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* 1. Enter Your Name, Email and Phone Number here

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* 2. Are there any special circumstances which should be taken into account when completing this financial review? For example recent illness, bereavement, any diffculties in following the review due to hearing or sight problems, redundancy, retirement or maybe if you find financial discussions confusing?

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* 3. What is your family's joint total annual income?

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* 4. What is your family's net disposable monthly income after all bills have been paid?

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* 5. What outstanding debts do you currently have? (Tick multiple if necessary)

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* 6. Do you or your spouse/partner currently have any of the following?

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* 7. What do you need Life Assurance for? (Tick multiple if necessary)

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* 8. If you or your spouse/partner had died yesterday, how much income would your family need each month to maintain your current standard of living? Of the income that you are generating, and / or the value of the work you provide in the home, how much monthly income would your family need to replace?

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* 9. What other areas of financial planning would you like to discuss? (Tick multiple if necessary)

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