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Personal Budget Plan

Your Details

Name: Date of Birth:

Is this a joint budget with your partner?

Partner’s Name: (if applicable):

Partner’s Date of Birth (if applicable):

Your Address:

How many children under 16 do you have? How many children aged 16-18 do you have?

How many other dependents do you have?

What is the total number in your household?

How many vehicles in your household? Do you: Own your home outright

Have a mortgage Rent from private landlord

Rent Local Authority Housing

Rent Housing Association

Live with parents/family

Other: Please give details ____________________

YES / NO

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Employment

Are you Employed: Full-time Part-time

Unemployed Self-employed

Not working due to illness / disability Retired

Carer Student

Other (Please give details)

Is your partner Full-time Part-time

employed: (if applicable) Unemployed Self-employed

Not working due to illness / disability Retired

Carer Student

Other (Please give details)

Your Assets

Do you own any assets that could be sold to raise money to pay your debts?

If yes, please discuss the type & value of the assets with your advisor. Tick to confirm ✔

If you are an owner/occupier:

How much is the property worth (approx.)?

How much in mortgage & secured loans is outstanding?

Is your property part-buy/part-rent? Yes/No

If you own a car/van:

Car/Van Registration Number

How much is the car/van worth?

How much HP or other secured loan is outstanding on the vehicle?

Do you have any savings, if so how much?

Any other assets, e.g. jewelry, antiques etc. Please give approx. value.

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Your Income

Your Salary or Wages - Include normal take home pay after deductions for tax, National Insurance and pension

contributions. Only include overtime if you receive this on a regular basis. (Note: 4 weekly is not the same as monthly.)

Earned Income Amount (£) Payment Frequency

Salary or wages (take home) ☐ Weekly, ☐ Monthly, ☐ Other

Partner salary or wages (take home) ☐ Weekly, ☐ Monthly, ☐ Other

Other earnings (including self employment) ☐ Weekly, ☐ Monthly, ☐ Other

Benefits and tax credits Amount (£) Payment Frequency

Universal Credit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Jobseeker’s Allowance (income based) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Jobseeker’s Allowance (contribution based) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Income Support ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Working Tax Credit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Child Tax Credit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Child Benefit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Employment and Support Allowance or Statutory Sick Pay

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Disability benefits (PIP/DLA) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Carer’s Allowance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Local Housing Allowance / Housing Benefit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Council Tax support/reduction ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other benefits/tax credits (e.g. maternity benefits). Please specify:

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Pensions Amount (£) Payment Frequency

State pensions ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Private or work pensions ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Pension credit ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other pensions. Please specify:

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other income Amount (£) Payment Frequency

Maintenance or child support ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Boarders or lodgers ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Non-dependant(s) contributions ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Student loans and grants ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other income (Please specify) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

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Your Outgoings: Fixed Costs Only include details of your normal payments for these items. If you have arrears, include them in the section about debts below. Don’t include debt or credit payments here.

Home and contents Amount (£) Payment Frequency

Rent ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Ground rent & service charges ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Mortgage ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Mortgage endowment ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Secured loans ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Council tax/rates

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Appliance & furniture rental (including appliance and furniture HP, conditional sale and so on)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

TV licence ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (Please specify)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Utilities Amount (£) Payment Frequency

Gas (Prepay Meter? Yes/No) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Electricity (Prepay Meter? Yes/No) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (including coal, oil, calor gas etc)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other expenditure (Please give details) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Water Amount (£) Payment Frequency

Water supply ☐ Weekly, ☐ Monthly, ☐ 6 Monthly, ☐ Annually

Water waste ☐ Weekly, ☐ Monthly, ☐ 6 Monthly, ☐ Annually

Care and health costs Amount (£) Payment Frequency

Childcare costs ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Adult-care costs ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Child maintenance or child support ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Prescriptions and medicines ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Dentistry and opticians ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Other costs (Please give details)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

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Transport and travel Amount (£) Payment Frequency

Public transport (e.g. work, school, shopping)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Hire Purchase or conditional sale vehicle ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Car insurance ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Road tax ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

MOT and ongoing maintenance ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Breakdown cover ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Fuel, parking and toll road charges ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (including taxis)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

School costs Amount (£) Payment Frequency

School uniform ☐ Weekly ☐ Monthly, ☐ Termly, ☐ Annually

After-school clubs and school trips ☐ Weekly ☐ Monthly, ☐ Termly, ☐ Annually

Other costs (Please specify)

☐ Weekly ☐ Monthly, ☐ Termly, ☐ Annually

Pensions and insurances Amount (£) Payment Frequency

Pension payments paid ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Life insurance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Mortgage payment protection insurance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Buildings and contents insurance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Health insurance (medical or accident or dental)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other (Please Specify) ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Professional costs Amount (£) Payment Frequency

Professional courses ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Union fees ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Professional fees ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Self-Employed Business Expenses (if not already deducted from income above)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Other (Please specify)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Other essential costs Amount (£) Payment Frequency

Other essential costs ☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

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Your Outgoings: Flexible Costs

Communications and leisure Amount (£) Payment Frequency

Home phone, internet, TV package (including film subscriptions)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Mobile phone(s) (Contract or PAYG?) If Contract, when does the contract end?

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Hobbies, leisure or sport (e.g. socialising, eating out, outings, clubs, leisure courses)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Gifts (e.g. birthdays, festivals, charity donations)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Pocket money ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Newspapers, magazines, stationery and postage

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Gambling (e.g. Lottery, Scratch Cards, Football Pools, Other Betting)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (Please Specify)

☐ Weekly, ☐ Fortnightly, ☐ Monthly, ☐ Annually

Food and housekeeping Amount (£) Payment Frequency

Groceries (e.g. food, pet food, non-alcoholic drinks, cleaning)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Nappies and baby items ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

School meals and meals at work ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Laundry and dry cleaning ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Alcohol ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Smoking products ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Vet bills & pet insurance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

House repairs and maintenance ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (Please Specify)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Personal costs Amount (£) Payment Frequency

Clothing and footwear ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Hairdressing ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Toiletries ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Other costs (Please Specify)

☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

Savings Amount (£) Payment Frequency

Savings ☐ Weekly, ☐ Fortnightly, ☐ 4 weekly, ☐ Monthly

It is important to put aside a small amount each week/month in savings to protect yourself from unexpected expenses, e.g. appliance breakdowns, car repairs, etc. Having a small amount of savings means it is less likely to be necessary to take out short term, usually expensive, credit, e.g. PayDay loans or overdrafts.

Debts Some debts are more important than others because the law gives creditors different ways of getting their money back. Only include arrears on priority payments here. If you are up to date with a payment you do not need to write it down here. Please bring supporting paperwork with the contact details for each creditor/collector

Priority Debts Amount (£) C r e d i t o r / C o l l e c t o r A c c o u n t / R e f e r e n c e

N u m b e r

Rent

Mortgage Arrears

Secured Loan Arrears

Housing Service Charges

Gas

Electricity

Other Fuel (e.g. Oil, Calor Gas)

Council Tax

TV Licence

Court Fines

Child Maintenance

Business debts (i.e. debts that would prevent you trading)

NOTE: You must keep paying these priority debts, both ongoing & any agreed arrears repayments, unless advised otherwise.

Non-priority Debts For example: Water arrears, unsecured loans, credit cards, catalogues, store cards, overdrafts etc.

Creditor / Collector Amount (£) Type of Debt e.g. overdraft/credit card/catalogue

Account / Reference Number CCJ

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NOTE: It is usual to stop paying these non-priority debts, unless advised otherwised

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Additional notes (e.g. reasons for debt, circumstances, temporary situations)

e.g. Made redundant in June 2014 and was out of work for 6 months

e.g. Communications and leisure: mobile phone – I have multiple family members abroad

PTO

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This information is an accurate to the best of my/our knowledge: Signed: (1st Client) Date: Signed: (2nd Client) Date:

citizensadvice.org.uk

Published June 2015

Citizens Advice is an operating name of The National Association of Citizens Advice Bureaux. Registered charity number 279057.

Do you have a complaint aboutCitizens Advice?

Financial Ombudsman ServiceBy post:Financial Ombudsman ServiceSouth Quay Plaza183 Marsh WallLondon E14 9SR

By phone:0800 023 4567 – free for people phoning from a ‘fixed’ line (eg a landline at home).

0300 123 9123 – free for mobile phone users who pay a monthly charge for calls to numbers starting 01 and 02.

By email:complaint.info@financialombudsman.org.uk

Who to complain to Local Citizens AdviceThe Manager of the local Citizens Advicecentre or the Chair of the Trustee Board atthe address below: Barnards YardSaffron WaldenCB11 4EB

 To contact the Citizens AdviceFeedback team: 03000 231 900feedback@citizensadvice.org.uk

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That’s why, if we’ve let you down, we want to hear from you – no matter how big or small the issue is.

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Don’t be afraid to speak to the Manager or person in charge of complaints. They will often be able to solve the problem straight away.

If they can’t, or you’re still not happy, you can make a formal complaint.

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If you want to progress to this stage, you must contact us within four weeks of receiving your review decision from Citizens Advice. Contact the Feedback team using the details on the back of this leaflet.

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The Financial Ombudsman Service will only step in once a local Citizens Advice has had the opportunity to investigate a complaint, so please contact the local service first.

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