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ADR-07-08-09- SECURE ONLINE PORTAL CURRENT EMPLOYMENT, SUPER AND OTHER BENEFITS

THE INFORMATION PROVIDED IN THIS SECURED PORTAL IS STRICTLY USED ONLY FOR THE APPLICATION TO SUPPORT YOUR CLAIM FOR BANKRUPTCY.

This component of your application Statement of Financial Affairs the Government  requires you to answer all question relevant to you, remembering this is a LEGAL document you are filing to the Government all answers must be accurately any false information can lead to court action against you and a possible jail term. 
** ALL YES / NO QUESTION ARE TO BE ANSWERED.
** IF A QUESTION  DOES NOT APPLY TO YOU GO TO THE NEXT QUESTION.
** ONCE COMPLETED FILL IN YOUR DETAILS AND SUBMIT TO US.

THE INFORMATION PROVIDED IN THIS SECURED PORTAL IS STRICTLY USED ONLY FOR THE APPLICATION TO SUPPORT YOUR CLAIM FOR BANKRUPTCY.
This component is required for the Trustee to accept your application for bankruptcy and covers:
Employment, payslip, tax, deductions, childsupport, garnishee( if applicable).

All YES/NO questions are required to be answered otherwise.

If you have two jobs lower section can be filled in to allow for this, if not scroll past and continue answer
the questions.
Fill in your details and submit and this information will come to Aussie Debt Relief in preparation of you full bankruptcy paperwork.








YOUR INCOME STATEMENT THIS SHOULD REFLECT WHAT IS ON YOUR PAYSLIP EXACTLY









No_18Yes_18

PRIVATE PATIENT HEALTH COVER

No_20Yes_20
SALARY SACRIFICE

No_21Yes_21

MOTOR VEHICLE BENEFITS WHERE THE VEHICLE YOUR DRIVE NOW IS OWNED BY SOMEONE ELSE.

No_24Yes_24

ABOUT YOUR INSOLVENCY ALLOWS ONE SELECTION ONLY THIS IS FOR GOVERNMENT STATISTICS.

Unemployment or loss of incomeAdverse legal actionLiabilities due to guaranteesGambling, speculation & extravagance in livingIll health or absence of health insuranceDomestic discord or relationship breakdownsExcessive use of credit facilities including losses on repossessions, high interest payments and pressure selling

BUSINESS RELATED ONLY APPLIES IF YOU HAVE PERSONALLY OPERATED A BUSINESS
Economic conditions affecting industry, including competition, credit restrictions, fall in prices or increases in costsLack of business ability including underquoting or failure to assess potential of businessExcessive interest payments on loan monies and capital losses on repaymentsExcessive drawings including failure to provide for taxationInability to collect debts due to disputes, faulty work or bad debtsFailure to keep proper books of account and costing recordsLack of sufficient working capitalGambling or speculationOther reason not listedSeasonal conditions including floods and drought

Have you previously presented a declaration of intention to present a debtor’s petition, proposed or entered into a debt agreement or a personal insolvency agreement or become bankrupt.
No_25Yes_25





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