Your finances

Please fill in the following as best as you can and click submit. The form will be then be emailed to us.

Your details

Your name

Address

Telephone number

Email address

How should we reply? Telephone
Email

How old are you?

What do you do for a living?

Morgage, loans and credit cards

Do you own a house? No
Yes. What is it worth? £

If you have a mortgage how much do you owe? £

Is the mortgage up to date? Yes
No

Do you have any second charges on the house? This figure should not include the mortgage or second charges if you have any. No
Yes

How much do you owe in loans and credit cards in total? £

Monthly income

Monthly Income (if none put ‘0’) £

Salary and Wages £

Pension, if any £

State benefits, if any £

Child allowance, if any £

Monthly essential expenses (you do not need to put down credit cards and loans)

Monthly Expenses £

Mortgage or rent £

Other secured loans £

Housekeeping (food, toiletries etc) £

Endowments £

Life insurance £

Council Tax £

Water Rates £

Electricity £

Gas £

Home Telephone £

Mobile Telephone £

Pension £

Car finance £

Car running costs £

Public Transport £

TV Licence/Sky £

Other e.g. medical £