Debt Counselling Pre-Qualification Assessment

Are you currently working?

Do you receive any additional monthly income?

Your Living Situation

Estimated Monthly Disposable Income

Your Debt and details

Do you currently have outstanding debt?

Consent & Credit Information

I consent to my personal and financial information being collected and processed for the purpose of assessing my financial situation and responding to my debt counselling enquiry.

I consent to the obtaining and processing of my credit information, where legally permitted, for the purpose of assessing my debt position and determining whether debt counselling may be suitable for me.

I confirm that the information I have provided is true and correct to the best of my knowledge.

Debt Counselling Pre-Qualification Assessment

Are you currently working?

What is your approximate monthly income after deductions? Please enter the amount you receive after PAYE, UIF and other deductions.

Do you receive any additional monthly income?

Approximately how much additional income do you receive per month?