MDL Financial Services Limited

CONFIDENTIAL FACTFIND SHORT FORM

 

 

How was contact made?
_____________________________________________________________
Name
 ____________________________

Date of Birth

____/____/____
Spouse
 ____________________________

Date of Birth

____/____/____
Address
 ____________________________

Telephone

__________________________

 

 ____________________________

Email

__________________________

 

 ____________________________

 

 
Gender:
 Male      Female    

Are you a smoker?

 Yes       No      

Are you Employed/Self Employed?

______________________________

Have you Income Protection?

Yes       No      

Have you a Pension Arrangement?

Yes       No                    Company / Personal

Lump Sum on Death from Pension Scheme?

Yes       No                   

Have you any Life Cover?

Yes       No                   

Have you any Serious Illness Cover?

Yes       No                   

Your Investment/Savings Experience:

Bonds       SSIA       Bank       Other   

Your attitude to Risk:

HIGH       MED       LOW      NO RISK 

What financial Advice are you seeking?

___________________________________________

Have you any specific priorities?

___________________________________________

DECLARATION
I/We confirm that MDL Financial Services Ltd has permission to contact me/us to discuss the above details. I/We have seen a copy of the Terms of Business letter. I/We understand that any recommendations made by MDL Financial Services Ltd are based on the information disclosed by me/us and the suitability to my/our needs of the products of the Life Companies and Lending Institutions. I/We understand MDL Financial Services Ltd may not offer financial advice on the products of Life Companies and Lending Institutions with whom it does not hold a letter of appointment. I/We understand that MDL Financial Services Ltd may require additional information to carry out a full financial review.

Signed: _______________________________________________________________________

OR Alternatively: I/We confirm that it is not my/our wish to have a Confidential Factfind completed as I/We only require information / advice on the following:
______________________________________________________________________________

Signed: _______________________________________________________________________

                                                              

MDL Financial Services Ltd is regulated by the Financial Regulator.