Full legal name as per driving licence/passport:

Please detail who your debts are with, and how much you roughly owe on each one: (eg ANZ Credit Card - $5,000



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Please complete the following information, so that I can assist with your enquiry.

Date of Birth:

Roughly how old are your debts: (ie 2 years old)

Are you up to up todate or behind in payments?

If you are behind, please can you explain what circumstances have led to you faling behind? (ie Medical issues, loss of job, relationship breakdown)

If you own a property (or properties), how much would their combined value be if you were to sell them tomorrow?

What is are your current rental or mortgage payments (ie $300/wk)

If you own a property is it in your own name or jointly with someone else?