Professional Documents
Culture Documents
Name
Client
Spouse
Child 1
Child 2
Dependant Father
Dependant Mother
AVL
Outstanding
Liabilities
Home loan
Car loan
Personal loan
Other loan
Amount
Total
Description
(indicative list)
Emergency Fund
First Child Graduation
First Child Graduation (PG)
Second Child Graduation
Second Child Graduation (PG)
First Child Marriage
Amount to be
provided in Today's
Value (Rs.)
Life Assured
Type
Example of types are endowment, money back, term, ULIP, ULPP, etc. If it is a pension plan, i
Please provide a copy of your policy documents. Surrender value and current fund value are t
Notes by financial planner and Client
Member Covered
Type
Personal Information
DOB
Age
A
B
* A*12
Assets
Living house
Building/Land
Gold
Expected year of
usage
Cash in Hand
FD/Bond/NCD
EPF/PPF
Equity
Mutual FUNDS
Total
Asset mapping
Name of Plan
ULIP, ULPP, etc. If it is a pension plan, indicate which payout option has been choosen, example defin
ender value and current fund value are to be provided seperately, they are not available in the policy d
GENERAL INSURANCE
Start Date (dd/mm/yy)
Name of Plan
nce Details
Plan
Sum
Assured
(`)
Rider
Sum
Name Assured
(` )
Policy
Term
Premiu
Premiu
m
m
Frequen
paying
cy
Term
(M/Q/HY/Y)
n has been choosen, example defined benefit for 5 years, 10 years, etc.
hey are not available in the policy documents.
INSURANCE
Name of Plan
Sum
Assured
(`)
Rider
Name
Sum Assured
(` )
Premiu
m
( `
)
Current
Surrend
Premiu
Fund
er Value
m ( ` ) Value ( `
( `)
)
Renewal
Special Features
Date
(dd/mm)
10
Scheme Name
Instrument Name
Sum
Current Value
Invested
(` )
( `)
Maturity Value
(` )
Instrument Name
Sum
Current Value
Invested
(` )
( `)
Maturity Value
(` )
Equity shares
Bank fixed deposits
Accumalated EPF
Gold
Cash at Bank
Types of investments: Equity Shares, ESOP's, PMS, Accumulated EPF, PPF, Post Office Time Deposit
Deposits, Recurring Deposits, Capital Gain Bonds,Infrastructure Bonds, Physical Gold, Gold ETF, Jew
13
Asset
Available for
Plan (Y/N)
rtfolio statement
12
INVESTMENTS DETAILS
Interest
Rate (%)
Start /
Deposit Date
(dd/mm/yy)
Maturity
Date
(dd/mm/yy)
Tenure
(Yrs/
Months)
Asset
Available for
Plan (Y/N)
Interest
Rate (%)
Start /
Deposit Date
(dd/mm/yy)
Maturity
Date
(dd/mm/yy)
Tenure
(Yrs/
Months)
Asset
Available for
Plan (Y/N)
Y
Y
Y
Y
Y
F, Post Office Time Deposits, Post Office MIS, NSC, KVP, Bank Fixed Deposits, Company
Physical Gold, Gold ETF, Jewellery, Cash/Bank, Contingency Fund,etc.