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AVALONfs Pty Ltd ABN 43 162 297 298

Australian Financial Services License no. 437518

Client Profile
This is an important and confidential document. The information you have provided within this
document forms the basis of any advice given by your Financial Planner.

Name of Client (1)

Name of Client (2)

Prepared by
Glen Killen
Planners business address
22 The Mainsail, PORT MACQUARIE NSW 2444
Telephone number Mobile number
1300 201 087 0437 863 422
Facsimile number Email address
1300 848 718 glen@strategyfc.com.au
Location of interview

Page 1
Personal Details
Personal details Client 1 Client 2
Client Identifier

Title (eg Mr, Ms)

Surname

Given Names

Preferred name

Marital status

Date of birth

Relationship between Client 1 & 2

Residential Address

Business Address

Postcode Postcode

Postal address

Postcode Postcode

Home telephone no.

Business/Mobile no.

Facsimile no.

Email address

Employment mode Self-employed Part-time Self-employed Part-time


Not working/Retired Full-time Not working/Retired Full-time
Hours worked per week

Employers name

Your occupation

Income tax structure Individual Partnership Individual Partnership


Primary Producer Company Primary Producer Company
SMSF Trust SMSF Trust

Are you an Australian resident for taxation Yes No Yes No


purposes?
If No, what country?

When do you expect to retire? Date: / / Age Date: / / Age

Do you have private health insurance? Yes No Yes No

Health issues: Are there any health issues that need to be considered in making an investment decision? .. Yes No

If Yes, provide details:

Page 2
Dependents
When would you expect
Name Date of birth Relationship dependency to cease?

/ /
/ /

/ /
/ /
English language

You are fluent in the English language? . Yes No


Do you require the assistance of an interpreter? .. Yes No
Third parties

Do you need to consult any of the following in your decision making process? .. Yes No

Name Contact details (include address and phone number)

Family member
Accountant/Tax agent
Banker

Solicitor
Other

Notes

Page 3
Lifestyle and Financial Goals

What is important to you? When How much is


What would you like to achieve? (Time- required in todays
frame) dollars $

Tell us about
your family
needs e.g.
Childrens
education?

Tell us about
your
occupation?

Tell us about
your sports and
leisure,
entertainment
and holidays?

Tell us about
your monetary
needs both long
and short term?

If injury, illness, disability or death were to occur, what impact would this have on your goals and
commitments?
Planning/Protection
Considerations

Do you have an alternative source of income or capital in place if any of these events were to
happen to you and/or your partner? How confident are you that this is adequate for your needs?

If Yes, when was it last reviewed?

Page 4
Family and Asset Protection Goals
In the event of death, illness, accident or disability, which of the following are important to you?

Client 1 Not important Very important Comments

Receiving a lump sum to clear/reduce 1 2 3 4 5 6 7 8 9


debts to relieve financial stress
Receiving a lump sum to assist with 1 2 3 4 5 6 7 8 9
medical expenses and rehabilitation costs
Replacing income in order to maintain your 1 2 3 4 5 6 7 8 9
familys current lifestyle
Client 2 Not important Very important Comments

Receiving a lump sum to clear/reduce 1 2 3 4 5 6 7 8 9


debts to relieve financial stress
Receiving a lump sum to assist with 1 2 3 4 5 6 7 8 9
medical expenses and rehabilitation costs
Replacing income in order to maintain your 1 2 3 4 5 6 7 8 9
familys current lifestyle
In the event of death: Client 1 Client 2
How long would an income be required by your partner?........................... Life of partner Life of partner
Maintain capital Capital drawdown Term yrs Term yrs
How much income p.a. after tax? . $ $
How much is required to clear/reduce debt? ..Home mortgage $ $
Other $ $
Any other capital requirements? ..Education $ $
..Estate Planning $ $
...Childcare/Housekeeper/Nanny $ $
Other $ $
In the event of trauma (eg cancer) or total and permanent disability:
Trauma TPD Trauma TPD

How much is required for medical expenses here/overseas? . $ $ $ $


How much is required to clear/reduce debt? Home mortgage $ $ $ $
.Other $ $ $ $
Any other capital requirements? .Home modifications $ $ $ $
..Education $ $ $ $
.Childcare/Housekeeper/Nanny $ $ $ $
.Other $ $ $ $
In the event of an extended illness or injury: Client 1 Client 2
Do you have an alternative source of income?............................................................. Yes No Yes No
Is this sufficient to maintain your current standard of living?......................................... Yes No Yes No
How many months could you go without your regular income?....................................

Page 5
Please provide the following: Client 1 Client 2
Poor Good Poor Good

What is the state of your health? .. Average Excellent Average Excellent


Are you a smoker?....................................................................... Yes No Yes No
Accrued sick leave days..
Accrued days leave (eg annual leave, long service)..
Do you have salary continuance through superannuation?......... Yes No Yes No
What are the main duties of your occupation?.............................
Are you involved in hazardous pursuits? (If Yes, provide details) Yes No Yes No

Estate Planning
How important is Estate Planning to you? Low Medium High

Personal assets Client 1 Client 2

Will
Do you have a Will? . Yes No Yes No
Is this Will current? ............................................................................................... Yes No Yes No
What is the date of your Will? / / / /
Does your Will include provision for a Testamentary Trust?................................. Yes No Yes No

Power of Attorney
Do you have a current Power of Attorney? . Yes No Yes No
If Yes, please state type: Enduring/Medical/Normal/General/Other ...................

Adequacy and Equity


Will sufficient funds be available to your dependants between your death and
the distribution of your Estate?.. Yes No Yes No
Have you considered capital gains tax on any assets you bequeath directly to
beneficiaries? .....................................................................................................
Yes No Yes No
Superannuation assets

Have you made binding nominations on death? .. Yes No Yes No


If Yes, who? ..

Companies or Trusts

Will your company shares go where you want them to go? ... Yes No Yes No
Has Trustee succession been addressed? ... Yes No Yes No

Social Security
Is access to Social Security important to you?................................................. Yes No

Client 1 Client 2

Are you currently eligible for Centrelink/DVA Benefits? Yes No Yes No

If 'Yes', what benefit/s are you eligible for?...........................................................

Do you have any Centrelink concession cards (PCC, HCC or CSHC)?.............. Yes No Yes No

Have you 'Gifted' assets in the last 5 years?....................................................... Yes No Yes No

If 'Yes', how much and when?...............................................................................

Page 6
Income / Expenditure Analysis
Income Select: Weekly Fortnightly Monthly Yearly
Client 1 Client 2 Joint
Value of salary package
Salary and wages (before tax)
Social security income
Investment income
Annuity/Pension income *
Distributions (eg trusts)
Net business income (eg sole trader, partnership)
Other taxable income
Other
TOTAL

Is any portion of the above income non-taxable? If Yes, provide details.

*Deductible Amount Annuity/Pension


Non-taxable payments 1)
Non-taxable payments 2)
Expenses Select: Weekly Fortnightly Monthly Yearly
Client 1 Client 2 Combined Tax Deductible
Household (rates/utilities/food)
Rent/Home mortgage
Credit Cards
Other debt repayments
Personal
Transport (car(s), fares)
Insurance
Health insurance premiums
Dependants
Entertainment
Education
Investment expenses (regular costs excl.
loan repayments)
Donations
Superannuation
Regular savings plans
Other
TOTAL
Surplus/Deficit

Are your income and expenses likely to changer over the next few years?

Page 7
Personal Balance Sheet
1 Assets $ $ $ Date
Lifestyle: Client 1 Client 2 Joint Purchased Insured

Principal residence / / Yes No


/ / Yes No
Home contents / / Yes No
Motor vehicle / / Yes No
Caravan, boat etc. / / Yes No
Collectibles / / Yes No

Total A
Direct investments: (Totals only please provide details within Current Investments section)
Cash Bank accounts How much cash/liquidity do
Credit Unions you need for unforeseen
circumstances or
Other emergencies?
$
Fixed interest Term Deposits
Debentures
Bonds

Property Real estate What amount do you want


to invest today?
Rental property 0 - 1 year $
Shares 1 - 3 years $
Business Assets 3 - 5 years $
Total B 5 - 7 years $
Managed investments: (Totals only please provide details on page 7) 7 - 10 years $
Unit trusts 10 years + $
Insurance policies Total $
Friendly Society/Funeral Plans
Personal Super Rollovers
Employer Superannuation
Annuities/Pensions
Any other assets

Total C
Total all assets (A+B+C)
OVERALL TOTAL
2 Liabilities
Mthly Repayment
Type Bank/Lender Owner Loan Balance Rate % P&I or Int. only Start Date Term $

Mortgage / /

Investment loan / /

Credit cards / /

Personal loans / /

Business loans / /

Other / /

Net Value
Estimated funds available for investment
Current Investments
Page 8
Please list your bank accounts, debentures, bonds, other investments, or shares which you own at present.
If any are to be sold and reinvested as part of your planned investment arrangements, detail the investments
involved as Sell in the column provided. Accurate details of these investments are essential for full portfolio
and cash flow analysis.
Cash and Fixed Interest Owner Current Value Interest Rate Purchase Term Reinvest Hold/Sell
Investments % pa Date Income
$ % / / Y N

$ % / / Y N

$ % / / Y N

$ % / / Y N

$ % / / Y N

Direct Property Owner Current Value Rental Purchase Purchase Mortgaged Hold/Sell
Investments Income (net) Price Date
$ $ $ / / Y N

$ $ $ / / Y N

$ $ $ / / Y N

Shares and Managed Owner Current Value Asset Purchase Total Reinvest Hold/Sell
Funds Allocation Date Units/Shares Income
$ / / Y N

$ / / Y N

$ / / Y N

$ / / Y N

$ / / Y N

$ / / Y N

Super and Rollover Owner Current Value Asset Annual Type of Start Date Hold/ Super
Rollover Choice
Funds Allocation Contributions Contribution
$ $ / / Y

$ $ / / Y

$ $ / / Y

$ $ / / Y

$ $ / / Y

Pension/Annuity Details Owner Current Value Start Date Term RCV ETP Hold/
Rollover
$ / / Y N

$ / / Y N

$ / / Y N

Savings Plan(s) Owner Amount Start Date Term Frequency

$ / /

$ / /

$ / /

Page 9
Please list your income protection, personal and general insurance which you own at present.
Current Income Protection
Provider Owner Policy No. Monthly Benefit Annual Premium Waiting Period Benefit Payment
Period

$ $
$ $
$ $
$ $
$ $
Current Personal Insurance (Life cover Term, Total Permanent Disablement, Trauma, Whole of Life, Endowment)
Provider Type Life Insured Owner/ Cover Level Annual Premium Surrender Maturity
Beneficiary Value (if any) Value (if any)

$ $
$ $
$ $
$ $
$ $
What assets are to be realized upon death?
Asset Client 1 Client 2

$ $
$ $
$ $
$ $
$ $
Current General Insurance
Asset Insurer Sum Insured Market Value Annual Premium Renewal Date Notes

Family home
Home contents
Motor vehicle 1
Motor vehicle 2
Other
Notes

Page 10
Eligible Termination Payment
Have you, or will you receive an Eligible Termination Payment (ETP)? .. Yes No
Please provide any documentation relating to such payments.
Service Period Client 1 Client 2
Date of rollover/retirement / / / /
Eligible Service Start date / / / /
Composition of ETP
Tax Free Component
ie Concessional component
Pre 1983 component
Non-concessional contributions
Post June 1994 invalidity component
CGT exempt component

Taxable Component
Ie Post 1983 component
(taxed and untaxed)

TOTAL ETP
Compulsory preserved benefit

Non-concessional Contribution Amounts


Non-concessional Contribution amounts that have been contributed to superannuation after 9 May 2006
Client 1 Client 2
Date contributed / / / /
Amount contributed $ $

Date contributed / / / /
Amount contributed $ $

Date contributed / / / /
Amount contributed $ $
Notes

Page 11
Entity Details
Business Details Client 1 Client 2

Business name

Business address

Business structure
Contact person and position

Amount available for investment $ $

Current asset allocation

Partnership, Company
Name of company or trust

Name of Partners, Directors, and/or


Trustees
Shareholders/Beneficiaries

Proportion of ownership/entitlement

Nature of income (tax free, franked,


capital)
Distribution/Dividend rate ($ or %)

Amount available for investment $ $

CGT exempt/rollover amount

Superannuation Fund
Name of fund
Name of trustees

Name of members and age

Date established

Accumulation or pension?

Amount available for investment $ $

Annual contributions

Current investment strategy or asset


allocation

Page 12
Notes

Page 13
Determining your Investment Risk Profile
Important Information
Each individual has different preferences to levels of risk when profile is a good first step and can help determine an investment
investing. Risk is the chance that you may lose your money or plan to achieve your short and long-term investment goals.
that the returns on your investments will vary widely from year The profiling questions are designed to assist you in
to year. determining your investment profile and the type of investor you
Some investors may be prepared to accept higher risk are, based on your personal preferences and life situation. This
investments in search of higher returns while others may prefer information will be used in conjunction with your goals to
lower risk investments. It is important that you determine a level determine an appropriate financial strategy.
of risk you are comfortable with and balance that risk against For couples, each partner should complete this
the returns you are seeking on your investment. Understanding questionnaire separately.
your personal risk

Profiling questions
1. Which of the following best describes your investment experience?
A. I have no investment experience
B. Mainly bank accounts cash, term deposits and/or debentures
C. Cash and some shares (EG Telstra, Qantas) and/or investment property
D. A mix of cash, bonds, various shares, share funds and investment property Client 1 Client 2

E. Australian and international shares and/or share funds, property, venture capital and derivatives

2. Which of the following is important to you when considering investments?


Not important Very important
Client 1 Client 2
A. To avoid any losses ......................................A B C D E
B. To avoid short-term losses ......................................A B C D E

C. Receive regular income from investments ..............A B C D E

D. Long-term growth in the value of investments .........A B C D E

E. Protect against inflation ...........................................A B C D E

3. What percentage of your money would you be prepared to invest in higher-risk investments?
(ie. investments which may fluctuate in value, even incurring short to medium term losses, but may
return higher gains over the longer term.)
A. 0%
B. 10%
C. 30%
Client 1 Client 2
D. 50%
E. 75%

4. How long before you would expect to require access to part or all of your investments?
A. Less than 1 year
B. Less than 3 years
C. Between 3 and 5 years Client 1 Client 2
D. Between 5 and 7 years
E. Greater than 7 years

5. In what form would you prefer your investment returns?


A. Income from interest regardless of tax implications
B. Interest and some income from shares to improve return and reduce tax
C. Interest, income from shares and some capital growth Client 1 Client 2
D. Income from shares and capital growth
E. Mostly capital growth

Page 14
6. Assume that you inherit a reasonable share portfolio valued at $100,000 and you do not need the
money for any other purpose.
Would you:
A. Sell the entire portfolio immediately to avoid any loss in value?
B. Sell 75% and place the money in more conservative investments? Client 1 Client 2
C. Sell 50% and place the money in more conservative investments?
D. Sell 25% and place the money in more conservative investments?
E. Keep the entire share portfolio but move to more conservative, dividend paying shares?

7. Are you prepared to accept the possibility of a negative return at any time in exchange for
potentially higher long term returns? The more often you experience a negative return, the greater
the investment volatility.
A. Yes. One negative year in every 10 years
B. Yes. One negative year in every 7 years
Question 7 considered that all of your funds were at risk for
C. Yes. One negative year in every 5 years the entire period, what percentage (if any) would you be Client 1 Client 2
prepared to place into a single category or multiple
D. Yes. One negative year in every 3 years categories as per question 7.
E. I am not prepared to accept any negative returns A B C D E
% % % % %

8. Assume your long-term investments dropped in value by say 10% or more in one year, how would
you react?
A. You cannot accept any decline in the value of these investments
B. You consider selling and reinvesting elsewhere
Client 1 Client 2
C. You adopt a wait and see approach
D. You expect that your investment will recover in value at some time in the next 1 to 2 years
E. You consider purchasing more

Scoring (Adviser to complete)


Question 1 A 6
Question 3 A 6
B 4 Results Risk Profile
B 5
C 3 17 to 22 High Growth
D 2 C 4
D 3
E 1 23 to 28 Growth
E 2
29 to 33 Balanced
Question 2
Question 4 A 6 34 to 40 Conservative
Part A A 1
B 5
B 2 41 to 49 Defensive
C 4
C 3 D 3 50 to 60 Defensive (high cash and
D 5 E 2 fixed)
E 6
Question 5 A 7 >60 Cash or cash equivalents
Part B A 2
B 3 B 6
C 4 C 5 Indicative Risk Profile
D 4
D 5
E 2 Based on your total score, your Indicative risk profile has been
E 6
assessed as follows:
Part C A 1 Question 6 A 6
B 2 B 5 Client 1 TOTAL SCORE:
C 3 C 4
D 4 D 3
E 5 E 2 Indicative Profile:
Part D A 5
Question 7 A 4
B 4
B 3 Client 2 TOTAL SCORE:
C 3
C 2
D 2 D 1
E 1 Indicative Profile:
E 6
Part E A 5
B 4 Question 8 A 6
C 3 B 4
D 2 C 3
E 1 D 2
E 1

Page 15
Explanation of Return/Volatility

Growth Shares
and MIS EG
Hedge funds etc
Defensive shares,
balanced MIS

Cash, cash trusts and


government bonds

Over the years, your capital and income are expected to rise and fall.
At times, this value may fall below the value of your initial investment.

Adviser Notes
Adviser notes of discussion about risk profiling, client(s)' investment time frame and objectives:

Page 16
Additional Information
High Growth is a portfolio of investments predominantly in Australian and international shares. Due to the
inherently high levels of volatility associated with these asset classes this portfolio is suited to
people with an investment horizon of at least 7 years. This type of portfolio is unsuitable for
clients requiring high levels of income from their investment
Growth is a diversified portfolio of investments in mainly the more aggressive asset classes of
Australian and international shares. The capacity for capital volatility in this portfolio makes it
more suitable for investors with a long term investment time frame of more than five years. It is
not suitable for investors requiring an income return from the portfolio.
Balanced is a balanced portfolio of investments with a moderate tilt towards the more aggressive asset
classes of Australian and international shares. The portfolio is designed with a long term time
horizon of five years or more. It will exhibit some volatility in the short term.
Conservative is a balanced portfolio of investments taking in all normal asset classes. This portfolio will aim
to achieve a satisfactory market related return over the longer term (at least five years) with
potential for moderate capital volatility in the shorter term.
Defensive is a portfolio containing core investments which have a bias towards security of capital.
Normally less than half the portfolio would be placed in property and Australian and overseas
share investments. These components give added capacity for capital growth over a period of
three to five years but will also entail some short term capital volatility.
Defensive (low Risk) is a portfolio of diversified investments with the emphasis on cash and fixed interest. Growth in
portfolio value can be mainly achieved by accumulating income. There is potential for low
capital volatility. A low exposure to shares of up to 25% of the portfolio can be considered.
Cash Only is a portfolio held exclusively in cash and cash equivalents such as short term deposits and / or
Government bonds that will provide security of capital and a regular stable income.
Capital growth in the portfolio may only be achieved by reinvesting income.

Based on our discussions, you confirm your risk profile to be:


Client 1 Client 2

Please ensure the agreed risk profile is correctly transferred to the Authorisation page.

Volatility

Page 17
Authorisation
I/We have received a copy of the FSG at the first interview and have read and understood it, including the section titled
Respecting Your Privacy. I/We agree to Avalon collecting, using and disclosing my personal information in accordance with
the Privacy Policy.
I/We will inform any other individual, such as dependants, spouse, partner, that I/We have provided information about them
and make them aware of the information provided in the Privacy Policy.
I/We request that you provide financial advice based on the information disclosed and acknowledge that you will rely on the
information contained in this document.
Basis of Advice
Full Advice
Provide details if not full advice
Limited to Client Need

Limited to Product(s)
Limited Advice (incomplete information)

Important information about your risk profile


It is essential that you review your profile carefully to ensure that it reflects your attitude to investment. If it does not, you
must bring this to the attention of your adviser. You should also consider whether your response to the questions do in
fact reflect your attitude. It is important that you answer the questions as accurately as possible.
The risk profile is only indicative of your overall attitude to investment. It is always important to consider the
appropriateness of an investment to your circumstances prior to proceeding.
Your risk profile may change over time and should be reviewed before making investment decisions in the future.

I/We confirm the risk profile of


(client 1) and (client 2)

as agreed in Determining Your Investment Risk Profile.

I/We declare that I/we am comfortable with the risk profile that I/we have been assigned and I/we understand that this will be
used to assist Avalon in determining an appropriate financial strategy for me/us.

I/We acknowledge that you will charge a fee of $ for the written advice.

On completion of this advice document, I authorise you to :

Bank the attached cheque

Other (please specify)

Signature Client 1 Date

/ /

Signature Client 2 Date

/ /

Signature Financial Planner Date

/ /

The following documents have been supplied:

Bank/Investment/Superannuation Statements
Insurance Policies
Tax Returns

Financial Statements

ETP Statements

Page 18
Client Authorisation for Additional Information
from other Institutions or Advisers
To whom it may concern
I/We

of

request that all information relating to my investments, insurances, superannuation, bank accounts or other
financial information be released to the AVALONfs Pty Ltd AFSL: xxxxxx on request.
Please forward the requested information to the representatives address as per the attached business card.

Yours faithfully

Signature Client 1 Date


/ /

Signature Client 2 Date

/ /

Page 19
Investment Replacement Checklist
Planner Date

Client Name

Contact name and number


Name of Investment Provider
Product name
Type of fund Cash Unit Trust Mastertrust Wrap Other
Policy owner(s)
Commencement date / /
Current balance $ Units
Surrender value $
Fees ($ amount/%) Current Proposed
Entry
Exit
MER
Buy/Sell
Admin
Adviser Fee
Other
Will the replacement result in:
Capital loss on initial investment Yes $ No

Duplication of entry fees


Yes $ No
Capital gains tax liability
Yes $ No
Loss of taxation benefit - break of
125% contribution rule (Ins.Bonds) Yes $ No
Adjustment to Centrelink benefits
Yes $ No
Any other taxation implications
Yes $ No
Investment Allocation Current Proposed

If replacing an existing Avalon fund,


has business rules been applied in
regard to charging of duplicate fees?
Benefit to client(s) of replacing
policy(ies)

Page 20
Insurance Replacement Checklist
Planner Date

Client Name

Contact name and number


Name of Insurance Provider
Product name
Type of cover Accidental death Ordinary Super
Life Insured
Policy Owner(s)
Commencement date / /
Type & Sums Insured Current Proposed
Death $ $
TPD (Any/Own/Home duties) $ $
Living $ $
Income Protection
Occupation Category Waiting period Waiting period
Benefit period Benefit period

Will the replacement result in:


Increased premium/policy fee Yes $ No

Health loadings
Yes $ No
Loss of loyalty discount
Yes $ No
Loss of benefit
(eg suicide exclusion) Yes $ No
Loss of bonus (eg Whole of life or
Endowment policies) Yes $ No
Surrender Value (if there is an
investment value) Yes $ No
If replacing an existing Avalon policy, is
there an option to increase/decrease
the existing policy?
(Note: some older policies have more
favourable terms than the newer
policies)

Page 21
Superannuation Replacement Checklist
Planner Date

Client Name

Contact name and number


Name of Superannuation Provider
Product name
Type of fund Employer Personal Industry
If employer fund, is it Defined Benefits Accumulation
Membership Number and / /
Commencement Date
Current balance $ Units
Surrender value $
Tax free component, ie concessional,
Pre 1983, Non-concessional, Post-
June 1994, Invalidity, CGT Exempt
Taxable Component ie Post 1983
- Taxed and untaxed
Compulsory Preserved Benefit
Investment Allocation Current Proposed

Beneficiaries (Name and %)


Death Benefit $ Premium $
TPD Benefit (Any/Own Occupation) $ Premium $
Salary Continuance Benefit $ p.m. Waiting period
Benefit period Premium $
Fees ($ amount/%) Current Proposed
Entry
Exit
MER
Buy/Sell
Admin
Adviser Fee
Other
Will the replacement result in:
Capital loss on initial investment Yes $ No

Duplication of entry fees


Yes $ No

Loss of employer provided


insurance eg. Death/TPD and Yes Please provide details No
salary continuance

Has replacement been recommended

Page 22
If Defined Benefit, has pension Provide details
option been explored?
Change in preservation status
Yes $ No

Any impact on Centrelink benefits


Yes Please provide details No

If switching an allocation pension,


will this have any impact on Yes Please provide details No
deductible amounts?

Any other implications if replacing


an existing policy, has business Yes $ No
rules been applied in regard to
charging of duplicate fees?
Benefit to client of replacing policy(ies)

Further notes if required on next page.

Page 23
Notes

ABN

ABN number

SFN

Super Fund Number (SFN)

Tax File Number

Client 1 Client 2

Page 24

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