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most recent copies of all outstanding balance due) Name of Creditor Total amount outstanding (Capital) Account Number Current Instalment TOTAL I, and hereby confirm that these are the only outstanding creditors for my Debt Review application. Signed at Applicant Signature Debt Counsellor (NCRDC1078) on this day of Spouse Signature 2012. Page 3 of your new beginning My Budget Budget Client Spouse INCOME (Gross) Salary / Pension Investment Income Income from any other sourc.

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