CreditAid Full Assessment

We will use this confidential information to review your financial situation and provide recommendations on how we can help you.

Please fill in all pages of the following form. All fields marked with an asterisk (*) are required.

Creditaid Long Form

Step 1: Personal Information *Indicates required information.
How did you hear about us? (*)	Must choose a valid option before proceeding.
First Name (*)	First Name is Required
Last Name (*)	Last Name is Required.
Email Address (*)	Valid email address required.
Home Phone	Invalid Input
Mobile Phone	Invalid Input
Work Phone	Invalid Input
	Spouse's Information
Spouse's First Name	Invalid Input
Spouse's Last Name	Invalid Input
Spouse's Email Address	Enter Valid Email Address
Spouse's Home Phone	Invalid Input
Spouse's Work Phone	Invalid Input
Spouse's Mobile Phone	Invalid Input
	Home Address
Street Address (*)	Address is required.
	Invalid Input
City (*)	Invalid Input
Province (*)	Invalid Input
Postal Code (*)	Invalid Input
Number of Dependants (*)	Please enter only numbers
Best time to contact you (*)	Must choose a valid option before proceeding.

Step 2: Employment Information Please enter your employment information.
Employer (*)	Enter name of company here.
Employer's Address (*)	Enter Workplace Address.
Occupation (*)	Enter job title.
Length of Employment (*)	Enter number of years of employment.
	Spouse's Information
Spouse's Employer	Invalid Input
Spouse's Employer Address	Invalid Input
Spouse's Occupation	Invalid Input
Spouse's Length of Employment	Invalid Input

Step 3: Monthly Income Please enter your monthly income information.
Gross Income (*)	Must enter information before proceeding.
Net Income	Must enter information before proceeding.
CPP	Must enter information before proceeding.
OAS	Must enter information before proceeding.
Child Tax Benefit	Must enter information before proceeding.
Support	Must enter information before proceeding.
Other	Must enter information before proceeding.
	Spouse's Income
Spouse Gross Income (*)	Must enter information before proceeding.	If no spousal income, enter "0"
Spouse Net Income	Must enter information before proceeding.
Spouse CPP	Must enter information before proceeding.
Spouse OAS	Must enter information before proceeding.
Spouse Child Tax Benefit	Must enter information before proceeding.
Spouse Other	Must enter information before proceeding.

Step 4: Monthly Expenses Please enter your monthly expenses.
	HOUSING
Mortgage	Invalid Input
2nd Mortgage	Must enter information before proceeding.
Rent/Strata Fees	Invalid Input
Property Taxes	Invalid Input
Maintenance & Repairs	Must enter information before proceeding.
Insurance (Home/Content)	Must enter information before proceeding.
	UTILITIES
Hydro/Electricity/Gas	Must enter information before proceeding.
Water	Invalid Input
Telephone	Invalid Input
Mobile Cellular	Invalid Input
Cable/Internet	Invalid Input
Other	Invalid Input
Other	Invalid Input
Other	Invalid Input
	GENERAL
Food	Invalid Input
Clothing & Personal Care	Invalid Input
Child Care	Invalid Input
Alimony/Child Support	Must enter information before proceeding.
Medical/Life Insurance	Invalid Input
Drugs/Dental/Medical Travel	Invalid Input
Recreation	Must enter information before proceeding.
Auto Loan(s)	Invalid Input
Auto Insurance	Must enter information before proceeding.
Auto Expenses (Gas & Maintenance)	Must enter information before proceeding.
Transportation	Must enter information before proceeding.
Lunch/Coffee Breaks	Invalid Input
Alcohol/Tobacco	Invalid Input
Pet Food	Invalid Input

Step 5: Assets Please provide an estimated value of your assets.
Savings Account	Must enter information before proceeding.
Home Value/Equity	Invalid Input
Vehicle Value	Invalid Input
Vehicle Value	Invalid Input
Other Assets	Invalid Input
RRSP/Investments	Invalid Input

Step 6: Liabilities Please provide information on all debt, secured or unsecured.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.

Step 6a: Liabilities Continued Please provide information on all debt, secured or unsecured.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.

Step 6b: Liabilities Continued Please provide information on all debt, secured or unsecured.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.

Step 6c: Liabilities Continued Please provide information on all debt, secured or unsecured.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.
Name of Financial Institution/Credit Card	Must enter information before proceeding.
Type of Credit	Must enter information before proceeding.
Balance Owing	Must enter information before proceeding.
Monthly Payment	Must enter information before proceeding.

Creditaid: Helping Canadians Be Debt Free Since 1992

Get Debt Help Now

Click for Free Consultation

1-877-900-2659

Credit Counselling

Debt Consolidation

Debt Management

Calculate Payments

CreditAid Full Assessment

We will use this confidential information to review your financial situation and provide recommendations on how we can help you.

Step 1: Personal Information

Step 2: Employment Information

Step 3: Monthly Income

Step 4: Monthly Expenses

Step 5: Assets

Step 6: Liabilities

Step 6a: Liabilities Continued

Step 6b: Liabilities Continued

Step 6c: Liabilities Continued