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
General State of Health
Details of any medical conditions
Income Details
Self
Partner
Occupation
Share / Salaried Partner
Firm Name
Profit share / salary
$
$
Bi-monthly draw
$
$
Total Gross Income
£
£
Average Monthly Expenditure
£
£
Property
Value
Ownership
Mortgage
Rental Income
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
Other Assets
Self
Partner
Joint
Private Equity, PEF, DIF
$
$
$
Cash
£
£
£
Stocks & Shares
£
£
£
Pension
£
£
£
Other
£
£
£
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?
Cover
Type
Self
Partner
Joint
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
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Debt
Self
Partner
Joint
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
$/£
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