Assets & Liabilities

Forename

Surname

Net drawings/salary

State benefits (e.g. child benefit)

Other regular income

Spouse/partner’s net salary

Investment income

Mortgage/rent

Utilities

Other expenditure

Life assurance/pension

Council tax payments

Name of finance/source of finance

Balance outstanding

Final payment date (if applicable)

Type of financing (e.g. HP/leasing)

Monthly payment

Who was the guarantee provided to?

Amount

Purpose of guarantee