Personal Details Priorities Questionare Basic Objective Fixed Assets Financial Assets Equity Investments Liabilities Income Expenses Loans Life Cover
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1 Personal Details Priorities Questionare Basic Objective Fixed Assets Financial Assets Equity Investments Liabilities Income Expenses Loans Life Cover Tax Efficiency Retirement Scenarios Total Assets Financial Snapshot Goals Calculations Asset Allocation Scenarios
2 Financial Road Map Disclaimer Impetus Wealth Planner is a tool created by Impetus Wealth Management for enhancing We have used many Mathematical formulae and assumptions based on empirical data in developing this financial tool. Investment decisions cannot be Neither Impetus Wealth Management Private Limited nor any of its Directors/employees are responsible for losses arising if any our investment decisions taken All rights are reserved. No unauthorised copying, distribution, editing, re-branding etc is allowed. Any copyright violation will give rise to damages, claims etc, towards Impetus Wealth Management Private Limited, the sole owner/user of this wealth
3 Dear Investor, Greetings! At Impetus, we have been striving to provide unbiased Financial Road Map to investors based purely on the respective investor's Goals and overall profile. We need to have all the relevant information about each investor, to be able to guide them appropriately. The information would be preserved with utmost confidentiality. Once you provide us all the information required in the respective pages given herewith, please these data sheets to We shall evaluate the entire data and provide you a suitable Financial Road Map. Thanks & regards on behalf of the entire team at Impetus Wealth Management P R Dilip Managing Director IMPETUS WEALTH MANAGEMENT
4 Home
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7 Personal Details Profiling Date Rerence Number Your Name Date of Birth : Marital Status : Date of Marriage : Your Spouse's Name Dependents (Specify number of dependents & their age) : Type of Profession : Experience in the profession(years): Educational Qualifications Designation : Retirement Age : Number of Years for Retirement from now Any other relevant information : Resident Status (Resident Indian/NRI/Citizenship) : Permanent Address : Correspondence Address : Contact Number - work : Contact Number - Mobile : Contact Number - Residence : Fax Number : Your Personal Id : Medical History (Please mention in case of any major illness/surgeries/diabetes/hypertension) : Home A Bas
8 Name of the Person to be contacted in your absence : Home
9 SEBI Registered Portfolio Manager sic Data of the Investor
10 Priorities Please Rank your Priorities (write the Rank order) 1 Panning for Retirement 2 Planning for Child s education 3 Planning for Child s Marriage 4 Planning for Real Estate Purchase 5 Insurance coverage Life/Health 6 Monthly Income Plan 7 Buying a New Car 8 Overseas Vacation with Family 9 Planning to set up a Business 10 Others( Please specify if any) Priority Rank (1-10) When do you want to achieve this? Year
11 A SEBI Registered Portfolio Manager Home What would be the approximate cost of this goal at present? Please write your priority number (1,2,3 etc. ) in the Priority Rank Coloumn Home
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15 Questionnaire Please provide the following details ~ understand you better Are you fully aware about the nature of different asset classes you are currently holding? (YES/NO) Are you happy with the rate of returns you are getting from your overall investments at present? (YES/NO) Do you think you have more than adequate cash in savings accounts? (YES/NO) Were there major fluctuations in your incomes during the last 10 years? (YES/NO) If yes, specify the pattern: Are you satisfied with the present Insurance cover? (Health & Life) (YES/NO) What was the maximum % of exposure you have taken in Equity Investments in the past? How often you review your investments & financial goals? ( Yearly/Quarterly/Monthly/Rarely) How many more years do you wish to be actively working? Do you have adequate pension / retirement plans in place? (YES/NO) Number of years experience in Indian Equity Market
16 What is your average holding period in Equity/Mutual Fund Schemes? How often you review your portfolio? Do you propose to increase your exposure in Indian Market? (YES/NO) If yes, which Asset Class would you prefer to invest? (Equity/Debentures/Real Estate/Gold/Silver/Others) Are you expecting any major Cash OUT-flows in the near future? (YES/NO & IF YES, AMOUNT) Are you expecting any major Cash IN-flows in the near future? (YES/NO & IF YES, AMOUNT) Maturity Amounts from various Investment/Insurnace Instruments INR Have you Nominated any person in all your investments? If Yes, Please mention the Name of the Nominee Do you have a 'Second Holder' in all the investment documents? If yes, Please mention the Name of the 'Second Holder' Please specify the minimum time-frame you wish to allocate for investments in India:
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18 Narration Remarks if any Home A SEBI R
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20 Home
21 Registered Portfolio Manager
22 Basic Objective Please choose one of the followings Your Primary Goal is to, Achieve the Maximum Growth Possible YES/NO Strong Growth over Long Term Long Term Growth along with Regular Income Regular Income from Investments Safety of Capital
23 A SEBI Registered Portfolio Manager Home Please type "YES" for whichever is your Primary Goal Home
24 Fixed Assets Fixed Assets Details FIXED ASSETS OWNED BY YOU Value i Principal Residence : - Holiday Home/Second Property Commercial Property Land CAR(s) Other Fixed Assets - Other Assets Other Investments (Which are not liquid investment in a business) SUB TOTAL - Investments in Gold Silver Other Commodities Jewellery COMMODITIES SUB TOTAL Art Loans given OTHER ASSETS SUB TOTAL -
25 TOTAL FIXED ASSETS (Fixed Assets + Commodites+Other Assets)
26 A SEBI Registered Home OWNED BY SPOUSE in INR
27 - Home
28 Portfolio Manager tusindia.in
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30 Financial Assets - Non-Equity FINANCIAL ASSETS - Non- Equity OWNED BY YOU (A) FINANCIAL ASSETS - Debt Savings in the Bank Account - 1 Savings in the Bank Account Bank Fixed Deposits - 1 Bank Fixed Deposits- 2 Cash Mutual Fund Schemes - Debt/Money Market - PPF as on National Savings Certificate - Equity Linked Savings Schemes (ELSS) Senior Citizens Investment Scheme MIS (Post Office) - Infrastructure Bonds Debentures/Bonds - Other asset classes of Fixed return nature if any - SUB TOTAL - FINANCIAL ASSETS - DEBT - TOTAL- FINANCIAL ASSETS (A + B) - -
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32 A SEBI R Home OWNED BY SPOUSE (B) RATE OF RETURN % YEARLY INCOME FROM THIS INVESTMENT Total Yearly income rom these investments = -
33 Home
34 Registered Portfolio Manager
35 Financial Assets - Equity Details of Equity Investments OWNED BY YOU (A) Mutual Fund Schemes - Equity (Lumpsum) Mutual Fund Investments - SIP Investments under PMS (Portfolio Management Services) Direct Equity Investments Private Equity Holdings Sub Total- Financial Assets - EQUITY - TOTAL - FINANCIAL ASSETS - EQUITY (A+B) - Details of Equity Portfolio Stock Holding Quantity Mutual Fund Holding Details Scheme Name Units held
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37 A SEBI Registered Home OWNED BY SPOUSE (B) RATE OF RETURN % YEARLY INCOME FROM THIS INVESTMENT - Total Yearly income rom these investments = - Average cost/share LTCG/STCG Avg cost / unit Gowth / Divi. LTCG / STCG
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39 Portfolio Manager tusindia.in
40 Liabilities FINANCIAL LIABILITIES BY YOU Mortgage of Home Outstanding Car Loans Outstanding Creditors Investment Loans Education Loans Private/Family Loans Credit Card outstanding Tax Liabilities if any Other Liabilities SUB TOTAL - TOTAL LIABILITIES (Financial Liabilities + Other Liabilities)
41 A SEBI Registered Portfolio Manager Home BY SPOUSE Please provide all information regarding your Outstanding Liablities SOLVENCY R #DIV/0! Home
42 Annual Income INCOME & CASH FLOW DETAILS BY YOU Annual Net Income - Salary (After Tax) Annual Income from Business/Profession Annual Income from Rent/Property Capital Gains Long Term Capital Gains Short Term Interest Income Dividend Income Income from other Sources Non-Taxable Income if any (Agriculture Income etc.) Sub Total TOTAL YEARLY INCOME OF THE FAMILY Expected Changes in Income Profile BY YOU % of Average Yearly Increase in Income 0% Do you Anticipate any change in your income in the near future? Please specify the amount / percentage of change Salary Business/Profession Rent/Property Capital Gains No Other Sources - Number of Earning Members in the same family 0 Gross Income of all earning members per year
43 Are the incomes of all the earning members clubbed for the investment purpose?
44 A SEBI Registered Portfolio Manager BY SPOUSE Home Please provide all information regarding your Income - BY SPOUSE
45 Home
46 Annual Expenses FAMILY ANNUAL EXPENSES Amount Living Expenses - Personal Expenses Phone Electricity Water Fuel Housing/Rent/Repairs etc. Educational Entertainment (Eating Out, Movies etc.) Expenses for Dependants living outside your home Life Insurance Premium Payments Health Insurance Premium Payments Vehicle Insurance Premium Payments Other General Insurance Premium Payments Pension Plan Premium Home Loan Repayments - Towards Capital Home Loan Repayments - Towards Interest PPF EPF Property Tax Holiday Travel
47 SUB TOTAL - TOTAL EXPENSES
48 A SEBI Registered Portfolio Manager Remarks Tax effect Home C Please provide all information regarding Expenses 80C 80D 80C 80C Section 24 80C 80C
49 0 - Home - -
50 g your
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52 Loans & Repayment Details Details of Loans - Repayment by You - Yearly Repayment by spouse - Yearly Housing Loan Repayments Vehicle Loan Repayments Personal Loan Repayments SUB TOTAL - - TOTAL LOAN REPAYMENTS -
53 A SEBI Registered Portfolio Manager %of Interest Tenure of Loan (Balance no of years) Please provide details about the EMIs Debt to Income Ratio (Debt/Gross Income) Home
54 #DIV/0!
55 Life Insurance Details INSURANCE DETAILS Life Insurance - 1 Life Insurance - 2 Name of the Policy Holder Issuing Company Policy Number 0 Sum Insured - - Date of Commencement Maturity Date Premium Payment Mode (Monthly/qtrly/h.yealy/yearly) 0 Premium Amount per Year - - TOTAL PREMIUM PAYABLE PER YEAR -
56 A SEBI Registered Portfolio Manag Home Health Vehicle Required Risk Cover = - ( - ) Present Risk Cover = - ( + ) Outstanding Liabilities = - Additional Risk Cover needed = - Home
57 ger
58 Tax Efficiency Table Recurring Investments - Yearly Amount Remarks UNDER SECTION 80C - TOTAL DEDUCTABLE EXPENSES = Rs. 1 Lac Tution Fee - EPF - - PPF - - PF & VPF (Voluntary PF) - NABARD Rural Bond Equity Linked Savings Schemes - ELSS Home Loan Principle Repayment - Life Insurance Premium - Notified Term Deposits - Banks/Post office - Pension Plans Senior Citizens Investment Scheme - Stamp Duty & Registration Charges - Home TOTAL - UNDER SECTION 24- TOTAL DEDUCTABLE EXPENSES = Rs Lac Home Loan Interest Repayment - UNDER SECTION 80D - TOTAL DEDUCTABLE EXPENSES = Rs. 15, Medical / Health Insurance Premiums - UNDER SECTION 80E - TOTAL DEDUCTABLE EXPENSES = No Limit Education Loan UNDER SECTION 80CCF - TOTAL DEDUCTABLE EXPENSES = Rs. 20, Notified Infrastructure Bonds
59 UNDER SECTION 80G - TOTAL DEDUCTABLE EXPENSES = 100% or 50% Donation to Charitable Trusts
60 A SEBI Registered Portfolio Manager Tax effect Home 80C 80C 80C 80C 80C 80C 80C 80C 80C 80C 80C 80C SECTION 24 80D 80E SECTION 80CCF
61 80G Home
62 Please save this file and
63 to:
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