Income and Expenditure Form

Please complete the form below in as much detail as you can and as accurately as possible to help us see:

  • What money is coming in
  • What you need to pay your essential bills
  • What money you have left to pay your debts

Some tips before you start…

This budget is based on monthly amounts. If any of your income or expenses aren’t monthly, please let us know the monthly equivalent in the Additional Notes section.

Once you’ve completed the form, it’ll go straight to our team. They’ll be in touch with you shortly to chat about your arrangement.

Please note: If you don’t need to declare an income or expenditure for one of the items below, just type 0 as your answer.

    Your Details





    Please enter your thisbank Loan Account Number to help our team find your details.


    See list at the end of the form to list any priority bills outstanding

    Anything else you think we should know?

    Income – Earning




    Anything else you think we should know?

    Income – Benefits and Tax Credits













    Maternity Benefits, etc.

    Anything else you think we should know?

    Income – Pensions





    Anything else you think we should know?

    Income – Other Income






    Anything else you think we should know?

    Expenses – Home and Content










    Anything else you think we should know?

    Expenses – Food and Housekeeping

    For example, food, pet food, non-alcoholic drinks, cleaning products, etc.





    Anything else you think we should know?

    Expenses – Personal Costs







    Anything else you think we should know?

    Expenses – Utilities







    Anything else you think we should know?

    Expenses – Care and Health Costs








    Anything else you think we should know?

    Expenses – Transport and Travel

    For example, travel you use to get to work, school, for shopping, etc.








    Anything else you think we should know?

    Expenses – School Costs




    Anything else you think we should know?

    Expenses – Pensions and Insurances








    Anything else you think we should know?

    Expenses – Professional Costs





    Anything else you think we should know?

    Expenses – Other Essential Costs


    Your debts – priority debts

    This includes mortgage, rent, council tax, secured loans, gas/electricity, court fines, child maintenance
    Please enter the name(s) of your Creditor(s), the amount you owe, and the agreed monthly payment amounts.


    Please enter the name(s) of your Creditor(s), the amount you owe, and the agreed monthly payment amounts.

    Before submitting

    Please ensure you have filled in a value for every item on the Income and Expenditure form. If you do not have an income or expense to declare, please type ‘0’ as your answer

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