Please complete the relevant sections of this questionnaire. For full plans, complete all sections. If
the terms of your engagement with Lyster Financial Services are restricted to certain kinds of
planning, some sections may be omitted.
Planning of any kind – including financial planning – begins with a vision of what is important to you. The purpose of the planning process is to set out what needs to be done, within real world
constraints, to accomplish what you think important. It requires a good faith effort by you to
identify and prioritize your goals.
We cannot tell you what your financial goals are. Only you know. No adviser can recommend
specific strategies until you specify what you want to accomplish. You tell us what. We tell you how.
Rank the following, #1 being the most important to you. If something is not important at all, leave
the space blank. If you have goals not listed here, add them to the list and rank them.
Buying a house Vacation property Reducing / eliminating debt Providing for family in case of death or disability Funding post-secondary education Minimizing taxes Early retirement Funding retirement Increasing investment income Maximizing investment returns Increasing the value of your estate Charitable contributions
Client Spouse (if applicable)
Home Address Home Address (if different)
Mailing Address (if different) Mailing Address (if different)
Home Phone Business Phone Home Phone Business Phone
Home Email Business Email Home Email Business Email
Marital Status Citizenship Marital Status Citizenship
Date of Birth Social Insurance No. Date of Birth Social Insurance No.
Employer and Address Employer and Address
Years with Annual earned income Years with Annual earned income
current employer (gross) (net) current employer (gross) (net)
Insider or Director of a Public Company Insider or Director of a Public Company
Will? Year updated Original’s location Will? Year updated Location
Power of Attorney Year updated Original’s location Power of Attorney Year updated Location
Children, including children of previous marriages, or grandchildren
Years of Projected Current
Birth Current Funded Annual Educational
Name Date Married? Grade Education Costs Savings
Parents and other adults
Projected Do you hold
Birth In Current Annual power(s) of
Name Date Care? Health Cost to You attorney?
Employment details (required for full financial planning engagements)
Are the earned income figures in section 1 …
Approximate? You ? Your spouse ?
Variable from year to year? You ? Your spouse ?
Employment benefits: Please provide an indication of whether your (or your spouse’s) employer
provides the following benefits. Provide details where possible; e.g. the dollar amount of monthly
long-term disability coverage.
Supplemental health Dental Long-term disability Group life insurance Pension/RRSP contributions Profit sharing Stock options Other
Funds from sources other than employment or self-employment
Please provide annual amounts received from the following sources.
Property rental income (gross & net) Investment income Pensions and annuities
RRSP/RRIF payments Spousal support Child support Trust funds Other
If you expect a substantial gift or inheritance in the foreseeable future, please indicate the
approximate amount and a timeframe.
Insurance (may be omitted if no insurance planning desired)
Please provide details of current insurance coverage.
Group life insurance Individual life policies
Group disability Individual disability Critical illness Long term care Property (home/tenant) Property (vacation) Excess liability Automobiles Other
Estimated taxable income this year RRSP contribution room Capital loss carry forwards available Shareholder of private corporation? Capital gains exemption claims Subject to U.S. income tax?
Retirement (may be omitted if no retirement planning is desired)
Please provide as much information as you can about pensions for which you are eligible. For
pensions provided by the government of Canada, contact your local HRDC office to ask for an
estimate of the amount of Old Age Security and Canada Pension you may receive at age 65.
Age you want to retire Desired spending in today’s dollars Would you consider leaving Canada? Eligible for Old Age Security? Canada Pension entitlement (approx) Foreign government pensions
Provide an approximation of pension entitlements from an employer or union pension plan. If early
retirement is possible at a reduced pension, provide that information as well. This information is
available upon request from pension providers.
Projected monthly pension Indexed for inflation? At age
Estate Planning (may be omitted if no estate planning is desired)
Life insurance has named beneficiaries? RRSP/RRIF has named beneficiaries? Assets held as joint tenants?
Have you considered or established trusts to provide long-term support for dependents (children,
grandchildren, disabled adults, parents)? Do you use alter ego or joint spousal trusts?
Do you have an up to date will? Where is the original located? Does the executor have a copy? Is the executor younger than you? Is the executor in your province? Is the executor willing and able? Does the will:
Specify guardians for minor children?
Make bequests to charities?
Establish testamentary trusts?
Give the executor broad investment power?
Have you considered planned giving strategies for charitable contributions, either before or after
Do you own foreign real estate? Do you own U.S. securities? Are you subject to foreign estate taxes?
For partners and shareholders in private businesses
Are buy-sell agreements in place?
How are they funded?
Other information (may be omitted)
Bank Branch Address
If there was insufficient room to provide information on other pages or you have any other sorts of
information that we should consider during the planning process, please provide it in the space
below. Possible or actual problems of a personal, legal, financial, or medical nature for you, a
spouse, dependents, or a business in which you have an interest may affect the quality of our
Provide a breakdown of your assets and liabilities at this time, rounding to the nearest thousand
dollars. If you have requested basic financial planning as part of the engagement, indicate the
interest rate being charged on all liabilities. Investments held as mutual funds should be categorized
by fund type (e.g. a Canadian equity fund belongs on one of the “Canadian stocks” lines).
Client Spouse Joint Other
Cash and chequing accounts Savings accounts Canada savings bonds Cash value of life insurance
Cash / money market GICs Canadian fixed income Foreign bonds Canadian stocks U.S. stocks International stocks Income and royalty trusts Venture capital
Cash / money market GICs Canadian fixed income Foreign bonds Canadian stocks U.S. stocks International stocks Income and royalty trusts Venture capital Private businesses
Principal residence Vacation property Vehicles Other
Taxes Credit cards Personal loans / lines of credit Student loans Investment/business loans Residential mortgages Vehicle loans Other
Cash Flow (may be omitted if basic financial planning is not required)
Provide a breakdown of your anticipated income and expenditures for the current year, rounding to
the nearest thousand dollars.
Client Spouse Joint Other
Salary Bonuses Business income Spousal/child support Pensions Annuity payments Interest Dividends Capital gains Rental income Other
Food Clothing Rent or mortgage Property taxes Home insurance Utilities Vehicles and transportation Life/disability/health insurance Spousal/child support Entertainment and vacations Charitable contributions Pension contributions Income taxes, CPP & EI premiums Other