Application Form For Transitional Housing Page 5
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7PART 4.4 BANKRUPTCY (if relevant)
4.4a Bankruptcy Status
Are you currently bankrupt or have you filed for bankruptcy?
Yes
No
If you answered yes, when did you file?
___________________ (dd/mm/yyyy)
4.4b Debt Agreement
Are you currently engaged in a debt agreement?
Yes
No
If you answered yes, when was this approved?
___________________ (dd/mm/yyyy)
PART 5 – ASSETS
Do you own or are you currently purchasing any of the following? Please select and provide information for all that apply.
House
Address
Land
Address
Other
Address
PART 6 – FURTHER INFORMATION
Please provide any additional information / supporting evidence including the housing reference (PART 1.4)
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