Client questionnaire phone appointment form

Please complete and submit this form prior to your appointment. 1

If you are seeking specific non-Australian Retirement Trust or more complex advice, we can arrange a referral with a specialist advice partner (fees may apply).²

APPOINTMENT DATE AND TIME

Please confirm your appointment date and time (refer to your confirmation email).

If your appointment has not been confirmed, please contact us on 13 11 84 before completing this form.

Appointment date: Appointment time:

PERSONAL DETAILS

Member number Find member number

Member first name

Member last name

Gender

Male Female Prefer not to say

Member date of birth

At what age would you like to retire?

Occupation

Work status

Member income

Member before-tax salary/wages (p.a.)

Member other income (eg. Age/Lifetime pensions, rental income etc).

Do you have a partner?

Yes No

PARTNER DETAILS

*Please make a selection if applicable - whether your partner is a Australian Retirement Trust member or not.

Partner member number (if applicable) Find member number

Partner first name

Partner last name

Gender Male Female Prefer not to say

Partner date of birth

Partner retirement age

Occupation

Work status

Partner income (if applicable)

Partner before tax salary/wages (p.a.)

Partner other income (eg. Age/Lifetime pensions, rental income etc).

Children or other dependants

Age of children or any other dependants

Main region