Rental budget form – Redbridge eforms

Outgoings: Housing & Utility Bills
Enter the total amount you pay including towards arrears you may have
Name*
First Last
Pay ref (if known)
Address*
Street Address Address Line 2 City County Postcode
Phone
Email
Rent
Payment amount £ Average per calendar month Not paid
Frequency
Mortgage
Payment amount £ Average per calendar month Not paid
Frequency
Secured loan (other than your mortgage)
Payment amount £ Average per calendar month Not paid
Frequency
Mortgage endowment premium
Payment amount £ Average per calendar month Not paid
Frequency
Service charge or ground rent
Payment amount £ Average per calendar month Not paid
Frequency
Water
Payment amount £ Average per calendar month Not paid
Frequency
Council tax
Payment amount £ Average per calendar month Not paid
Frequency
Gas
Payment amount £ Average per calendar month Not paid
Frequency
Electricity
Payment amount £ Average per calendar month Not paid
Frequency
Other household fuels (oil, coal etc)
Payment amount £ Average per calendar month Not paid
Frequency

Outgoings: Household services
Enter the total amount you pay including towards arrears you may have
Buildings & contents insurance
Payment amount £ Average per calendar month Not paid
Frequency
Telephone and internet
Payment amount £ Average per calendar month Not paid
Frequency
TV licence
Payment amount £ Average per calendar month Not paid
Frequency
Satellite or cable TV
Payment amount £ Average per calendar month Not paid
Frequency
Repairs, service contracts
Payment amount £ Average per calendar month Not paid
Frequency
Appliance rental
Payment amount £ Average per calendar month Not paid
Frequency
Child support paid by you
Payment amount £ Average per calendar month Not paid
Frequency
Childcare
Payment amount £ Average per calendar month Not paid
Frequency
Life insurance & private pension
Payment amount £ Average per calendar month Not paid
Frequency
Medical or accident insurance
Payment amount £ Average per calendar month Not paid
Frequency

Outgoings: Travel
Enter the total amount you pay including towards arrears you may have
Spares & servicing
Payment amount £ Average per calendar month Not paid
Frequency
Road tax
Payment amount £ Average per calendar month Not paid
Frequency
Car insurance
Payment amount £ Average per calendar month Not paid
Frequency
Breakdown cover
Payment amount £ Average per calendar month Not paid
Frequency
Fuel & parking
Payment amount £ Average per calendar month Not paid
Frequency
Public transport
Payment amount £ Average per calendar month Not paid
Frequency

Outgoings: Food & Housekeeping
Enter the total amount you pay including towards arrears you may have
Food, toiletries & cleaning products
Payment amount £ Average per calendar month Not paid
Frequency
School meals
Payment amount £ Average per calendar month Not paid
Frequency
Meals at work
Payment amount £ Average per calendar month Not paid
Frequency
Pets (food & insurance)
Payment amount £ Average per calendar month Not paid
Frequency
Tobacco
Payment amount £ Average per calendar month Not paid
Frequency
Clothing & footwear
Payment amount £ Average per calendar month Not paid
Frequency

Outgoings: Other services
Enter the total amount you pay including towards arrears you may have
School trips & activities
Payment amount £ Average per calendar month Not paid
Frequency
Medicines & prescriptions
Payment amount £ Average per calendar month Not paid
Frequency
Dentist & opticians
Payment amount £ Average per calendar month Not paid
Frequency
Hairdressing
Payment amount £ Average per calendar month Not paid
Frequency
Professional fees e.g. membership of a trade or regulatory body
Payment amount £ Average per calendar month Not paid
Frequency
Education fees
Payment amount £ Average per calendar month Not paid
Frequency
Laundry or dry cleaning
Payment amount £ Average per calendar month Not paid
Frequency

Outgoings: Personal & Leisure
Enter the total amount you pay including towards arrears you may have
Newspapers & magazines
Payment amount £ Average per calendar month Not paid
Frequency
Sports, hobbies & entertainment
Payment amount £ Average per calendar month Not paid
Frequency
Children's pocket money
Payment amount £ Average per calendar month Not paid
Frequency
Church or charity donations
Payment amount £ Average per calendar month Not paid
Frequency
Sundries & emergencies
Payment amount £ Average per calendar month Not paid
Frequency
Other costs
Payment amount £ Average per calendar month Not paid
Total Expenses £

Income: What money do you receive
If income is variable enter an average
Your wage
Payment amount £ Average per calendar month Not paid
Frequency
You partner's wage
Payment amount £ Average per calendar month Not paid
Frequency
Part-time wages
Payment amount £ Average per calendar month Not paid
Frequency
Child benefit
Payment amount £ Average per calendar month Not paid
Frequency
Rent or board received
Payment amount £ Average per calendar month Not paid
Frequency
State pension
Payment amount £ Average per calendar month Not paid
Frequency
Private pensions
Payment amount £ Average per calendar month Not paid
Frequency
Pension credit
Payment amount £ Average per calendar month Not paid
Frequency
Universal credit
Payment amount £ Average per calendar month Not paid
Frequency
Employment & Support Allowance (ESA)
Payment amount £ Average per calendar month Not paid
Frequency
Jobseeker's Allowance (JSA)
Payment amount £ Average per calendar month Not paid
Frequency
Child Support or CSA
Payment amount £ Average per calendar month Not paid
Frequency
Disability Living Allowance (DLA)
Payment amount £ Average per calendar month Not paid
Frequency
Income Support
Payment amount £ Average per calendar month Not paid
Frequency
Working Tax Credit
Payment amount £ Average per calendar month Not paid
Frequency
Child Tax Credit
Payment amount £ Average per calendar month Not paid
Frequency
Housing Benefit
Payment amount £ Average per calendar month Not paid
Frequency
Total Income £

Debts: Who do you owe money to?
This could include rent arrears, gas or electricity, credit and store cards, bank loans etc.
Name of organisation or lender Type of debt Amount owed Usual payment Per calendar month Not paid
Frequency
Total debt payments £
Court payments
Type of court order Amount owed Usual payment Per calendar month Not paid
Frequency
Total court debt £

Name of organisation or lender	Type of debt	Amount owed	Usual payment	Per calendar month	Not paid

Type of court order	Amount owed	Usual payment	Per calendar month	Not paid

Payment amount £	Average per calendar month	Not paid

Payment amount £	Average per calendar month	Not paid

Payment amount £	Average per calendar month	Not paid

Payment amount £	Average per calendar month	Not paid

Outgoings: Housing & Utility Bills