Personal Details
Self
Partner
Surname
First Name
Title
Marital Status
Address
Postcode
Telephone No. Home
Telephone No. Work
Mobile No.
Email address
Date of Birth
NI Number
Countries of Citizenship
Countries of Residence (for tax purposes)
Nationalities
Preferred form of contact
Cantab Adviser
Children, Grandchildren and Dependants
Name:
Date of Birth:
Relationship:
Health
Self
Partner
Are you in good health?
Details of any medical conditions
Income Details
Self
Partner
Occupation
Employed / Self Employed
Firm Name
Total Gross Income
£
£
Average Monthly Expenditure
£
£
Property
Value
Ownership
Mortgage
Rental Income (pa)
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
Other Assets
Self
Partner
Joint
Dependants
Cash
£
£
£
£
Stocks & Shares
£
£
£
£
Pension
£
£
£
£
Other
£
£
£
£
Self
Partner
Which fixed/enhanced pension protection do you hold, if any
Please give details of life/critical illness policies, if any
Portfolio Objectives
Self
Partner
I want my portfolio to provide:
Please specify your financial objectives by selecting those that apply:
Other objectives:
ESG
Self
Partner
Would you like the investments in your portfolio to be selected from a narrow universe which has been screened for Environmental, Social and Governance ('ESG') factors?
Vulnerability
Self
Partner
Would you consider yourself vulnerable as per FCA guidance?

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