Financial Independence Services

Email address *

Full Name *

Contact Number *

Pan Number *

Marital Status *

Primary Source of Income *

Salary

Business

Pension/PF - Retired

Dependent on other

Secondary Source of Income *

Dividend

Rental

Others

None

Annual Income Range *

Between Rs.2.5 Lakhs to Rs. 5 Lakhs

Between Rs. 5 Lakhs to Rs. 10 Lakhs

Between Rs. 10 Lakhs to Rs. 20 Lakhs

More then Rs. 20 Lakhs

Your Proposed Investment Amount *

Less than 2 Lakhs

2 to 5 Lakhs

5 to 10 lakhs

More than 10 Lakhs

Market Value of portfolio held* *

<1 lacs

1-2 lacs

2-5 lacs

> 5 lacs

Select the investments you currently own *

Equity & Equity Mutual Funds

Debt & Debt Mutual Funds

Other (PMS/AIF/Real Estate) Products

FD & Savings Account

Value of Liabilities/Borrowings as on date *

Below 5 Lakhs

5 to 10 Lakhs

10 to 20 Lakhs

Above 20 Lakhs

Portion of income allocated to paying off debts/EMIs *

Below 15 percent

15 to 30 percent

30 to 50 percent

Above 50 percent

Objective of Investment *

Regular Income Growth

Higher returns on investment with some losses in short term

Long term value creation with chances of higher short-term losses

Capital growth/appreciation consistently with a moderate volatility

What is your Investment Horizon? *

Less than 2 years

2 to 5 years

5 to 10 years

More than 10 years

What if your investment is down by more than 15% *

Invest more

Keep investments as they are

Sell and preserve cash

Wait till the market recovers and then sell

Age Group* *

18 to 30

31 to 45

46 to 60

60+

How many dependents do you financially support ?* *

None

Between 1-3

4+

SCORE *

Scores

Signature *

Declaration *

Terms & Conditions *