AG Debt Solutions

Personal financial review form…

Personal Information:

Income Information:

Role	Monthly/Weekly	£
Net Salary
Partner’s net salary
Average overtime
Partner’s average overtime
Income support/family credit
Child benefit
Non-dependent contribution
Other state benefits
Other income
TOTAL INCOME

Asset Information:

Property	Joint or Owned	£
Estimated value of property
Less amount due on mortgage
Less amount due on secured loans
Equity
Endowment policies

Motor vehicles:	Joint or Owned	£
Current value
Less hire purchase
Net value
Stocks, shares, unit trusts
Cash at bank
Premium bonds
Any other assets (please detail)

Expenses

Home Related Expenses	Monthly/Weekly	£
Mortgage/rent
Other secured loans
Ground rent/service charges
Buildings/contents insurance
Life insurance/endowment
Electricity/gas/other fuel
Council Tax
Telephone Bills
Water rates

Other Expenses:	Monthly/Weekly	£
Food and drink
Clothing
Household items
Entertainment
Car and travel expenses
Maintenance payments
Prescription/health expenses
Regular savings
School meals/meals at work
Children’s expenses
Other (not debt repayments)

Details of Creditors

Please give as much detailed information as possible.

Press the Submit button to send this data to AG Debt Solutions