Statement of Means

  • PLEASE NOTE

    All figures entered below must be monthly amounts.

     

    If you receive/pay-out an amount on a weekly/fortnightly basis etc. ,
    please calculate how much these would be per month before entering them into the form

     

    * denotes a mandatory field
Statement of Means Form
Your Details
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Your Situation
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Priority Bills
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  •   We consider the above 4 amounts to be a priority bill, are you up to date with each of the above payments? *
Other Expenditure
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Your Income
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Summary
  • These fields are automatically calculated from the figures entered above

     
     
     

    per month

Payment Offer
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Submit Form
  • By submitting this form, you confirm that you are the customer stated above (or are authorised to act on their behalf) and that you agree with our policies (opens in a new window)
Request a Statement of Means Form
  • To request a hard copy or an email version of this form, please visit our contact page and complete the contact form.

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