Client Interview Form

1ABOUT YOU & OTHER PARTY

2OTHER PARTY’S LAWYER’S DETAILS (IF KNOWN)

3RELATIONSHIP DETAILS

4OTHER

5ASSETS AND LIABILITIES

ABOUT YOU
Untitled
- Husband/Father
- Wife/Mother
*CONTACT DETAILS
*
- Mr
- Mrs
- Ms
- Miss
- Dr
- Other
Surname*
Given*
Maiden*
Residential Address*
Street Address Address Line 2 Suburb State Postcode Country
Can we post to this address?
- Yes
- No
Postal Address*
Street Address Address Line 2 Suburb State Postcode Country
Email*
Phone (Work)*
Phone (Mobile)*
*PERSONAL DETAILS
Date of birth*
DD slash MM slash YYYY
Age*
Country of birth*
Gender*
- Male
- Female
Mother’s country of birth
Father’s country of birth
Are you of Aboriginal/Torres Strait Islander origin
- No
- Yes - Aboriginal
- Yes - Torres Strait Islander
- Yes - Aboriginal and Torres Strait Islander
How well do you speak English?
- Very well
- Well
- Not well
- Not at all
Is an interpreter required?*
- Yes
- No
Dialect
Which of the following applies to you?*
- Present in Australia
- Australian citizen
- Ordinarily resident in Australia
- Domiciled in Australia
*EMPLOYMENT
Occupation
Name of employer
Basis of employment
- Full time
- Part time
- Casual
- Permanent
Annual salary
CONTACT LIST
Next of Kin (name)
Next of Kin (telephone)
Next of Kin (address)
Can we contact your next of kin in case of an urgent situation?
- Yes
- No
Accountant’s name
Are you in good health?
- Yes
- No
If no, what medical condition(s) do you have?

ABOUT THE OTHER PARTY
Untitled
- Husband/Father
- Wife/Mother
*CONTACT DETAILS
*
- Mr
- Mrs
- Ms
- Miss
- Dr
- Other
Surname*
Given*
Maiden*
Residential Address
Street Address Address Line 2 Suburb State Postcode Country
Can we post to this address?
- Yes
- No
Postal Address
Street Address Address Line 2 Suburb State Postcode Country
Email*
Phone (Work)*
Phone (Mobile)*
*PERSONAL DETAILS
Date of birth*
DD slash MM slash YYYY
Age*
Country of birth*
Gender*
- Male
- Female
Mother’s country of birth
Father’s country of birth
Are you of Aboriginal/Torres Strait Islander origin
- No
- Yes - Aboriginal
- Yes - Torres Strait Islander
- Yes - Aboriginal and Torres Strait Islander
How well do you speak English?
- Very well
- Well
- Not well
- Not at all
Is an interpreter required?*
- Yes
- No
Dialect
Which of the following applies to you?*
- Present in Australia
- Australian citizen
- Ordinarily resident in Australia
- Domiciled in Australia
*EMPLOYMENT
Occupation
Name of employer
Basis of employment
- Full time
- Part time
- Casual
- Permanent
Annual salary
CONTACT LIST
Next of Kin (name)
Next of Kin (telephone)
Next of Kin (address)
Accountant’s name
Are you in good health?
- Yes
- No
If no, what medical condition(s) do they have?

Save Progress

DESCRIPTION OF ASSET	OWNER	ASSET ($E)	LIABILITY ($E)

DESCRIPTION	OWNER	WHEN?	AMOUNT ($E)

ABOUT YOU