PERSONAL CLIENT INFORMATION DETAILS

The contents of this document shall remain confidential.

Name:
Age: Marital Status: Citizenship:
Address:

Name of Real Party in Interest: _____________________________________________

Relation to the Real Party in Interest: ________________________________________
Financial Capacity Assessment
Complete this section only if you intended to retain or be represented by a lawyer.

Annual Income Compensation Option

Employer:

No. of Years Employed:

Salary Range:

Annual Income Option

Business Name:
Annual Gross Income:
Details of Bank Statement:
Name of Account: Bank:
Main Source of Fund:
Details of Loan:
Name of Loan Holder: Bank:
Loan Collateral:
Mortgage Attached (If applicable):
Others:

I declare that, to the best of my knowledge and belief, the information herein is true and
complete. All information provided above is freely and contentiously given by me personally, in
lieu of a possible engagement of a lawyer. I understand this statement may be made for use
as evidence in court and is subject to penalty for perjury.

_________________________________
Client
Date:_________