1. Total Outstanding Debts Less than your annual gross salary One to 2 times annual gross salary Two to three times annual gross salary More than three times annual gross salary

2. Number of Creditors (Agreements) One (1) Two (2) to Five (5) Six (6) to Ten (10) More than Ten (10)

3. Payment status in respect of these accounts/agreements 3.1 Missed one payment in last six months on: Current on all accounts (nothing in arrears) One (1) account Two (2) to Three (3) accounts More than three (3) credit accounts 3.2 Missed three or more payments in last six months on: Current on all accounts (nothing in arrears) One (1) account Two (2) to Three (3) accounts More than three (3) credit accounts

4. Household financial stress 4.1 Do you: Pay everything you need to every month Have savings in an account for unforseen happenings Have a cash shortfall most months necessitation borrowing money from somewhere Decide not to pay some account obligations as you habe insufficient cash Use borrowings to pay your debts (credit card, personal loans, overdraft etc.) 4.2 Are you: Less than three (3) months in rent/rates and or utility payments? More than three (3) months in rent/rates and or utility payments?