--- title: Assessment Form - Debt Rescue --- Assessment Form ![](https://solutions.debtrescue.com.au/hubfs/Revive/img/revive-financial-logo.png) In partnership with Powered by ![](https://solutions.debtrescue.com.au/hubfs/Revive/img/revive-financial-logo.png) Step 1 of 5 Important Information Step 2 of 5 Your Debts Step 3 of 5 Your Income Step 4 of 5 Your Living Arrangements Step 5 of 5 Your Solution ## Your Details ### First Name ### Last Name ### Email ### Phone This phone number will be used for 2 factor authentication (2FA) later to ensure your account is secure. ### Post Code Allows us to contact you at an appropriate time. ## We Take Your Privacy Seriously Before you enter into an agreement with us, you have a duty to disclose any accurate and relevant information regarding your financial circumstances that may affect the service that you are eligible to enter into. This may include: - Personal information - Statements for outstanding secured and unsecured debts - Relevant financial statements - Evidence of Income - Proof of Australian residency status At Revive Financial Group, we are committed to protecting your privacy at all times. We are bound by the Privacy Act 1988 (“the Privacy Act”) that outlines how we collect, hold, use and disclose your personal information. By visiting our website, having a telephone call with our team members or applying for a service, you agree and consent to your personal information being collected, held, used and disclosed as set out in our [Privacy Policy](https://revivefinancial.com.au/privacy-policy/). We take reasonable precautions to secure your personal information and ensure it is protected against unlawful use, unauthorised access, modification and disclosure. As part of our services to you, we may provide your personal information that you disclose in this online assessment form to our referral partners. We work with a number of referral partners and when you choose to consider the refinance option we will advise you of the name of the referral partner. We may receive commissions from our referral partners for a referral that we make. You will not be charged any referral fees. If you take-out credit that is regulated by the National Credit Code, your credit contract will usually describe the referral fees and commission that will be paid by the lender in relation to your credit contract. Agree and Continue Previous Step ## Your Debts ### What kind of debts do you have? Select an option(s) Credit/store cards Personal loan Pay day loan Buy now pay later Tax debt Disconnected service bills Home loan Car loan Others Please select at least one of the above options. If you were required to provide your Car details to obtain any Personal Loans, it may be a secured loan. Please include those loan amounts as a Car Loan. Next Step Previous Step ## Unsecured Debts ### Total of your Credit/Store Cards $ ### Total of your Personal Loans $ ### Total of your Pay Day Loans $ A short term loan required to be paid back within a number or weeks generally with a higher interest rate ### Total of your Buy Now Pay Later debts $ ### Total of your Tax Debts $ Amounts owed to the ATO for income tax obligations. For Sole Trader/Partnerships obligations for BAS and Superannuation can also be included. Outstanding Tax Debt - unfortunately, we cannot assist with a Revive THP for tax debts, please remove this debt above if you would still like to proceed with a Revive THP. ### Total of your Disconnected Service Bills $ Electricity/Gas/Water bills that have been disconnected. This can also include old Telecommunication contracts that have been disconnected. ### Total of your other unsecured debts $ It is important to include any unsecured debts not listed above, this can include old medical bills, school fees, lawyers bills and accountant fees. Next Step Previous Step ## Congratulations, ### You qualify for a Temporary Hardship Plan, based on your total unsecured debt of . Select the option that feels right for you and we will begin to finalise your application. ## Temporary Hardship Plan Our Temporary Hardship Plan is a simple 3-month repayment solution to provide temporary debt relief when you need it most! - Simple online process to handle all your hardship requests - One easy to manage payment - No impact on your credit score Select For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/Temporary%20Hardship%20Plan%20brochure%20(2024)%209-18-24.pdf?hsLang=en-au) A Temporary Hardship Plan is not a Loan ## , Unfortunately we are unable to provide you with one of our solutions based on your Total Unsecured Debts ### Temporary Hardship Plan **Not recommended due to:** - Total Unsecured Debt too low to consider this solution - Outstanding tax debt You can review your unsecured debt amounts or seek a solution from any of the options we have listed below. If your circumstances change, you’re welcome back - our team is always available to assist. ## Alternative Solutions You may be eligible for one of the following alternative solutions, but will we require some additional information regarding your financial situation to determine if you are eligible. ### Apply for a Short Term Loan to cover urgent expenses In some circumstances, a short term loan can be a viable option to cover urgent expenses and/or simplify multiple short term loan commitments into one. It is important to consider the required repayments and total payable before accepting a loan. **Not recommended due to:** - Total Unsecured Debt too high to consider this solution with our lending partners - Outstanding tax debt Select ### Speak to a Free Financial Counsellor Financial Counselling services provide free, independent and confidential assistance to people in financial difficulty. They can help you to manage a short-term crisis and/or plan to prevent one in the future. Select ### Download Our FREE Budgeting Guide This Road Map to Financial Freedom is a step-by-step guide to help you plan your budget and manage for finances into the future. Download ### Consolidation Loan Taking out a personal loan may be all you need to consolidate your finances and take back control of your debts. This will be dependent on your credit score, income, and capacity to service a new loan. Our experts can review your ability to access this option. Select ### No Interest Loan Scheme If you are a low-income earner, you may be eligible to access the No Interest Loan Scheme. NILS can be used for essential good and services such as medical costs, educational fees, the purchase of whitegoods and furniture, vehicle servicing and repairs among other things. Select Just a Moment! We're Handling Your Details... Your account and application setup is underway, paving the way for you to take back control of your financial future. Almost there! Previous Step ## Home Loan ### Are you up-to-date with your home loan repayments? Select an option(s) Yes Yes, but on temporary relief No Please select at least one of the above options. ### What is your Home Loan repayment? $ Weekly Fortnightly Monthly Next Step Previous Step ## Car Loan ### Are you up-to-date with your car loan repayments? Select an option(s) Yes Yes, but on temporary relief No Please select at least one of the above options. ### What is your Car Loan repayment? $ Weekly Fortnightly Monthly Next Step Previous Step ## Repayments ### Are you currently up-to-date with your unsecured debt repayments? Select an option(s) Yes, up to date and maintaining all payments No, but expect to be able to within 3-6 months No, I need help to reduce payments permanently No, I’ve got no capacity to make repayments Please select at least one of the above options. Next Step Previous Step ## Circumstances ### What circumstances affected your ability to repay your debts on time? Select all relevant options Loss of employment Loss of employment by partner Loss of second job Reduction of employment income Overcommitment on credit Unexpected expenses Addition to the family Relationship breakdown Loss of family member Medical circumstances Addiction Incarceration Business failure Natural disaster Other Please select at least one of the above options. ### What is the primary reason for your enquiry? Select an option(s) 3 months of Reduced Debt Repayments Reduce debt, interest and clear with one affordable repayment Consolidation loan for existing debts Understand all options Please select at least one of the above options. Next Step Previous Step ## Employment ### Are you working at the moment? Select an option(s) Yes, employed Yes, self-employed No Please select at least one of the above options. ### What is your employment status? Select an option(s) Full time Part time Casual Please select at least one of the above options. Full-time and part-time employment generally involves a set amount of hours at the same time each week, whereas casual employment is irregular and hours generally change (this includes shift workers). ### What is your usual take home pay? (after tax) $ Weekly Fortnightly Monthly This is the after-tax amount you receive. Next Step Previous Step ## Your Business ### What is your business structure? Select an option(s) Sole Trader Partnership Company Trust Please select at least one of the above options. A sole trader and partnership have an ABN number, but do not have a Pty Ltd company. A company is registered with ASIC as a Pty Ltd company. You can search the register here. ### What is your usual take home pay from your business? $ Weekly Fortnightly Monthly This is the after-tax amount you receive personally from the business profits. Next Step Previous Step ## Government Support ### Are you receiving any Government Support? Select an option(s) No Yes, receiving JobSeeker Yes, receiving Disability Support Yes, receiving Age Pension Yes, receiving Family Tax Benefit Yes, receiving Other Government Payments Please select at least one of the above options. ### What are you receiving in Government Support? $ Weekly Fortnightly Monthly Next Step Previous Step ## Living Arrangements ### What are your current living arrangements? Select an option(s) Renting Boarding Home Owner with Home Loan Property Owned Outright Please select at least one of the above options. ### What is your rent? $ Weekly Fortnightly Monthly ### What is your board? $ Weekly Fortnightly Monthly ### What is the current value of your home(s)? $ ### How much is owed on your mortgage? $ ### Are you up-to-date with your home loan repayments? Select an option(s) Yes Yes, but on temporary relief No Please select at least one of the above options. ### What is your Home Loan repayment? $ Weekly Fortnightly Monthly Next Step Previous Step ## People in Household ### Adults ### Dependants Next Step Previous Step ## Congratulations, ## , Unfortunately we are unable to provide you with one of our solutions based on your Total Unsecured Debts ### You qualify for , based on your total unsecured debt of . Select the option that feels right for you and we will begin to finalise your application. You can review your unsecured debt amounts or seek a solution from any of the options we have listed below. If your circumstances change, you’re welcome back - our team is always available to assist. ## Temporary Hardship Plan Our Temporary Hardship Plan is a simple 3-month repayment solution to provide temporary debt relief when you need it most! - Simple online process to handle all your hardship requests - One easy to manage payment - No impact on your credit score Select For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/Temporary%20Hardship%20Plan%20brochure%20(2024)%209-18-24.pdf?hsLang=en-au) A Temporary Hardship Plan is not a Loan ## Debt Management Solution ### Before Total Debt $ Time to Repay years Total Estimated Payable $\* ### After Total Debt $ Time to Repay years Total Estimated Payable $ \* Based on total unsecured debts. Assumed interest rate of 15% on all unsecured debts. Does not consider late payment fees or penalties for missed payments which may increase the estimated repayment amount ### Repayment Estimate ### $0.00 / week Our Debt Management Solutions offer a structured way to reduce debt commitments after lending options have been exhausted. It allows you to: - Consolidate your unsecured debt repayments into one simple payment - Pause interest and fees on your unsecured debts - Reduce your unsecured debts, setting you on a path to be debt free If you’re concerned the Repayment Estimate is not manageable, speak to our team about your suitable repayment. Select Book a Call For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/(2025)%20Personal%20Brochure.pdf?hsLang=en-au) ## Refinance You may be eligible to refinance your home loan, allowing you to access equity in your property or a better rate. This can provide the opportunity to consolidate your credit card debts and personal loans, reduce fees, and alleviate stress. Select ## Consolidation Loan Taking out a personal loan may be all you need to consolidate your finances and take back control of your debts. This will be dependent on your credit score, income, and capacity to service a new loan. Our experts can review your ability to access this option. Select ## Your Affordable Payment Adjust the amount below to see what additional solutions are available to you based on your affordability $ per week ## Bankruptcy (Revive Financial) Bankruptcy generally lasts 3 years, can release you from obligations to repay unsecured debts and provide you with a fresh start. Our Bankruptcy experts will review your details and contact you to discuss exactly how Bankruptcy would work for you. For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/(2024)%20Bankruptcy%20Brochure.pdf?hsLang=en-au). Select ## Bankruptcy (Free) Bankruptcy generally lasts 3 years, can release you from obligations to repay unsecured debts and provide you with a fresh start. It may be more appropriate to consider entering Bankruptcy directly with the Australian Financial Security Authority (AFSA) free of charge, or seek assistance from a free financial counselling service. Please ensure you speak to our team if you are concerned about any impact on an asset (e.g. motor vehicle) or expected future income. Select ## Speak to a Free Financial Counsellor Financial Counselling services provide free, independent and confidential assistance to people in financial difficulty. They can help you to manage a short-term crisis and/or plan to prevent one in the future. Select ## Download Our FREE Budgeting Guide This Road Map to Financial Freedom is a step-by-step guide to help you plan your budget and manage for finances into the future. Download ## Alternative Solutions You may be eligible for one of the following alternative solutions: ### Debt Management Solution $0.00 / week Our Debt Management Solutions offer a structured way to reduce debt commitments after lending options have been exhausted. It allows you to consolidate your all repayments into one simple payment, pause interest and fees on your debts & reduce your debts, setting you on a path to be debt free. For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/Personal%20Brochure%20(2023).pdf?hsLang=en-au). **Not recommended due to:** - Current ability to meet repayment requirements - Total Unsecured Debt too low to consider this solution Select Book a Call ### Temporary Hardship Plan Our Temporary Hardship Plan is a simple 3-month repayment solution to provide temporary debt relief when you need it most! Say goodbye to financial stress and take back control of your life with our innovative plan that offers tailored guidance and a holistic approach. For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/Temporary%20Hardship%20Plan%20(2023).pdf?hsLang=en-au). **Not recommended due to:** - Outstanding tax debt - Total Unsecured Debt too low to consider this solution Select A Temporary Hardship Plan is not a Loan ### Mortgage Refinance You may be eligible to refinance your home loan, allowing you to access equity in your property or a better rate. This can provide the opportunity to consolidate your credit card debts and personal loans, reduce fees, and alleviate stress. **Not recommended due to:** - Required loan amount below our minimum requirement Select ### Consolidation Loan Taking out a personal loan may be all you need to consolidate your finances and take back control of your debts. This will be dependent on your credit score, income, and capacity to service a new loan. Our experts can review your ability to access this option. **Not recommended due to:** - Current ability to meet repayment requirements - Outstanding pay day loans - Outstanding utility bills - Current repayment status on existing debts - Total Unsecured Debt too low to consider this solution with our lending partners - Total Unsecured Debt too high to consider this solution with our lending partners Select ### Bankruptcy (Revive Financial) Bankruptcy generally lasts 3 years, can release you from obligations to repay unsecured debts and provide you with a fresh start. Our Bankruptcy experts will review your details and contact you to discuss exactly how Bankruptcy would work for you. For more information, [download our guide](https://solutions.debtrescue.com.au/hubfs/Brochures/(2024)%20Bankruptcy%20Brochure.pdf?hsLang=en-au). **Not recommended due to:** - Expected payments under Bankruptcy exceeds estimated Debt Management Plan payment - Income exceeding required thresholds - Property value exceeding threshold limits - Limited Income & Asset position suggest Revive assisted Bankruptcy may not be appropriate - May not be suitable based on total unsecured debt balance Select ### Bankruptcy (Free) Bankruptcy generally lasts 3 years, can release you from obligations to repay unsecured debts and provide you with a fresh start. It may be more appropriate to consider entering Bankruptcy directly with the Australian Financial Security Authority (AFSA) free of charge, or seek assistance from a free financial counselling service. Please ensure you speak to our team if you are concerned about any impact on an asset (e.g. motor vehicle) or expected future income. Select Just a Moment! We're Handling Your Details... Your account and application setup is underway, paving the way for you to take back control of your financial future. Almost there! ## Ready to chat or need immediate assistance? Call us now to discuss your debt solution options with our Customer Success Team. [Call us now1800 534 534](tel:1800%20534%20534) [Privacy Policy](https://revivefinancial.com.au/privacy-policy/) | [Terms of Use](https://revivefinancial.com.au/terms-of-use/) © 2024 Revive Financial Revive Financial Group Pty Ltd ACN 632 845 124 undertakes its Australian Credit Licenced activities via its wholly-owned subsidiaries Revive Financial Pty Ltd ACN 621 446 697, Australian Credit Licence 503321, Revive Debt Agreements Pty Ltd (RDAA 1337) and our other related corporate bodies that are appointed as authorised credit representatives. Any corporate insolvency services that are accessed via our website are provided by our referral partner Business Reset Pty Ltd. Any services provided by Business Reset Pty Ltd, are provided by Business Reset Pty Ltd on its own behalf and for its own account. Business Reset Pty Ltd is not a subsidiary nor a related entity of Revive Financial Group Pty Ltd and is independently owned. In requesting services from Business Reset Pty Ltd you acknowledge and agree that Revive Financial Group Pty Ltd (or any of its related entities) has no responsibility for the acts or omissions of Business Reset Pty Ltd notwithstanding that you may have requested corporate insolvency services via our website. Liability limited by a scheme approved under professional standards legislation.