
i.e Family Assistance, child support
Amount
Frequency
Ownership
Type
i.e Family Assistance, child support
Amount
Frequency
Ownership
Type
i.e Family Assistance, child support
Amount
Frequency
Ownership

MONTHLY LIVING EXPENSES

Please enter the amount of your monthly living expenses for the following categories
Utilities & Rates
Owner occupied
Utilities & Rates
Investment
Telephone & Internet
Groceries
Clothing & Personal Care
Insurance
Including home & car
Medical & Health
Excluding Health Insurance
Transport
Including fuel & registration
Education
Childcare
Health Insurance
Recreation & Entertainment
Miscellaneous
Other - (not listed above)

Goals & Objectives

Please list your top 5 Goal & Objectives with a brief description
1. Goal/Objective
2. Goal/Objective
3. Goal/Objective
4. Goal/Objective
5. Goal/Objective

Other Information

Please provide any other information that will assist
Supporting Documents

Browse Files
Documents required but not limited to: payslips, loan statements (including home loans & personal loans), card statements, transaction account statements, rates notices, drivers licence, birth certificate, passport, medicare card Cancelof
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Client Fact Find

MAIN APPLICANT'S PERSONAL DETAILS

SECOND APPLICANT'S PERSONAL DETAILS

Dependents

Assets - Real Estate

ASSETS - Superannuation & Insurance

ASSETS - Home Contents & Motor Vehicles, Boats & Caravans

ASSETS - Bank Accounts

ASSETS - Other

LIABILITIES - Home Loans & Personal Loans

LIABILITIES - Credit Cards or Store Cards

OTHER INCOMES

MONTHLY LIVING EXPENSES

Goals & Objectives

Other Information