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Co-Signer Income and Expenditure Form
Debtor’s Details
Full Name
Address
Date of Birth
*
Phone Number
*
Email Address
*
Monthly Income
Source of Income |
Monthly Amount
(£)
Salary/ Wages (after tax)
*
Benefits (e.g., Universal Credit)
*
Pensions
*
Child Support/ Alimony
*
Other Income (please specify)
*
Total Monthly Income
£
Household Expenses
Type of Expense | Monthly Amount (£)
Rent / Mortgage
*
Council Tax
*
Utilities (Gas, Water, Electricity)
*
Telephone/ Internet
*
Food and Groceries
*
Childcare/ Schooling
*
Transport (Petrol, Public Transport)
*
Insurance (e.g., Health, Car, Home)
*
Loan Repayments Total (please list below)
*
Other Expenses (please specify)
Total Monthly Expenses
£
Debt Repayments
Please provide details of any debts or payment plans currently in place.
Creditor 1
Amount Owed (£)
Monthly Payment (£)
Creditor 2
Amount Owed (£)
Monthly Payment (£)
Creditor 3
Amount Owed (£)
Monthly Payment (£)
Creditor 4
Amount Owed (£)
Monthly Payment (£)
Creditor 5
Amount Owed (£)
Monthly Payment (£)
Creditor 6
Amount Owed (£)
Monthly Payment (£)
Creditor 7
Amount Owed (£)
Monthly Payment (£)
Creditor 8
Amount Owed (£)
Monthly Payment (£)
If you have more than 8 debt repayment creditors please list them below along with the amount owed (£) and the monthly repayments (£)
Total Monthly Creditor Repayment (Up to 8 Creditors)
£
Financial Proposal
Based on the above information, please indicate any repayment offer you wish to make regarding the debt owed.
Amount you can pay each month:
*
Submit