Halifax : 902.405.3832 | Kentville : 902.365.3032

Serving the HRM core and Annapolis Valley

Online Assessment Form

Name

Address

Phone Number

Email Address

Total Number of People in Household

Number 17 years of age or less

Have you been bankrupt previously? *

Have you filed a consumer proposal previously?

Have you owned a business in the past five years?

If yes – name and type of business:

Still Operating? Or date ceased operations

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Net Monthly Income (you)

Net Monthly Income (spouse)

Child/ Spousal Support

Child Care

Expenses as result of medical condition

Other Details

Online Assessment Form

Name

Address

Phone Number

Email Address

Total Number of People in Household

Number 17 years of age or less

Have you been bankrupt previously? *

Have you filed a consumer proposal previously?

Have you owned a business in the past five years?

If yes – name and type of business:

Still Operating? Or date ceased operations

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Name

Amount Owing

Monthly Payments

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Asset

Description

Value

Net Monthly Income (you)

Net Monthly Income (spouse)

Child/ Spousal Support

Child Care

Expenses as result of medical condition

Other Details

For a free, private consultation

please call, email us or fill out our online application.

HALIFAX OFFICE
168 Hobsons Lake Drive, Ste 301
Halifax, NS B3S 0G4 (Bayers Lake)
Call: 902.405.3832

KENTVILLE OFFICE
15 Aberdeen Street
Kentville, NS B4N 2M9
Call: 902.365.3032

Toll Free: 1.855.733.3032

Email: [email protected]

Golding and Associates Limited is a Licensed Insolvency Trustee helping Nova Scotians with bankruptcy and debt relief in Kentville and Halifax Nova Scotia.
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