Pension Health Check - Pre-Meeting Information Form

Prior to your consultation, we ask that you take some time to prepare some background information but also to think about your retirement.

We want to ensure you get as much value as possible from your Pension Health Check. The information you provide will enable us to make the
discussion relevant and practical for you, so we suggest you put aside 30 mins to prepare. Please complete this form to the extent you can.

Name

Date of Birth

Employment Status
Think about how this may change between now and
retirement.

Target Retirement Date - scenario 1

You may want to consider more than one retirement age or
partial retirement.

Target Retirement Date - scenario 2

Income
The income we currently receive is usually a good starting point for the income we will need in retirement. Please make a note of your current
annual income; remember to include all sources of income such as salary, rental income, benefits etc. We can then use this as a starting point to
discuss your income requirements once you retire.

Main source of income Investment Income Other income

(Employment, pension etc.) (Rental, dividends, interest) (Benefits etc.)

Gross Income £ /per year £ /per year £ /per year

Outgoings
Similar to income, your current outgoings are a good indicator for what you will need to be paying for once you retire. Some outgoings may no
longer be applicable once you retire but may be replaced by other expenditure. The following table may help you assess your current outgoings.

How much do you pay? Per year Anyone else contribute? How much? Per
year

Mortgage, Rent & Insurance

including repairs & maintenance

Personal Loans & Credit Cards

Council Tax & Utilities

gas, water, electricity, TV, phones etc.

Travel & Car

car costs, fuel, insurance, public transport

Household, Leisure & Gifting food, drink, furnishings,

hobbies, gym, birthdays, Christmas

Child Care nursery, clubs, education, childminder etc.

Regular Savings ISA, investments, pensions

Other any other regular expense

Total
Pensions
You will need to pull together the current fund values for all your pensions. You may want to jot down the details below so that they are to hand
for your consultation.

Pension 1 Pension 2 Pension 3 Pension 4

Pension Provider

Current Value / Transfer Value

Valuation Date

Regular Contributions (monthly)

Assets - Property and Investments/Savings

Retirement planning isn’t just about pensions. You may have other assets that you can use to supplement your retirement income.

Property
One of our biggest assets and largest outgoing is our home. Prior to the consultation, you may want to consider any changes you plan to make for
your property. Please make a note of the details below.

Main home Other property Other property Other property

Who does it belong to?

your asset or jointly owned

Current Value

Valuation Date

Is there a mortgage, how much?

Years left on the mortgage, how many?

Investments/Savings
Think about all your assets and investments: these may be savings in deposit accounts, ISAs, bonds, shares, OIECs. Make a note of them below but
also consider what plans you have for these investments.

Asset 1 Asset 2 Asset 3 Asset 4

Who does it belong to?

your asset or jointly owned

What is it?
savings account, ISA etc.

Which company is it with?

Barclays, Prudential etc.

Current Value

Regular Contribution?

Income Withdrawals