The List below shows some of the standard question the application form asks. This is by no means comprehensive as some other parts may occur if you select certain answers requesting more information.
Are you, or have you previously been known by any other name?
Date of Birth
Town of Birth
Do you Rent/Own your home?
Number of dependant children
Do you currently live, or is your principal place or residence in England or Wales?
Have you either lived, or had your principle place of residence, in England or Wales?
Have you carried on business in either England or Wales in the last 3 years?
Any previous addresses in the past 6 years?
National Insurance Number
What is your ethnic group?
What do you consider your national identity to be?
Do you consider yourself to have a disability?
Are you currently subject to a formal Insolvency Proceeding?
Is there a pending bankruptcy petition against you?
Are you currently subject to a Debt Management Plan or County Court Administration Order?
Have you been in any kind of Insolvency procedure before?
Reasons for your debt problems: (Relationship Breakdown, Significant reduction in household income, Loss of debtors employment, Living beyond means, Illness/Accident, Business Failure, Increase in household expenses, Other)
Are you currently? (Self Employed/Trading, Employed, Unemployed, Housewife/husband – incl. caring for dependents, Company Director/Promoter, Retired, Student, Other)
Have you had a previous trading name?
Cash in hand
Cash at bank or building society
Money owed to you
Tools for trade
Year of 1st Registration
Motor vehicles value
Do you own any freehold or leased property?
Do you have any realisable assets?
Property Transactions and Preferred Creditors
Have you given away any property or sold it for less than its true value in the last 2 years?
Have you preferred any creditors over others in your payments in the last 2 years?
Type of Creditor
Name of Creditor
Address of Creditor
Roll or Account Number
Amount owed to Creditor
Is this an excluded debt?
Is this a secured debt?
Is there an attachment of earnings order associated with this debt?
Any more creditors?
Income and Expenditure Account
Monthly Total Salary / Wages
Monthly Total Other Income
Monthly Total Benefits
Monthly Total Pensions
Ground rent and Service charges
Other Secured Loans
Mortgage Endowment and MPPI
Building & Contents Insurance
Pension and Life Insurance
Other Utilities(Coal, Oil, Calor Gas)
Magistrate Court Fines
Maintenance or Child support
Hire Purchase / Conditional Sale
Child Care Costs
Adult Care Costs
Monthly Total Phone
Monthly Total Travel
Monthly Total Housekeeping
Monthly Total Other Expenditure
Income less Expenditure