Assumptions:

-          A younger individual can generally afford to take more risk.

-          An individual with a spouse and/or dependants should have a more conservative approach to investments.

-          An individual with an existing investment portfolio can generally afford more risk.

-          Individuals with a secure source of income can afford to take more risk.

-          An individual who is healthy can generally afford more risk than one who may not be in good health.

-          High net worth individuals can afford more risk than medium to lower net worth individuals.

-          The longer the investment term, the lower the risk associated with the investment.

-          It is recommended that an investor has the equivalent of 3 month’s income readily available for emergencies.
 

1.  Age of individual

20 – 30

A

31 – 40

B

41 – 50

C

51 – 60

D

60 +

E

2.  Marital status

Single

A

Married

B

Divorced

C

Separated

D

Widowed

E

3.  Number of dependants, if any

None

A

1

B

2

C

3

D

4

E

5 +

F

4.  Current value of your investments

Less than R100 000

A

R100 001 – R150 000

B

R150 001 – R250 000

C

R250 001 – R500 000

D

More than R500 001

E

5.  Source of income

Employment

A

Self employed

B

Retired

C

6.  How will your income grow in relation to inflation?

With inflation

A

Less than inflation

B

More than inflation

C

Uncertain

D

7.  What is the proportion of your spouse’s income     to yours?

None

A

25%

B

50%

C

75%

D

100%

E

8. How would you rate your health against the    average for your age?

Average

A

Better

B

Worse

C

9. What is your current net asset value?

Less than R100 000

A

R100 001 – R500 000

B

R500 001 – R1 Million

C

More than R1 Million

D

10.  How much do you currently have invested in        Unit trust funds, bank accounts, fixed deposits, shares, single premium policies, etc?

Less than R20 000

A

R20 001 – R100 000

B

R100 001 – R500 000

C

R500 001 – R1 Million

D

More than R1 Million

E

11.  What experience of investments do you have?

I have never invested

A

I invest, but do not follow performance

B

I follow performance, but rely on my adviser

C

I manage my own portfolio

D

12.  Are you prepared to take more risk in order to
       achieve a higher return?

No

A

I would risk 10% of my capital

B

I would risk 25% of my capital

C

I would risk 50% of my capital

D

13.  How well do you understand financial markets        & investments?

I am an experienced investor

A

I understand basic financial matters

B

I fully understand financial matters

C

I don’t understand financial matters

D

I know very little about financial matters

E

14.  How do you feel about taking investment risk?

I must maintain capital value

A

I want capital stability but with a fair return

B

I accept a small degree of risk with good returns

C

I accept the risk but it must be diversified

D

I want the highest returns regardless of risk

E

15.  When do you want to start drawing on this
       investment?

0 – 3 yrs

A

3 – 5 yrs

B

5 + yrs

C

16.  How well do you think your existing retirement
      investments will perform?

With inflation

A

Less than inflation

B

More than inflation

C

17.  Do you have sufficient liquidity to cover
      emergencies?

Definitely, yes

A

Yes

B

Not enough

C

Definitely not

D

Date of completion

Client name

ID Number

Financial Adviser

Brokerage

Question 1

Answer

Score

Question 7

Answer

Score

Question 13

Answer

Score

A

5.4

A

0

A

10.2

B

4.3

B

2.3

B

7.6

C

3.2

C

3.5

C

5.5

D

2.1

D

4.8

D

3.4

E

1.5

E

6.2

E

1.1

Question 2

A

4.5

Question 8

A

5.1

Question 14

A

3.3

B

0.8

B

7

B

5.4

C

2.5

C

0.9

C

6.9

D

3.1

D

8.6

E

0.8

E

10.3

Question 3

A

4.5

Question 9

A

1.6

Question 15

A

2.5

B

1.8

B

3.9

B

5.6

C

2.2

C

5.1

C

8.3

D

3.1

D

6.7

E

1.1

F

0.4

Question 4

A

2.7

Question 10

A

0.4

Question 16

A

6.3

B

5.1

B

1.6

B

9.9

C

7.1

C

3.3

C

4.4

D

8.8

D

5.6

E

10.5

E

7

Question 5

A