Optus – Hardship Request - Australian Debt Recoveries

We understand that you may be facing financial difficulties. To provide you with a personalized solution, we kindly request you to fill out the form below to the best of your ability.

Upon completion, our expert team will evaluate your case and reach out to you with an appropriate resolution.
Please let us know the reason for your hardship request:*
Statement of Financial Position
- (A) Personal Details
- 1. Account Holders’ Names*
- 2. Account Number*
- 3. ADR Reference Number*
- 4. Email Address*
- 5. Residential Address*
  Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
- 6. Number of Dependents*
- 7. Occupation
- 8. Employer’s Name
- 9. Employer’s Address
  Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
- 10. Employer’s Phone No
- (B) Partner Details
- 11. Spouse Name
- 12. Spouse’s Employer’s Name
- (C) Income Source
- 13. Income Frequency*
- 14. Account Holder Wage (Net)*
- 15. Spouse Wage (Net)*
- 16. Government Benefits*
- 17. Other Income*
- 18. Sub Total (C)*
- (D) Monthly Expenditure
- 19. Expenditure Frequency*
- 20. Food*
- 21. Electricity*
- 22. Gas*
- 23. Telephones*
- 24. Legal Obligations*
- 25. Land & Water Rates*
- 26. Transport*
- 27. Vehicle Expenses*
- 28. Rent*
- 29. Mortgage*
- 30. Sub Total (D1)*
- 31. Hire Purchase, Credit Cards, Personal Loans
  Financial Institution Type of Account Balance Monthly Repayment
- 32. Total Monthly Repayments (D2)*
- 33. Total Expenditure (D3)*
- 34. Surplus/Deficit*
- (E) ASSETS – Current Value
- 35. Residential Property*
- 36. Investment Property*
- 37. Other Land*
- 38. Household Furnishings*
- 39. Other Assets (e.g., shares, boat)*
- 40. Motor Vehicles
  Make Model Year Value
- 41. Amounts Owed*
- 42. Bank / Credit Union / Building Society Account Details
  Institution Type of Account Account Number Balance
- (F) INSTALMENT OFFER
- 43. Payment Frequency*
- 44. Instalment Amount
- 45. Commencement Date
- 46. Arrangement Review Date
- (G) DECLARATION
- *
  - By ticking this box, I declare that the information in this statement and accompanying documentation is true and correct in every detail and discloses income derived from all sources. I understand that provision of false or misleading information could result in the cancellation of any agreements and the initiation of legal action for debt recovery, and that failure to make payments due on any agreed arrangement may also result in further debt recovery action.
  • Please ensure you attach all relevant documentation, including proof of any Social Security Benefits received.
  • If any business interests are included, please provide Balance Sheet for the last 2 years.

Optus – Hardship Request

Welcome to Australian Debt Recoveries

Our Philosophy

Call us directly

1300 767 721 – Debt Enquiries
1300 330 284– Sales & Existing Clients

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Links

Contact us

Optus – Hardship Request

Welcome to Australian Debt Recoveries

Our Philosophy

Call us directly

1300 767 721 – Debt Enquiries 1300 330 284– Sales & Existing Clients

Pages

Links

Contact us

1300 767 721 – Debt Enquiries
1300 330 284– Sales & Existing Clients