On-line Advice

You can now make an appointment to speak to an advisor free through Skype by calling our offices on 0117 954 3990 or sending an e-mail request to simon@bdac.org.uk  Alternatively, please complete the information form below to receive advice via e-mail.

In order to provide you with the best possible advice, please help us to do this by completing this form as fully as possible.

Please be aware that the information you enter into the form below will be sent to a specialist debt adviser via email. [please note the on-line form is currently out of service, but will be up and running again asap]

Your Name (required)

Your Email (required)

Telephone number(s) (required)

Postcode (required)

Date of birth (required)

Ethnicity (required)

Number of adults at your home

Number of dependant children at your home

Answering the following questions will help us understand the options available for you:

If you are working:

How many hours do you work per week?

Do you receive Working Tax Credit?  Yes No

Do you receive Child Tax Credit?  Yes No

Are you receiving statutory sick pay?  Yes No

If you receive benefits:

Are you claiming any means-tested benefits:

Are you claiming any other benefits:

Contributions-based Jobseeker's Allowance (JSA)  Yes No

Contributions-related Employment and Support Allowance (ESA)  Yes No

Incapacity benefit  Yes No

Disability Living Allowance  Yes No

Carer's Allowance  Yes No

Any other benefit - Please tell us which one:

If you are retired:

Are you receiving any private or employment pensions?  Yes No

Are you receiving state pension?  Yes No

Are you receiving Guarantee Pension Credit?  Yes No

Your home:

Do you have arrears with any of the following - please give approximate figures if you don't know the exact amount:

Rent or mortgage (how much?)

Council Tax (how much?)

Electricity (how much?)
supplier

Gas (how much?)
supplier

Water & sewerage (how much?)

Income Tax (how much?)

Credit debts, such as loans, credit cards etc. (how much?)

Do you have a benefit overpayment of:

Tax Credits (how much?)

Housing Benefit (how much?)

Other Benefit (how much?)

Do you have a bank overdraft?  Yes No

Is it within it's limit?  Yes No

Do you have a bank loan from the bank you are banking with?  Yes No

Please describe the debt problem(s) you are having

Please type the letters you see in the box below

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