Affordability Calculator - Self Assessment

We have identified that you need some time to pay your taxes which are due to HMRC.

To help us approach HMRC Debt Department we require you to complete this Affordability Calculator which feeds into a Statement of Financial Facts. The information supplied will enable HMRC to assist you in a repayment plan.

The overdue debt should be paid within 12 months, and at least 50% of surplus income needs to be paid to HMRC (or more, should the 50% be less than the required payment). You will need to complete this form based on your monthly income and expenditure. If you have weekly figures then multiply by 52 and divide by 12, and use this figure.

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

ABOUT YOU

What is your full name?(Required)

What is your UTR number?(Required)

This is a 10-digit number. It might be called 'tax reference'.

What is the amount of overdue debt?(Required)

This is the amount of debt owed at the time of completing this form.

Insert Today's Date(Required)

YOUR INCOME

This section asks you to detail all of your monthly income.

WAGES / OTHER INCOME

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Wages?(Required)

Other income?(Required)

Total monthly wage income

BENEFITS & TAX CREDITS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Child Benefit?(Required)

Child Tax Credit?(Required)

Working Tax Credit?(Required)

Universal Credit?(Required)

Local Housing Allowance / Housing Benefit?(Required)

Employment and Support Allowance?(Required)

Income Support?(Required)

Disability Allowance?(Required)

Child Disability Allowance?(Required)

Jobseekers Allowance?(Required)

Statutory Sick Pay?(Required)

Carers Allowance?(Required)

Other benefits?(Required)

Total Benefits & Tax Credits

PENSION INCOME

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

State Pension?(Required)

Private / Work Pension?(Required)

Pension Credit?(Required)

Other Pension?(Required)

Total Pension Income

OTHER INCOME

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Boarding / Lodging?(Required)

Non-Depentant contribution?(Required)

Child Support / Maintenance?(Required)

Student Loans?(Required)

Rent?(Required)

Total Other Income

YOUR OUTGOINGS

This section asks you to detail all of your monthly outgoings. PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Rent?(Required)

Mortgage?(Required)

Council Tax?(Required)

TV Licence?(Required)

Secured Loan?(Required)

Ground Rent / Service Charge?(Required)

Household appliance hire purchase?(Required)

Household rental?(Required)

Mortgage endowment?(Required)

Total Fixed Costs

UTILITY COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Dual Fuel?(Required)

Electricity?(Required)

Gas?(Required)

Water?(Required)

Other?(Required)

Total Utility Costs

CARE & HEALTH COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Prescriptions?(Required)

Dentist?(Required)

Opticians?(Required)

Childcare?(Required)

Child maintenance / support?(Required)

Adult care?(Required)

Total Care & Health Costs

TRANSPORT & TRAVEL COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Car insurance?(Required)

Road tax?(Required)

Fuel & parking?(Required)

Breakdown cover?(Required)

MOT & vehicle servicing?(Required)

Vehicle hire purchase / lease?(Required)

Public transport?(Required)

Total Transport & Travel Costs

PENSION & INSURANCE COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Buildings & Contents?(Required)

Life Insurance?(Required)

Mortgage Payment Protection Insurance?(Required)

Health Insurance?(Required)

Pension Payment(s)?(Required)

Total Pension & Insurance Costs

PROFESSIONAL COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Professional courses?(Required)

Professional fees?(Required)

Union fees?(Required)

Total Professional Costs

SCHOOL COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

School uniform?(Required)

School after clubs / trips?(Required)

Total School Costs

OTHER ESSENTIAL COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Criminal fees?(Required)

Loan repayment to family or friend?(Required)

Legal fees?(Required)

Total Other Essential Costs

FOOD & HOUSEKEEPING

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Groceries?(Required)

Meals at work?(Required)

Alcohol?(Required)

Laundry & cleaning?(Required)

Household repairs & maintenance?(Required)

Nappies & baby items?(Required)

School meals?(Required)

Smoking products?(Required)

Vet bills & pet insurance?(Required)

Total Food & Housekeeping Costs

COMMUNICATION & LEISURE COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Home phone & internet?(Required)

Mobile telephone?(Required)

Hobbies, leisure & sport?(Required)

Gifts?(Required)

Newspapers, magazines & subscriptions?(Required)

Pocket money?(Required)

Charitable donations?(Required)

Religious contributions?(Required)

Total Communication & Leisure Costs

PERSONAL COSTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Clothing & footwear?(Required)

Toiletries?(Required)

Hairdressing / Barber?(Required)

Total Personal Costs

PRIORTY DEBTS

PLEASE NOTE: Required fields must have an entry, if not applicable please enter 0.

Credit cards and Loans (monthly repayments)(Required)

Mortgage arrears / Rent arrears? (monthly arrears payments)(Required)

Court Orders such as CCJ (monthly repayments)(Required)

Total Priority Debts

AFFORDABILITY CALCULATIONS

This section of the form totals the figures you've input and calculates any surplus funds, including a proposed monthly repayment to HMRC. It also includes an area to detail why you may not be able to pay the debt.

Total monthly Income

Total monthly Costs

Surplus (Total monthly income minus total monthly costs)

REPAYMENT PLAN

HMRC minimum requirement (Amount owed to HMRC divided by 12 months)

Actual proposed payment (Total monthly income minus total monthly costs)

Number of months to repay (Amount owed to HMRC divided by 'Actual proposed payment')

Explanation as to why you cannot pay the debt:

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Affordability Calculator - Self Assessment

ABOUT YOU

YOUR INCOME

WAGES / OTHER INCOME

BENEFITS & TAX CREDITS

PENSION INCOME

OTHER INCOME

YOUR OUTGOINGS

UTILITY COSTS

CARE & HEALTH COSTS

TRANSPORT & TRAVEL COSTS

PENSION & INSURANCE COSTS

PROFESSIONAL COSTS

SCHOOL COSTS

OTHER ESSENTIAL COSTS

FOOD & HOUSEKEEPING

COMMUNICATION & LEISURE COSTS

PERSONAL COSTS

PRIORTY DEBTS

AFFORDABILITY CALCULATIONS

REPAYMENT PLAN

GET IN TOUCH

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