Personal Business

01224 625554

Form

Your Name  
Your Address  
Your Email  
Your Phone Number  

1. Assets >> 2. Liabilities >> 3. Income/Expenditure

       
Details of assets   Estimated value (£)
       
Private residence i.e. your home  
Less : any outstanding mortgage and secured loans   (-)
       
Cash    
       
Bank/savings accounts  
       
Premium bonds  
       
Motor vehicle (if value in excess of £3,000)  
Less : any finance secured on vehicle   (-)
       
Caravan/mobile homes  
Less : finance secured on asset   (-)
       
Shares : quoted on stock exchange  
       
Shares : unquoted companies  
       
Life insurance policies : encashment value  
       
Endowment policies : encashment value  
       
Other investments (describe)  
       
Loans to people/companies i.e. who owe you money  
       
Other assets i.e. valuable jewellery/paintings/antiques  
       
Total assets  
Next
       
Notes    
       
1.The figures should be round-sum estimates.
       
2. Exclude any contingent assets e.g. a right to receive value depending upon the occurrence of an event, such as inheriting money if someone dies and has named you in their Will.
 
       
3. If you have insurance/endowment policies that are secured to a lender, this should be stated on the form.

1. Assets >> 2. Liabilities >> 3. Income/Expenditure

Details of liability Estimated value £ Notes e.g. ongoing legal action
       
Personal loan(s) (list individually)  
     
Add More
Overdrafts  
       
Credit cards (list individually)  
     
Add More
Store cards (list individually)  
     
Add More
Rent arrears  
       
Mortgage arrears  
       
Child maintenance arrears  
       
Utility arrears  
       
Payday loan(s)  
       
Loan(s) from family/friends  
       
Council tax arrears  
       
Others (list individually)  
     
Add More
Total liabilities ()  
       
Surplus (deficiency) of Assets over Liabilities  
Previous Next
       
Notes :    
       
1. Having more assets than liabilities is desirable, but it might not help if you cannot get a cash value for assets and creditors are pressing for immediate payment.
       
2. If you have been subject to legal/court action for payment of a debt, you may have little time to organise the sale of assets.
       
3. If there is an ongoing legal action, annotate the schedule because it helps to focus attention on what is of immediate importance.
       
4. For credit/store cards, either the amount currently owed rather than the credit limited allowed.

1. Assets >> 2. Liabilities >> 3. Income/Expenditure

Salary and wages

Please note that monthly figures should be used

Income

Amount (£)

Comments

Your salary/wages

Partner’s salary/wages

Subtotal :

Pensions

Pension(s)

Amount (£)

Comments

State Pension(s)

Private or work pension(s)

Pension Credit

Subtotal :

Other income

Other income

Amount (£)

Comments

Maintenance or child support

Boarders or lodgers

Non-dependant contribution

Student loans or grants

(To be completed with any
other household income)

Subtotal :

Benefits

Type of benefit

Amount (£)

Comments

Jobseeker’s allowance

Income support

Working tax credits

Child tax credits

Employment and support allowance

DLA, PIP or attendance allowance

Carer’s allowance

Housing benefit/local housing allowance

Council tax reduction

Universal credit

(Other)

(Other)

(Other)

Subtotal :

Total Income :

Please use the space provided below to give details of any benefit listed under “other”

Expenditure

Essential expenditure

Amount (£)

Comments

Rent

Ground rent, service charges, factor fees

Mortgages

Other secured loans

Building and content insurance

Pension and life insurance

Council tax

Gas

Electricity

TV licence

Magistrates or sheriff court fines

Maintenance or child support

Hire purchase/conditional sales

Childcare costs

Adult care costs

Subtotal :

Phone

Amount (£)

Comments

Home phone

Mobile phone(s)

Subtotal :

Travel

Amount (£)

Comments

Public pransport (work, school, shopping, etc)

Car insurance

Vehicle tax

Fuel (Petrol, Diesel, Oil, etc)

MOT and car maintenance

Breakdown and recovery

Parking charges or tolls

Subtotal :

Housekeeping

Amount (£)

Comments

Food and milk

Cleaning and toiletries

Newspapers and magazines

Cigarettes tobacco and sweets

Alcohol

Laundry and dry cleaning

Clothing and footwear

Nappies and baby items

Pet food

Subtotal :

Other expenditure

Amount (£)

Comments

Health (dentist, glasses, prescriptions, health insurance)

Repairs/house maintenance (including window cleaning, maintenance contracts)

Hairdressing/haircuts

Cable, satellite and internet

TV, video and other appliance rental

School meals and meals at work

Pocket money and school trips

Lottery and Pools etc.

Hobbies/leisure/sport (include pub, outings, etc.)

Gifts (christmas, birthday, charity etc.)

Vet bills and pet insurance

Subtotal :

All other expenses not covered above

Amount (£)

Comments

1.

2.

3.

Total :

Total Income :

Total Expenditure :

Surplus/(Shortfall) – see note 6 below :

       
   
Notes    
       
1. Round sum amounts can be used for convenience.
       
2. The weekly/monthly sum available for unsecured creditors can be paid in cash, by cheque or by standing order.
       
3. Income and expenditure varies and thus, the analysis should be updated every six months.
       
4. In this analysis, payments to unsecured creditors are excluded in order to determine if you have enough to live on before paying such creditors.
       
5. The figures you enter should be fair/reasonable and capable of being supported if asked.
       
6. If there is scope to pay something on a weekly/monthly basis, you may be eligible for DAS, a trust deed or sequestration.
Previous
   

We should be able to help you but require a little more information. Please click here and complete the form to send to us.

We may not be able to act for you but would be happy to discuss your financial affairs in order to point you in the right direction. Please feel free to contact us on 01224 625554 for a free, no obligation, confidential consultation.