DEBT ASSESSMENT

Your Path to $0 Debt Starts Here

Are you ready to be debt-free? Complete the Budget Worksheet below to see what consolidation options are available to you. Once submitted, a licensed credit counsellor will review your information and reach out with a free quote. A Debt Management Plan can reduce your interest rates for unsecured debt to as low as 0% interest and lower your monthly payments.

Not ready to fill out the budget? Contact us directly and we can walk through your situation with you.

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Budget Worksheet
NOTE: All information collected from this form will remain private and confidential between the applicant and Consumer Credit Counselling 1993 Ltd. Information will not be shared with any third party without the applicant’s consent.
Name*
First Last
Spouse’s Name (if applicable)
First Last
Phone
Email Address*
Number of Dependants
Income
Net Monthly Pay
Other Income (If applicable)
Child Tax Income
Spouse Income (If applicable)
Net Monthly Pay
Other Income (If applicable)
Monthly Expenses
Rent/Mortgage
Hydro/Gas
Sewer/Water
Property Taxes
Strata/Condo Fees
Phone/Cable/Internet
House Insurance
Groceries
Vehicle Payments
Vehicle Insurance
Gasoline
Public Transportation
Monthly Banking fees
Prescriptions
Medical Plan
Dental Plan
Child Support/Alimony Out
Life Insurance
Day Care
Pet Expenses
Student Loan Payments
Secured Loan Payments
Toiletries
MISC
List of Creditors
Use the + button to add another creditor
Creditor Name Balance $
Comments

Your Path to $0 Debt Starts Here

Budget Worksheet

Income

Spouse Income (If applicable)

Monthly Expenses

List of Creditors

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Creditor Name	Balance $