SimWealth Get to Know You Form

SimWealth Let's Get To Know You Form - Individual Investors

Personal Details
Personal details section. Kindly furnish us with your personal details as accurately as possible.
Client Type*
Names*
Prefix First Middle Last
Gender*
- Male
- Female
Date of Birth*
Marital Status*
Please indicate your marital regime
Date of marriage
Spouse Full Name*
First Last
Nationality*
ID/Passport number
Tax Number
Education
Name of Institution Qualification Obtained/Progress
Employment Status
Employment Details
Name of Employer Occupation Industry
Dependants
Name and Surname Relationship Date of Birth Special Provisions

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Contact Details
Mobile*
Work number
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Banking Details
*Optional (Not a requirement)
Name of Bank
Account Holder's Name
Account Number
Branch Name
Branch Code

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Assets, Liabilities, Equity/Net-worth
Saving, Investments and Risk Policies
Investment/Policy Name Contributions Current Market Value

Please provide a list of the financial assets you may have, inclusive of your investment and savings accounts. All risk insurance policies such as life cover, disability cover, severe illness.
Employee Benefits Details - Retirement Savings
Fund Type (Provident/Pension/Retirement) Employee Contributions Employer Contributions Latest Fund Value

Please kindly indicate any employment benefits you receive from your employer. i.e Pension, Provident or Retirement fund.
Employee Benefits Details - Group Life Cover
Cover Type Employer Contributions Employee Contributions Cover Amount or Cover multiple

Please indicate the risk covers your employer has provided you with as part of your employee benefits. i.e disability cover, severe illness cover, life cover.
Assets
Type of Asset Acquisition Date Market Value Acquisition Cost

These are your physical assets, inclusive of your motor vehicle, primary residence and investment property. Any capital asset you may own.
Liabilities
Type of Credit Name of Creditor Repayments Outstanding Balance Interest %

Please include all of your credit information in this section, this is inclusive of your bond, vehicle financing, credit cards, short-term loans, student loans. Kindly note that the interest rate information is vitally important, and should be as accurate as possible.
Sources of Income
Source of Income (Salary/Property/Business) Amount before tax Amount after tax

Please include all your income sources such as your salary, rental income and business income.
Monthly expenses
Expense Amount

These are all of your living expenses, including groceries, entertainment and transportation. You may exclude payments made to creditors and capital assets.
Disposable Income
Source of Income Amount

Please indicate your disposable income after taking into account all your expenses. i.e (All income less all expenses).

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SimWealth Get to Know You Form

SimWealth Let's Get To Know You Form - Individual Investors

Step 1 of 4 - Investor Details

Personal Details

Contact Details

Banking Details

Assets, Liabilities, Equity/Net-worth

Financial Planning Services

Name of Institution	Qualification	Obtained/Progress

Name of Employer	Occupation	Industry

Name and Surname	Relationship	Date of Birth	Special Provisions

Investment/Policy Name	Contributions	Current Market Value