Financial Statement Page 2

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Part B
Financial summary
IMPORTANT: As you complete the rest of this form you will be asked to transfer the totals for Items
D, G, I-L to this summary
A
$
2
Your total average weekly income.
(THIS IS THE FIGURE AT ITEM 16)
1
B
$
Your total personal expenditure
. (THIS IS THE FIGURE AT ITEM 33)
C
Total value of property owned by you.
$
(THIS IS THE FIGURE AT ITEM 44)
D
Total gross value of your superannuation.
$
(THIS IS THE FIGURE AT ITEM 45)
E
Total of your liabilities.
$
(THIS IS THE FIGURE AT ITEM 55)
F
Total of your financial resources.
$
(THIS IS THE FIGURE AT ITEM 58)
Part C
Your employment details
What is your current occupation?
3
4
Are you employed?
No. Go to Part D
Yes. Give details
full time
permanently
on contract
part time
casually
5
What is the name of your employer?
What is the address of your employer?
6
STATE
POSTCODE
PHONE
7
How long have you been employed at this place?
YEARS
MONTHS
DAYS
Are you self-employed?
8
No
Yes
STATE THE NAME OF THE BUSINESS / COMPANY / PARTNERSHIP / TRUST

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