CONFIDENTIAL FACT FIND FORM - ggldc.com€¦ · GLOC- Confidential Fact Find Form pg. 1 Core Values Guardian Group’s core values are the guiding principles of the organization’s

CONFIDENTIAL FACT FIND FORM

GLOC- Confidential Fact Find Form pg. 1

Core Values

Guardian Group’s core values are the guiding principles of the organization’s culture that inform our interactions with every stakeholder of the organization. The Group’s core values are aligned to our business aspirations; they represent the quality and character of our organization and reflect our leadership position in our industry.

Serving People: The willingness to go the extra mile to serve both internal and external customers

Trust: The essence of the insurance promise and is rooted in everything we do

Integrity: The pride in being viewed as a person who walks the talk, is seen as a professional,

whose actions are based on the highest code of standards or values.

Quality: The ability to consistently meet / exceed customers’ needs and expectations


PROSPECT/CLIENT FIRST NAME: PROSPECT/CLIENT LAST NAME:

TELL ME ABOUT YOU, YOUR DREAMS AND YOUR GOALS

Response:

What is your opinion on insurance?

Have you had any experience with insurance in the past?

If a financial advisor took a look at your current situation, what will they see?

What are your future goals?

What is the one goal you want to achieve the most?

How close are you to accomplishing those/this goal(s)?

Are you happy with your savings thus far? If not, kindly explain

What do you want to achieve for your family today?

• Next Year

• In five years

• In ten years

What are your retirement plans?


What is your number one financial priority?

Additional Comments/Notes


Insurance Advisor Name: Date:

PERSONAL INFORMATION (OBJECTIVE DATA GATHERING)

Last Name: First: Middle:

Mr. Ms. Mrs. Dr. Marital Status: Mar. Sing. Div. Other

Are you known by any other name?

Other name? Maiden Name (if applicable):

Date of Birth: Age: Sex:

Yes No M F

If Married: Spouses Name: Spouses Date of Birth: Spouses Current Age:

Home Address: ______________________________________________________________________________________________________________________________________________________

Home Phone No.:

Email Address: Mobile Phone No: Tobacco Use:

Main Applicant: Y N Spouse: Y N

EMPLOYMENT INFORMATION

Your Occupation: Your Employer: Your Employer phone no.:

Your Employer Address: __________________________________________________________________________________________________________________________________________________________

Current Income:

Spouse Occupation: Spouse’s Employer: Spouse Employer Phone No:

Spouse Employer Address: __________________________________________________________________________________________________________________________________________________________

Current Income:

CHILDREN AND DEPENDANTS INFORMATION

NAME DATE OF BIRTH CURRENT AGE CHILD OF WHOM

OTHER DEPENDANTS (Siblings, parents etc.)

NAME DATE OF BIRTH CURRENT AGE RELATIONSHIP


FAMILY INCOME How important is it to you to put a provision in place to take care of your family in the event of your untimely death?

How much will they need monthly?

MORTGAGE LIQUIDATION Do you have a mortgage? Y N

If yes, In the event of your untimely death will your mortgage be paid off?

If no, Does it concern you?

• Balance of your mortgage $$

• Years Outstanding

Years

In the event you succumb to a major illness or accident causing you to be disabled, will your mortgage be paid off?

If No – Does it concern you?

• Balance of your mortgage $$

• Years Outstanding

• Years Notes:

EXISTING LIFE INSURANCE/CRITICAL ILLNESS POLICIES

INSURANCE COMPANY PREMIUM/

FREQUENCY SUM INSURED

CASH SURRENDER VALUE

BENEFICIARY(IES)

Please state if the policy is supplied by your current employer:

EXISTING GENERAL INSURANCE POLICIES INSURANCE COMPANY ASSET INSURED SUM INSURED DATE OF RENEWAL LAST PREMIUM PAID


CHILD (CHILDREN’S) EDUCATION Do you have provisions for your child/children’s higher/tertiary education?

Does it concern you?

• How much is needed? $$

• How long from now?

RETIREMENT Is it important to you to put a provision in place for your retirement?

• What Age?

• How Much? $$

• Years

HOME PURCHASE Do you intend to have a home? Or a second home?

• When?

• What Value? $$

MEDICAL EXPENSES How important is it to you to put a provision in place to take care of medical expenses?

• Normal medicals?

• Lump sum benefits?

• If you had a Lump Sum of $$ in a savings somewhere, how much $$ would you like to have?

DISABILITY INCOME In the event you are unable to work because of an accident or sickness, disability lasting more than three months, would you like to put a provision in place to guarantee an income?

CURRENT HEALTH CONDITION Do you or any applicant have any medical condition which requires that you receive regular medical attention from any doctor? Y N

If Yes, please provide details:

Do any of your following family members suffer from any medical conditions?


FAMILY MEMBER CONDITION WHEN DIAGNOSED

Father Mother Siblings Grandmother (Maternal/Paternal) Grandfather (Maternal/Paternal)

NOTES:


YOUR NET WORTH ASSETS – WHAT YOU OWN

Current/Fixed Assets

Chequing Account $

Savings Account $

Money Market Funds $

Credit Union Share/Savings $

Bonds $

Investment Funds $

Cash Surrender Value(s) on Life Insurance (s) $

Stocks $

Registered/Unregistered Pension Plan(s) $

Other $

Personal Assets

Furniture $

Vehicles (car, boat, motorcycle etc.) $

Primary Residence $

Secondary Residence $

Land $

Art $

Jewels $

Other $

Total Assets $

LIABILITIES (WHAT YOU OWE)

Current Liabilities

Credit Cards $

Other $

Medium-Term Liabilities

Car Loans $

Personal Loans $

Other $

Long-Term Liabilities

Mortgage (Primary Residence) $

Mortgage (Secondary Residence) $

Mortgage (rental Property) $

Student Loans $

Other $

Total Liabilities $

Net Worth (Total Assets – Total Liabilities) $

NOTES:


PERSONAL BUDGET

CATEGORY PROSPECT SPOUSE/SIGNIFICANT

OTHER

INCOME

Wage and Bonuses $ $

Investment Income $ $

Miscellaneous Income $ $

Income Subtotal $ $

STATUTORY DEDUCTIONS $ $

P.A.Y.E. $ $

N.I.S. $ $

Health Surcharge $ $

Statutory Deductions Total $ $

Net Income (Income Subtotal - Statutory Deductions Total) $ $

EXPENSES

ESSENTIAL EXPENDITURES

Investments/Savings

Retirement Contributions $ $

Stocks, Bonds. Mutual Funds $ $

College Fund $ $

Savings $ $

Emergency Fund $ $

Home:

Mortgage or Rent $ $

Homeowners/Renters Insurance $ $

Property Taxes $ $

Home Repairs/Maintenance $ $

Home Improvements $ $

Utilities:

Electricity $ $

Water & Sewer $ $

Gas $ $

Telephone (Land Line & Cell) $ $

Food:

Groceries $ $

Eating Out $ $

Lunches & Snacks $ $

Family Obligations:

Child Support $ $

Alimony $ $

Day Care/Babysitting $ $

Health & Medical:

Life Insurance $ $

General Insurance $ $

Disability Insurance $ $

Fitness (Yoga, Gym, Aerobics etc.) $ $

Medical Expenses $ $


Toiletries $ $

Car Payments $ $

Fuel $ $

Auto Repairs/Maintenance $ $

Other Transportation (Bus, Maxi, Taxi) $ $

Debt Payments

Credit Cards $ $

Student Loans $ $

Other Loans $ $

Clothing:

Your clothing $ $

Children’s clothing $ $

NON-ESSENTIAL EXPENDITURES

Entertainment/Recreation:

Cable TV/Videos/Movies $ $

Computer Expenses $ $

Hobbies $ $

Vacation Expenses $ $

Pets:

Food $ $

Grooming $ $

Vet Visits $ $

Miscellaneous:

Household Products $ $

Gifts/Donations $ $

Grooming (Hair, Make-Up, Other) $ $

Other Miscellaneous Expense $ $

Other Miscellaneous Expense $ $

Total Expenses

Available Income: (Net Income – Essential Expenditures)

CASH NEEDS Should you close your eyes today, do you think your family will have enough money to maintain their existing standard of living?

What bills do they have to pay?

NEEDS PROSPECT SPOUSE

Cash Needs $ $

Final Expenses $ $

Mortgage Payment $ $

Other Loans $ $

Education Expenses $ $

Emergency Fund $ $

Other Immediate Cash Needs $ $

Total Immediate Need $ $

Would they be able to maintain their standard of living or will they have to make major life changes and sacrifices?


Will they need some or all your income to maintain their standard of living? How long will they need your income?

Current Annual Income $ $

Amount to be replaced Annually $ $

For how many years? X

X

Total Family Income Need $ $

Do you think you have enough savings? Will your existing insurance take care of your family or do they have to count on family and friends?

Savings, Shares & Other Investments $ $

Existing Employee Benefits $ $

Money from family and friends $ $

Other Assets $ $

Existing Life Insurance $ $

Total Funds Available for Immediate use $ $

Total Immediate Need + $ $

Total Family Income Needs $ $

Total of All Needs $ $

Total of All Needs - $ $

Total Funds Available for Immediate Use $ $

Deficit/Surplus $ $

Notes:


REFERRALS

Don’t forget to ask for referrals!

NAME CONTACT NO. ADDITIONAL INFORMATION

NOTES: RE-CAP NEEDS | SHORTFALLS


SCHEDULE NEXT MEETING

Date:

Time:

Location:

THANK PROSPECT/ CLIENT FOR THE OPPORTUNITY!

Reminders

When the data gathering aspect (FFF) of the process has ended:

Recap your prospect’s goals and desires

Identify any insurance need(s) - Shortfalls etc.

At this point you can seek permission to proceed with the second stage of the process to provide a tailored solution or solutions - if not….

Proceed to set the next meeting (presentation/close) – Schedule the next appointment in Sales Pal.

Please be reminded to enter any new information in Sales Pal

Ask for Referrals

Send a “Thank you” email to the prospect inclusive of a summary (recap) of the meeting (samples available on GGLDC for download)

Congratulations!!!

Next:

“Digital completion and submission of applications.”

Documents

CONFIDENTIAL FACT FIND FORM - ggldc.com€¦ · GLOC- Confidential Fact Find Form pg. 1 Core Values Guardian Group’s core values are the guiding principles of the organization’s