Other personal DESCRIPTION AND LOCATION $ property TOTAL VALUE OF PROPERTY OWNED BY YOU $ [Add extra lines, if necessary, so that all details of income and assets are disclosed.] LIABILITIES You should leave this section blank. It will need to be completed by the defendant/judgment creditor Average weekly expenses: Other liabilities: ITEM WEEKLY LIABILITIES NAME OF BANK/INSTITUTION TOTAL AMOUNT AMOUNT OWED Food $ Home mortgage $ Household $ Other loans $ supplies Mortgage/rent $ Credit $ Gas $ Credit cards $ Electricity $ Other liabilities $ (specify) Heating fuel $ $ TOTAL $ Telephone $ Motor vehicle Petrol $ • Maintenance $ • $ • Medical/hospital $ funds Other insurance $ (specify) Fares $ Clothing and $ shoes $ $ expenses, including fees and levies Medical/chemist $ /pharmaceutical Hire purchase $ payments Credit cards $
Other personal property DESCRIPTION AND LOCATION $ TOTAL VALUE OF PROPERTY OWNED BY YOU $ [Add extra lines, if necessary, so that all details of income and assets are disclosed.] LIABILITIES You should leave this section blank. It will need to be completed by the defendant/judgment creditor Average weekly expenses: Other liabilities: ITEM WEEKLY AMOUNT LIABILITIES NAME OF BANK/INSTITUTION TOTAL AMOUNT OWED Food $ Home mortgage $ Household supplies $ Other loans $ Mortgage/rent $ Credit $ Gas $ Credit cards $ Electricity $ Other liabilities (specify) $ Heating fuel $ $ TOTAL $ Telephone $ Motor vehicle • Petrol $ • Maintenance $ • $ Medical/hospital funds $ Other insurance (specify) $ Fares $ Clothing and shoes $ $ expenses, including fees and levies $ Medical/chemist /pharmaceutical $ Hire purchase payments $ Credit cards $
INS_exam_not_P.docx