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					                                           National Debt Advisors
                                           15173 61st ave Surrey BC, V3S 5J7
                                               Toll Free: 1-866-284-2527
                                                  Fax: 1-866-284-2527

                                                  Budget worksheet

General Information

First Name:                     _______________________    Last Name:              _______________________
Spouse Name:                    _______________________    Spouse Last Name:       _______________________
Home Address:                   __________________________________________________________________________
City:                           _______________________    Postal Code:            _______________________
Home Number:                    _______________________    Cell Number:            _______________________
Email Address:                  _______________________    Number Of Dependants:   _______________________


Employment Information

Employer:                       _______________________    Work Number:            _______________________
Employer Address:               __________________________________________________________________________
Time Employed:                  _______________________    Occupation:             _______________________
Start Date                      DD/MM/YYYY                 Net Monthly Pay:         $                  -
Overtime:                       Yes/No


Spouse Employment Information

Employer:                       _______________________    Work Number:            _______________________
Employer Address:               ______________________________________________________________________________
Time Employed:                  _______________________    Occupation:             __________________________
Start Date                      DD/MM/YYYY                 Net Monthly Pay:         $                  -
Overtime:                       Yes/No


Monthly Expenses

**** Please use numeric values only.


Rent or Mortgage:                $                   -      Hydro:                       $            -
Natural Gas                      $                   -      Sewer/Water:                 $            -
Home Phone:                      $                   -      Cell Phone:                  $            -
Cable:                           $                   -      Internet:                    $            -
Groceries:                       $                   -      Public Transportation:       $            -
Gas For Vehicle:                 $                   -      Car Payment:                 $            -
Car Insurance:                   $                   -      Car Maintenance:             $            -
Secured Loans:                   $                   -      Revenue Canada:              $            -
Cigarettes: (Max. $100)          $                   -      Entertainment: (Max. $100)   $            -
Prescriptions:                   $                   -      Medical Plan:                $            -
Day Care:                        $                   -      Child Support:               $            -
Home Insurance:                  $                   -      Life insurance:              $            -
Clothing: (Max. $50/person)      $                   -      Pet Expenses:                $            -
Strata Fees:                     $                   -      Student loans                $            -
Property Taxes:                  $                   -

Total Expenses:                  $                   -
Monthly Income

Your Income:                       $                           -        Spouse Income:                      $      -
Child Tax Credit:                  $                           -        Other Income:                       $      -

Total Income:                      $                           -        Total Expenses:                     $      -

This is the available income you have to pay your debt                   $                           -

Assets

Value of Home:                     $                           -        Mortgage Owed:                      $      -
Value of Vehicle:                  $                           -        Vehicle Loan:                       $      -
RRSP´s:                            $                           -        Mutual Funds:                       $      -
Other Investments:                 $                           -        Household Goods:                    $      -

Vehicle Make and Model            ________________________________________________________________________________
Mortgage held by?                 ________________________________________________________________________________

List of Creditors

**** This category is for unsecured debt only.
**** Mortgages, vehicle loans, Government debts, student loans, and other secured debt does not get listed here.


Total Debt                         $                           -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -

Creditor Name:                    _______________________               Account Balance:                    $      -
Account Number:                   _______________________               Monthly Payment:                    $      -
Creditor Name:    _______________________   Account Balance:   $   -
Account Number:   _______________________   Monthly Payment:   $   -

Creditor Name:    ______________________    Account Balance:   $   -
Account Number:   ______________________    Monthly Payment:   $   -

Creditor Name:    ______________________    Account Balance:   $   -
Account Number:   ______________________    Monthly Payment:   $   -

Creditor Name:    ______________________    Account Balance:   $   -
Account Number:   ______________________    Monthly Payment:   $   -

Creditor Name:    ______________________    Account Balance:   $   -
Account Number:   ______________________    Monthly Payment:   $   -

Notes:
_______________

_________________

				
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