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Confidential Client Profile Questionnaire

Know your client form

NOTIFICATION

You have expressed the wish to obtain advice from a controlled professional carrying out a regulated activity.

In accordance with the principles of the law of January 6, 1978 relating to data processing, files and freedoms modified by decree n ° 2019-536 as well as the general data protection regulations which came into force on May 25, 2018, we remind you that the present collection of information, as well as its use, is carried out in your interest and is intended to allow the professional to establish a risk profile in order to provide advice tailored to your situation.

The quality of the service will depend closely on the truthfulness, accuracy and completeness of your answers, to this questionnaire. If you do not provide the required information, your adviser will not be able to pursue his mission and will have to refrain from recommending to you the transactions, instruments and services related to investment advice. 

You acknowledge that you are aware of your adviser's rates, and their working methods and have in your possession their legal information sheet (DER).

Your advisor is committed to respecting rules of good conduct including professional secrecy and the protection of your personal data.


The information collected on this form is recorded in a file computerized by Desmond Cooney for the processing of personal data.

The files are kept for a duration of five years and are intended for Axis Financial Consultants and our business partners for the purpose of financial advice provision.

In accordance with the law "Informatique et Libertés", you can exercise your right of access, opposition and portability of data concerning you and have them rectified by contacting: Desmond Cooney, email: [email protected]

You can also file a complaint about the processing of your data with the CNIL.

Required documents notification

As a prospective client, we will require you to provide us with the following:

  • Valid identity document
  • Proof of address (utility bill or bank statement dated within the last three months).
  • Any other document that you consider relevant to the study of your situation.

General Elements

Your Partner

First Name
Last Name
Date of Birth
Profession
Legal form of the union
Since When

Family and Dependents

Full Name Age Relationship Financially Dependent
Full Name 1
Full Name 2
Full Name 3
Full Name 4
Additional Remarks

Your Income

Annual Income & Currency

Annual Bonus / Commission

Your Monthly Expenditure


Personal Balance Sheet (Assets & Liabilities)

Current Assets

Current/Deposit Account(s)

Other Account(s)

Fixed Assets (Property)

Principle Residence

Investment Property

Additional Remarks

Medium - Long Term Assets

Direct Equity Holdings

Insurance Bonds

Unit Trusts / Investment Trusts / Mutual Funds

Regular Savings / Education Plans / Retirement Schemes

Other Assets/Additional Remarks

Retirement Details

Details on existing UK Pension Schemes?

Other Pensions/Additional Remarks

Liabilities/Loans other than Mortgages

Type of Loan Capital Outstanding Annual Repayment Amount Maturity Date

Taxation

Family Tax Position

Last year income tax rate %
Average income tax rate % over ten years
Expected level of income tax % on retirement

Forseeable Developments


Wealth Tax

Last Year Amount
Average wealth tax amount
over last ten years

Forseeable Developments


Property Taxes

Property Taxes Amount
Property 1
Property 2
Property 3

Other Taxes Paid


Savings/Investment Capacity

Amount
Regularity
Percentage of total assets
(excluding your home) that this
particular investment represents
Overall debt as a
percentage of wealth

Foreseeable Events


Sustainable Finance/Investment Preferences

ESG criteria combine three different standards:

  • Environmental
  • Social
  • Governance

These criteria make it possible to measure the consideration of sustainable development and the long-term challenges of companies.

The criteria are associated with a number of good or bad practices. Here are a few examples:

  • Environmental criteria: carbon footprint, strategy for reducing greenhouse gas emissions, energy consumption, waste management and recovery, prevention of impacts on biodiversity (polluting discharges for example), etc.
  • Social criteria: parity, inclusiveness of minorities and disabilities, respect for Labor Law, quality of dialogue with stakeholders, employee training, workplace safety, etc.
  • Governance criteria: consideration of the opinion of stakeholders in the management of the company, audit of accounts by a third party, diversity within the board of directors, transparency of salaries, fight against corruption, etc.

Are you likely to be interested in sustainable investing, ESG criteria?
If so, would you like your adviser to take Environmental criteria into account?
Would you like your adviser to take Social criteria into account?
Would you like your adviser to take Governance criteria into account?

Are you willing to accept lower performance in ESG investing?

Do you want your investment to promote ESG characteristics / or meet environmental objectives?

(for example: Mitigation of Climate Change, low-carbon, SRI and ESG funds, green labeled funds, respect for equality between men and women, etc.). Please tick any relevant boxes below:

Environmental indicators Tick
Climate change mitigation
Adaptation to climate change
Sustainable use and protection of aquatic and marine resources
The transition to a circular economy
Pollution prevention and reduction
protection and restoration of biodiversity and ecosystems.
Social indicators Tick
Violations of UN Global Compact Principles and OECD Guidance Applicable to Multinationals
Absence of processes and mechanisms for monitoring compliance with the above principles and guidelines.
Unadjusted gender pay gap.
Gender diversity on boards
Exposure to controversial weapons (landmines, cluster munitions, chemical weapons and biological weapons)


Investor Experience Profile

Investor Experience Profile Which Profile Suits You? Tick
Inexperienced Investor You have invested in a limited range of asset classes for a period of four years or less and/or have stated that your investment knowledge is low/poor. However, you do understand that prices of securities may go up as well as down.
Experienced Investor You have invested in various asset classes for a period of more than four years and have experienced volatility. You have stated that your investment knowledge is good or higher and acknowledge investment risk.
Professional Investor You frequently trade various asset classes each year for more than four years. As an individual you have in excess of € 1 million of investable" assets and have extensive investment knowledge.

Customer Objectives:


Estate Planning


Inheritance & Gifting

Have you made any gifts during the current and previous years?
Are you expecting inheritance or gifts?

Client Declaration

I/We have reviewed the information contained in our confidential client profile and am/are satisfied that the information is accurate and relevant to my/our current financial situation. I/we invited your back for subsequent meetings for the purpose of recieving advice as requested by myself/ourselves.

Confidential Questionnaire completed in:

Client Signature:

Date: