Client instruction: complete the form in this browser. Totals update automatically as figures are entered. Use the buttons at the end to print/save to PDF. The Standard Financial Statement and Assets & Liabilities forms print in their original formats on separate page(s).
Standard Financial Statement
Under 16:   16-18:
Housing tenure:
Employment:
Please optionally provide a brief description of how these employment types apply in your circumstances.
Partner’s employment:
Please optionally provide a brief description of how these employment types apply in your partner’s circumstances.
OverviewAmount
(£)
Total income£0.00
Total outgoings£0.00
Total available for priority creditors£0.00
Total available for non-priority creditors£0.00
Please confirm you have considered (or discussed with an adviser) the use of any assets to make lump sum payments
Please confirm that a monthly contribution to savings has been considered (or discussed with an adviser)
Additional notes (e.g. reasons for debt, circumstances, temporary situations)
e.g. Made redundant in June 2014 and was out of work for 6 months
Monthly Income
Total income£0.00
Monthly Outgoings: Fixed Costs
Total fixed costs£0.00
Explanations / Details
Standard Financial Statement
Total fixed costs£0.00
Monthly Outgoings: Flexible Costs
Total flexible costs£0.00
Total monthly outgoings (fixed and flexible)£0.00
Explanations / Details
Debts
This financial statement is an accurate record of the information provided.
Signed:
Date:
Standard Financial Statement
Priority Debts
If you list a debt, please enter the monthly payment being made towards the outstanding balance. Enter 0 if it is not currently being addressed.
CreditorOwed
(£)		Monthly payment
of outstanding balance
Total priority debts
£0.00
Priority debt query: Priority debts usually need to be evidenced and are likely to be required to be addressed before a non-priority creditor will accept a settlement or payment arrangement. You will need to confirm that the priority debts listed above are being addressed or will be explained to BBF.
Non-Priority Debts
If you list a debt, please enter the monthly payment being made towards the outstanding balance. Enter 0 if it is not currently being addressed.
CreditorOwed
(£)		CCJMonthly payment
of outstanding balance
Total non-priority debts
£0.00
Token Payments
Assets and Liabilities
Client instruction: complete this section if BBF has asked for an assets and liabilities statement. Totals update automatically.
Assets£Liabilities£
PropertyMortgages etc
VehiclesVehicle loans etc
Cash at bank, investments etc.Overdrawn balance on personal account etc.
Furniture, household appliances and personal effects etc.Personal loans re: furniture etc. (including credit cards)
Other assetsOther liabilities
Total Assets =£0.00Total Liabilities =£0.00

SURPLUS ASSETS OVER LIABILITIES = £0.00

I / WE HEREBY CERTIFY THAT THE ABOVE IS A FULL AND TRUE STATEMENT OF MY / OUR PERSONAL ASSETS AND LIABILITIES AND INCOME AND EXPENDITURE AS AT THE

DAY OF 20

SIGNED
SIGNED