Assessment

Basic Information
Debts
Income
Assets
Investments

Let's get started

Your Name

Phone Number

Email Address

Spouse's Name

How did you hear about us?

Whos debt is it?

Marital Status

Postal Code

What province do you live in?

Additional Information

Do you have children under the age of 18? If so how many?

Do you have children over the age of 18? if so how many?

Are you financially supporting your children over the age of 18?

Have you declared bankruptcy before?

If yes, were you discharged from that bankruptcy?

Do you owe Revenue Canada (CRA) for back taxes? If so how much?

Do you owe Revenue Canada (CRA) for CERB? If so how much?

Have you filed your taxes up to and including 2023?

Do you owe money to Family Maintenance Enforcement Program? If so how much?

Are your wages currently being garnished? If yes by who?

Do you pay child support? If so how much?

Do you pay alimony? If so how much?

Do you receive child support? If so how much?

Do you receive alimony? If so how much?

Do you receive Child Tax Credits? If so how much?

In this section you will enter all of your unsecured debt. Please do not list car loans or mortgages. You will provide those at a later time. Please do not lump all of your debt into one. Each creditor and amount owed must be listed individually in order to conduct an assessment.

Are you up to date with your payments?

Debt #1 - Creditor and amount owing?

Debt #2 - Creditor and amount owing?

Debt #3 - Creditor and amount owing?

Debt #4 - Creditor and amount owing?

Debt #5 - Creditor and amount owing?

Debt #6 - Creditor and amount owing?

Debt #7 - Creditor and amount owing?

Debt #8 - Creditor and amount owing?

Debt #9 - Creditor and amount owing?

Debt #10 - Creditor and amount owing?

Debt #11 - Creditor and amount owing?

Debt #12 - Creditor and amount owing?

Debt #13 - Creditor and amount owing?

Debt #14 - Creditor and amount owing?

Debt #15 - Creditor and amount owing?

Your Income

How often do you get paid?

Are you self emnployed?

What is your total monthly employment income? (Average)

If you have a spouse, how often do they get paid?

If you have a Spouse, what is their total monthly employment income? (Average)

Child Support Retrieved (Monthly Average)

Alimony Support (Monthly Average)

Tips or Cash (Monthly Average)

Part time Employment (Monthly Average)

Rental Property Income? (Monthly Average)

Disability income? (Monthly Average)

Pension Income? (Monthly Average)

WCB Income? (Monthly Average)

Social Assistance? (Monthly Average)

Employment Insurance (E.I)? (Monthly Average)

Property

Do you own property outside of Canada?

Do you own a home?

What date did you move into your current residence? (MM/DD/YYY)

If you own a home, what is the current market value?

What is the oustanding mortgage on this property?

Do you have a second mortgage on this property? If so what is outstanding?

Do you have a secured line of credit on this property? If so what is outstanding?

How many people are on title for this property?

Do you own any other property other than the home listed above?

Other Assets

If you own a vehicle what is the year, make, and model?

Is there a loan outstanding on this vehicle? If so how much?

How many Kilometers are on the vehicle?

If you own a secondary vehicle what is the year, make, and model?

Is there a loan outstanding on the vehicle? If so how much?:

How many Kilometers are on this vehicle?:

Do you own any other vehicles?

If you own more than two vehicles please list any remaining vehicles here

Do you own recreational vehicles such as boats, campers, ATV's, snow mobiles?

If you said yes to the recreational vehicles please list all vehicles here.

Investment Accounts

How much do you have in RRSP's

If so, what have you contributed in the last 12 months?

Do you contribute to RESP's? If so what is the current balance of that account?

Do you own Stocks? If so what is the current value?

Do you own Bonds? If so what is the current value ?

Do you own GIC's? If so what is the current value?

Do you own Mutual Funds? If so what is the current value?

Do you contribute to a Tax Free Savings account? If so what is the current value?

Do you have a Pension? If so what is the current value?

Do you have a LIRA Fund? If so what is the current value?