Initial Data Collection

By completing and signing the declaration at the bottom of this page, I declare the following:

1. I declare that the information provided in this Fact Find is complete and accurate to the best of my knowledge (except where I have indicated that I have chosen not to provide the information).
2. I understand and acknowledge that by either, not fully or accurately completing the Fact Find, that any recommendation or advice given by the adviser in these circumstances may be inappropriate to my needs and that I risk making a financial commitment to a financial product that may be inappropriate for the needs identified.
3. I acknowledge that I have received the Consultum Financial Services Guide (‘FSG’) and Adviser Profile inclusive of Consultum’s Privacy Disclosure Statement.
4. I agree to the collection, use and disclosure of my information from and to my advisers as described in Consultum’s Privacy Disclosure Statement and at the front of this Fact Find, where required to assist my adviser to provide financial services to me.
5. Please provide a Statement of Advice for my consideration. I understand that the preparation of the Statement of Advice will be subject to the payment model outlined in the Adviser Profile provided by my Consultum Financial Advisers Authorised Representative.

I am authorising my Consultum Financial Advisers Authorised Representative to hold my Tax File Number(s) in a secure location and use it for the following financial product and strategy recommendations related purposes/documents, in accordance with the legislative requirements:

• Matters for superannuation and non-superannuation investment purposes as required by the Superannuation Laws; such as inclusion on application forms.
• That I have been informed of the legal basis for collection and am aware that declining to provide a TFN is not an offence and know the consequences of not providing a TFN.
• That the manner of obtaining the TFN was not reasonably intrusive.
• The disclosure of the TFN will only be disclosed to Fund Managers and Life Insurance Companies as relevant.