Debt Fact Find Form

If you are experiencing financial difficulty with mortgage payments, arrears, or other debts and would like confidential advice on how to tackle the situation, please complete the form below. Include as much information as possible, which will assist us in understanding the nature of your difficulties. One of advisors will review your information and reach out to you with advice regarding all available options.

Step 1: Household income (monthly)

Include as much information as you can about your income below. If there are additional income figures that aren't listed, please add these.

Income item	You	Your Partner (if applicable)
Salary / wages
Bonus / overtime / commission
Social welfare benefit
Mortgage interest supplement
Family income support
Carers allowance
Job seekers allowance
Maintenance
Pension

Add income item Delete income item

Step 2: Household expenses (monthly)

The Insolvency Service of Ireland (ISI) has established a set of guideline figures that outline reasonable living expenses for individuals, couples and families. These guidelines take into account the various costs associated with your day to day household living and travel expenses. We will use these figures for you according to your circumstances. Include as much information as you can below, so we can work out your expense costs accurately. If you have any additional expenses, please include these too.

Reasonal Living Expenses
Monthly mortgage or Rent
How many adults live at home?
Are there any children or dependents at home?	Yes No Please enter any ages of dependents (separated with a comma).
Do you own any vehicles?	Yes No How much do you spend per month on fuel on your vehicle(s)?
Additional Expenses	You	Your Partner (if applicable)
Childcare
Voluntary Health Insurance (VHI)

Add expense item Delete expense item

Step 3: Property details (if applicable)

PLease list all information about any properties you have.

Mortgage amount outstanding
Current house value
Mortgage lender
Years remaining on mortgage
Do you have arrears on your mortgage?	Yes No

Add a property Delete a property

Step 4: Information about your debts (credit cards, loans, overdrafts etc...)

Fill out as much information as you can about any debts you have (if applicable).

#	Debt / creditor name	Total balance (approx)	Monthly payment (approx)
1

Add a debt Delete a debt

Step 5: Personal details

	You	Your partner (if applicable)
Full name
Email address
Phone number
Could you provide some information about why you are having difficulties with your finances? (Optional)

By submitting this form I consent to the processing of my data & agree with the National Debt Relief Privacy Notice. All advice is free & confidential and you are under no obligations by submitting this form. Your information will never be passed to any third parties.

Why Choose National Debt Relief

By choosing us, you can have confidence that you are receiving reliable advice, accurate information, and effective insolvency solutions that are tailored to your specific needs.

Expert advice on all options

We have been working with clients and creditors in the Insolvency industry for almost 90 years. Our team have extensive knowledge and expertise in the field of Insolvency and in dealing with difficulties with secured and unsecured debts. After a brief review of your situation, we will advise on all options available for addressing your financial difficulties. You can then take the time to decide if and how you would like to proceed. We will be there to answer any questions you might have. If you choose to use our services, we will keep you up to date and informed throughout each stage of your application.

Excellent customer service

As a family run company, our priority is to provide a high level of Customer service. Whether you are seeking advice or entering into an Insolvency Arrangement, we are dedicated to providing you with support and care. We offer step-by-step guidance throughout the lifespan of your plan, from initial advice and set up, to acceptance, right through to regular reviews and completion.

High case acceptance rate

We have a great acceptance rate from creditors for any cases that we put forward. This is because we will only put a case forward if we believe it has a good chance of getting accepted. It would be unethical and time-wasting of us to try and put a case forward for you, if it is not the most suitable option or in your best interests. If your case is not accepted by your creditors, there is an appeals process which we can avail of for you if you are elgiible.

5 PIPs in-house

We have 5 PIPs (Personal Insolvency Practitioners) in-house, so no third parties need to be involved in setting up your arrangement. A PIP is the professional that is required in facilitating the application and oversight of an Insolvency Solution. You can have peace of mind that your arrangement will be managed successfully for it’s duration.

No upfront fees or hidden charges

If you contact us for advice there is no charge. We will not request payment of any upfront fees should you wish to apply for a solution. If your solution is not accepted by your creditors, you will never receive a bill from us. We only charge set up and management fees for a plan that is successfully accepted and any fees are outlined in your proposal and discussed prior to any application. Click here to read more about our fees and key information.