HTML Preview Personal Budget Form page number 1.


Wages or salary £
Step 1
Income
Weekly
Wages or salary (partner) £
Jobseeker's Allowance £
Income Support or Pension Credit £
Tax Credit £
Retirement or works pension £
Child Benefit £
Incapacity Benefit £
Maintenance £
Non dependants' contributions £
£
£
Box A £
Total income
Step 2
Outgoings
Weekly
Mortgage £
Mortgage endowment policy £
Second mortgage £
Rent £
Council Tax £
Water rates £
Ground rent or service charge £
Buildings and contents insurance £
Life insurance and pension £
Gas £
Electricity £
Other fuel £
Housekeeping £
TV rental and licence £
Magistrates' court fines £
Maintenance payments £
Hire-purchase vehicle £
Travelling expenses £
School meals and meals at work £
Clothing £
Laundry £
Phone and mobile phone £
Prescriptions and health costs £
Childminding £
£
£
£
Box B £
Total outgoings
Step 3
Total income
Box A £
Total outgoings
Box B £
take away
Box C £
Money for creditors
Other 1
2
Other 1
2
3
Personal budget sheet
England and Wales
Name
Number of people in my household
Address
Step 4
Mortgage arrears
Priority debts
Balanced owed
Weekly offer of
repayment
£
£
Arrears on a second
mortgage
£Rent arrears
£
Council Tax or community
charge arrears
£Fuel debts: Gas
£ Electricity
£ Other
£Magistrates' court fine arrears
£Maintenance arrears
£Hire-purchase arrears
££
£
£
Box D £
Total priority
debts repayment
Step 5
Total priority
debts repayments
Box D £
take away
Box C £
Money for creditors
Box E £
Money for
credit debts
Step 6
Balanced owed
Monthly offer of
repaymentCreditor
1 £ £
£2
£3
£4
5 £
6 £
7 £
8 £
9 £
Box F £
Total owed
Box E £
Total monthly
repayment
£
£
£
£
£
£
£
£
Credit debts
£
£
£
£
£
£
£
£
£
£
Other 1
2
This is an accurate record of my financial position
on
© National Debtline 2007 (England and Wales)
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