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Rothgard Financial Partners

Client Brief Form

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Surname*
Given Name*
Middle Name*
Date of Birth
Date Format: DD slash MM slash YYYY
Country of Residence / Citizenship
Country
Gender
- Male
- Female
- Not Listed
Other Option:
Marital Status
Residential Address
Street Address
Postal Address
ZIP / Postal Code
Preferred Telephone*
Preferred Email Address*
Do you have any health concerns or issues?
Are you a smoker or have you smoked in the past 12 months?
- Yes
- No
Occupation
Employment Income
Other Income (Not Rental)
Do you have partner information to enter?*
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Your Partner's Information
Surname*
Given Name*
Middle Name*
Date of Birth
Date Format: MM slash DD slash YYYY
Country of Birth
Country
Country of Residence / Citizenship
Country
Gender
- Male
- Female
- Not Listed
Other Option:
Marital Status
Residential Address
Street Address
Postal Address
ZIP / Postal Code
Preferred Telephone*
Preferred Email Address*
Does your partner have any health concerns or issues?
Is your partner a smoker or have smoked in the past 12 months?
- Yes
- No
Occupation
Employment Income
Other Income (Not Rental)

Dependant(s) Information
NAME OF DEPENDANT(S) EG. CHILDREN, PARENTS DATE OF BIRTH AGE RELATIONSHIP FINANCIALLY DEPENDANT

Details on your Assets and Liabilities
PROPERTY VALUE LOAN AMOUNT INTEREST RATE MONTHLY REPAYMENT RENT RECEIVED PER WEEK

Other Assets
OTHER ASSETS VALUE LOAN AMOUNT INTEREST RATE MONTHLY REPAYMENT RENT RECEIVED PER WEEK

Superannuation
SUPERANNUATION FUND NAME VALUE CONTRIBUTIONS (IE DO YOU SALARY SACRIFICE OR MAKE ADDITIONAL CONTRIBUTIONS)

Do you have Insurance?
INSURANCE TYPE SUM INSURED OWNER PREMIUM (PER MONTH)

What you are looking to get out of your meeting with us?
Which adviser are you meeting with?*
What is concerning you most about your finances?
What is the biggest issue in your life at the moment?
Why have you now decided it is time to seek a professional adviser?
Receiving documents and providing instructions electronically
We may send documents by the electronic means that you have nominated, including our financial services and credit guides, credit guides, advice documents and product disclosure statements. You can also authorise us to act on instructions we receive from your nominated electronic means and to receive your formal agreement via your nominated electronic means. Communications may be in the form of Email (including scanned documents), Fax, Mobile Phone and tablet devices.
- I am willing to accept documents being supplied electronically as above, including the financial services and credit guide, credit guides, advice documents and product disclosure statement. I also consent to using electronic means to provide instructions, agreement and acknowledgements on documents from time to time using the email address and phone number provided. This applies to all contact details provided on the above form.
Your privacy is important to us and Charter Financial Planning, which is part of AMP. You may request access to your personal information at any time by calling us on 07 3231 4250 or contacting AMP on 1300 157 173. Information collected will be subject to AMP's Privacy Policy. You can also contact us or AMP if you do not wish to receive information about products, services or offers available from us or AMP from time to time.
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Rothgard Financial Partners leadership team – Ross Vanderwolf and Gino Saggiomo have consistently appeared on Beddoes Institute Most Trusted Advisors list since 2013.

Disclaimer
Rothgard Financial Partners Pty Ltd ABN 74 105 595 364 trading as Rothgard Financial Partners
is an authorised representative and credit representative of Charter Financial Planning
Ltd ABN 35 002 976 294, Australian Financial Services Licence and Australian Credit Licence No. 234665.

This website contains information that is general in nature. It does not take into account the objectives,
financial situation or needs of any particular person. You need to consider your financial situation
and needs before making any decisions based on this information.

Google Rating

5.0

Rothgard Financial Partners Pty Ltd

5.0

Jon Hollenberg

04:30 18 Jun 18

My wife and I have been working Gino and Justin for over 4 years now. We started with some simple budgeting advice and have evolved to a full blown financial advice. Awesome bigger picture strategy coupled with consistent execution means we have been able to make some big shifts over the past few years thanks to the help of Rothgard.

Chris Price

00:42 05 May 17

Belinda and David are the nicest people to deal with,and speak in terms that we understand,it doesn't matter to them whether you have Millions or Hundreds they treat you the same and make you feel so Special,and Belinda is just a Sweetie.Thank you Rothgard for having such great people. Chris and Howard.

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NAME OF DEPENDANT(S) EG. CHILDREN, PARENTS	DATE OF BIRTH	AGE	RELATIONSHIP	FINANCIALLY DEPENDANT

PROPERTY	VALUE	LOAN AMOUNT	INTEREST RATE	MONTHLY REPAYMENT	RENT RECEIVED PER WEEK

OTHER ASSETS	VALUE	LOAN AMOUNT	INTEREST RATE	MONTHLY REPAYMENT	RENT RECEIVED PER WEEK

SUPERANNUATION	FUND NAME	VALUE	CONTRIBUTIONS (IE DO YOU SALARY SACRIFICE OR MAKE ADDITIONAL CONTRIBUTIONS)

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Rothgard

Get In Touch

Client Brief Form

Step 1 of 7

Your Partner's Information

Dependant(s) Information

Details on your Assets and Liabilities

Other Assets

Superannuation

Do you have Insurance?

Receiving documents and providing instructions electronically