Credit Counseling Session

Questionnaire

Major reasons you sought financial counseling: Select all that apply.
What chapter are you filing?
Home

Is your home in foreclosure?

Are you making the mortgage payment?

Household Information
Type and Source of Your Income: Select all that apply.
Do you anticipate any increase or decrease in your income in the future? Select all that apply.

Increases

Decreases

Neither

Business

Do you own or operate a business?

Save Changes Next Step: View Income

Business

Is this a home based business?
Business Type
Business Income
Business Expenses
Monthly PaymentsIf category does not apply, enter 0. It's okay to estimate!

Save Changes Next Step: View Income

Income

Net Income Please enter net income (after deductions) for all income sources for your household. For social security or disability, please scroll down to miscellaneous income.

Employment / Wage Source 1

I am paid...

Employment / Wage Source 2

I am paid...

Employment / Wage Source 3

I am paid...

Employment / Wage Source 4

I am paid...

Miscellaneous Income Enter income only once in the category you think best describes it.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Income Summary

Save Changes Next Step: View Expenses

Expenses

Housing
We recommend spending for this expense category stay below 30% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Food / Cleaning
We recommend spending for this expense category stay below 15% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Transportation
We recommend spending for this expense category stay below 15% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Medical / Dental / Vision
We recommend spending for this expense category stay below 5% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Charitable
We recommend spending for this expense category stay below 10% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Miscellaneous
We recommend spending for this expense category stay below 10% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!
Savings
We recommend that you save 10% of your total monthly income.
MonthlyIf category does not apply, enter 0. It's okay to estimate!

Save Changes Next Step: View Debt

Debt

Consumer Debt / Installment Loan Payments If needed, you may combine similar debts.
Monthly PaymentsIf category does not apply, enter 0. It's okay to estimate!
Non-Dischargeable Debts
 
Monthly Payments
Total Owed

Save Changes Next Step: View Assets

Assets

Personal Property
Fair Market ValueIf category does not apply, enter 0. It's okay to estimate!
Real Property / Real Estate Personal; not business related.
Fair Market ValueIf category does not apply, enter 0. It's okay to estimate!

Save Changes Next Step: Summary

Notes & Summary

Budget (Expense) Summary
Expense Category Recommended Actual
% Income Monthly Total % Income Monthly Total

Summary

Monthly

Income
$0.00
Expenses
$0.00
Debt Payments
$0.00
Difference
$0.00

Budget

Budget Summary

Expense Category Recommended Actual
% Income Monthly Total % Income Monthly Total
  1. Big Picture

    Here you can get an idea of the whole process. You can easily see what you have completed, which step you are working on and what is coming next.

  2. Moving Around

    Start at the top and work your way down. Or click on the one you want to begin with! The circle will complete once you’ve filled out everything in that section.

  3. You can either click the Next Step button at the bottom

  4. or click the next section you want to work on.

  5. Summary

    This will automatically update as you enter your financial information. Great visual to help you see where your money is going!

  6. Questionnaire

    You’ll answer some questions about yourself.

  7. Income

    How much money is coming into your household monthly?

  8. Expenses

    Let us know your average monthly expenses. We’ll be asking for housing, food, entertainment, transportation and more.

  9. Debt

    This will include credit cards, loans, medical bills, etc.

  10. Assets

    Here you’ll enter the value of any personal property that you own.

  11. Verify & Submit

    Look over your entries. If everything looks right, you’ll click submit so that one of our financial counselors can review your information and give you their advice and recommendations.