IVA Application Form
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IVA Application Form

The IVA application form from Access Debt Solutions. Are you looking for a way to recommit to settling your debts that is affordable and based around your current financial position? An Individual Voluntary Arrangement (IVA) can help you avoid bankruptcy and may be the answer to your financial problems.

ADS offer independent professional advice on the options open to you and can determine whether an IVA is right for you. Complete the form below to qualify for a free, no obligation assessment from our expert advisors.

If you prefer to return the form via e-mail, fax or post then click here to download a copy of the IVA application form.

Please complete all details as fully as possible. The more complete a picture of your present financial situation you are able to give the more comprehensive will be the options that we are able to offer you.

Your Personal Details
Please retype your e-mail
Date of birth (dd/mm/yyyy)
Marital status
Number of children living with you
Residential status
Home phone
Work phone
Mobile phone
Most convenient time to call you
Is your partner aware of the difficulties?

Your Monthly Income
Your take home pay (net of tax and NICs)
Partner's take home pay
Other regular income (Child benefit, CSA, maintenance, pension, other benefits)

Your Monthly Living Expenses
Other household living expenses (do not include secured car finance, second mortgages, pension contributions, savings plans or socialising)

Debt Details
Type of debt Total amount owing Monthly minimum payment
2nd & 3rd Mortgages
Secured car finance
Student loans company
Hire purchase
Unsecured debt (15,000 minimum unsecured debt for an IVA)

Additional Comments
If you have any comments you would like to make or questions you would like to ask, please do so here.