Please enter your details below . Client Name * Date of Birth * Email* Mobile* Smoker Status* YesNo Occupation * Superannuation Providers Superannuation Balances Life Insurance Provider Life Insurance Benefit Total Permanent Disability Benefit Critical Illness Benefit Income Protection Monthly Benefit Income Protection Waiting Period 14 days30 days60 days90 days180 days Income Protection Benefit Period 1 Year2 Years5 YearsUntil age 65 Premium per month for income Protection Total Current Assets Value estimated Total Current Debts Estimated Mortgage Provider Mortgage current outstanding amount Mortgage Rate Do you have a will ? YesNo Number of Financial Dependents Would you like a free review of your existing insurances and a comparison with 10 other insurance providers ? YesNo Are you interested in rolling your superannuation into one account ? YesNo Are you over 60 and interested in starting a Transition To Retirement Plan ? YesNo At CGH ACCOUNTING, we take pride in providing the best service and advice in managing your tax and accounting. We know that this is only one component of your overall financial success. To assist us, please take 60 seconds to complete this Gap Analysis. If there are any gaps in your financial world that are a priority for you to fix, we will discuss them with you, and, if you wish we can refer you to our preferred professional advisers in each area. Thank you CGH ACCOUNTING 1.How would you rate your overall financial organisation right now? Completely disorganisedTotally organised 2.How confident are you that you are on track to build the assets you will need for a long, comfortable stress free retirement? Completely disorganisedTotally organised 3.How confident are you that your family would have enough income and assets in the event of your death or disability? Completely disorganisedTotally organised 4.How confident are you that you know exactly what would happen to your assets, liabilities and super in the event of your death? Completely disorganisedTotally organised 5.How confident are you that your loans are properly structured, tax effectively, with a clear plan to reduce bad debt? Completely disorganisedTotally organised CGH ACCOUNTING value the privacy of every individual’s personal information. CGH ACCOUNTING are committed to protecting the personal information you provide. The collection, maintenance, use and disclosure of personal information by CGH ACCOUNTING are managed in accordance with the Australian Privacy Principles (APPs) in the Privacy Act . The Privacy Amendment (Enhancing Privacy Protection) Act 2012 (Privacy Amendment Act) made many significant changes to the Privacy Act 1988 (Privacy Act). These changes commenced on 12 March 2014. The Privacy Regulation 2013, made under the Privacy Act, also commenced on 12 March 2014. The personal information you provide to us for purpose of this “Gap Analysis” will be used to assist CGH ACCOUNTING and/or its agents to facilitate actions to address needs explicitly or inexplicitly outlined in the above. Subject to use for the purposes detailed in the above paragraph, this paragraph and except if required or allowed by law, all personal information you provide us will remain strictly confidential and will be held at CGH ACCOUNTING, . Under no circumstances will your personal information be sold or made available to marketing agencies or similar parties not involved with CGH ACCOUNTING without your express prior consent. Thank you