1
2
3
4
5
6
7
Do you have a partner?
Yes
No
All information will be treated confidentially and will not be shared with anyone. This analysis will not impact your credit report.
Do you {PARTNER}receive income solely from Centrelink?
Yes
No
Have you {PARTNER}been on Centrelink for less than 6 months?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
1
2
3 or more
Property 1
What is your property type?
Residential
Rural Residential > 5 and < 25 acres
Rural Residential < 5 acres
Land < 25 acres
Other Property Type
What is the estimated market value of this property?
$
How much do you owe against this property?
$
What is the postcode of this property?
Property 2
What is your property type?
Residential
Rural Residential > 5 and < 25 acres
Rural Residential < 5 acres
Land < 25 acres
Other Property Type
What is the estimated market value of this property?
$
How much do you owe against this property?
$
What is the postcode of this property?
Yes
No
We can only help you if you disclose all your debts.
Credit Cards and Store Cards
Total Owing $
Total Owing $
Personal Loans and Pay-Day Loans
Total Owing $
Collection Agencies/Debt Collectors
Total Owing $
Overdue Council/Strata/Water Rates
Total Owing $
All other debts and outstanding bills including fines and taxes
Total Owing $
Total: $
$
Per
Week
Fortnight
Month
Quarter
Year
Before Tax
After Tax
Not Taxable
$
Per
Week
Fortnight
Month
Quarter
Year
Before Tax
After Tax
Not Taxable
$
Per
Week
Fortnight
Month
Quarter
Year
Before Tax
After Tax
Not Taxable
Yes
No
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