Wealth Planning – Christian du Preez

Full name

ID number

Tax number

Sex

Male Female

Are you a smoker?

Yes No

Do you participate in any hazardous hobbies or sports?

Yes No

Hobbies or sports

Do you have any financial dependents?

Yes No

Full names and birthdays of all dependents as per their IDs

Primary cellphone number

Primary email

Marital Regime

Single Married in community of property Married out of community of property with accrual Married out of community of property without accrual Divorced Widowed

Maiden name

Spouse's full name

Spouse's gross annual income (before tax and deductions))

Spouse's ID number

Highest education level achieved

No matric Matric Diploma (3 years or more) Undergraduate degree Postgraduate degree

Employer

Occupation

Nature of duties

Do you participate in a pension/provident fund?

Yes No

Net monthly salary (after tax and deductions)

Other income (monthly)

Total average monthly expenses

Cash across all bank accounts

Do you own your primary residence?

Yes No

Value of primary residence

Do you have a bond on the property?

Yes No

What is the amount outstanding on the bond

Do you own your primary residence?

Yes No

1. Personal

2. Financials

3. Priorities

Personal & Contact Details

First Names

Surname

ID Number

Smoker

Personal Email

Cell Number

Net Income and Monthly Expenses

Please provide a breakdown of your current cash flow.

Net Salary (Monthly)

Other Income

Bond / Rent

Groceries

Your Priorities

Rank the following from 1 (Most Important) to 3 (Least Important).

Death Cover

Retirement Planning

What is the financial commitment you are willing to make for these solutions?