Statement of Means


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


    per month

Payment Offer
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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