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Financial
Health Check
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APPLICANT
1
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APPLICANT
2
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Name:* |
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E-mail Address : * |
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| Date
of Birth: * |
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No. of Children: (if
any)
- Ages:
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| Gross
Income : * |
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Existing Mortgage:
(name of institution)
- Outstanding Amount
- Monthly Repayments
- Term Remaining
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Other Loans
e.g. Car, Visa
etc.
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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| Existing
Life Policies: name of company. |
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(1)
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Life Cover: amount
of life cover (if any).
(Type,
Company, and/or Policy Number)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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Serious Illness: amount
of serious illness cover (if any).
(Type,
Company, and/or Policy Number)
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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Salary Protection: amount
of salary protection (if any).
(Type,
Company, and/or Policy Number)
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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Existing Savings Policies:
e.g. PIP, PEPS.
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Regular Savings:
(Type,
Company, and/or Policy Number)
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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Pension:
(Type,
Company, and/or Policy Number)
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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Lump Sum Investment:
e.g. Post Office, Credit Union, Bank or Insurance Company.
(Type,
Company, and/or Policy Number)
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(1)
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(1)
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| (2)
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(2)
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| (3)
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(3)
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| *
these fields are required |
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