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sfs-data-entry-template.html
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<!DOCTYPE html>
<!--[if lte IE 8]><html class="ie8 no-js" lang="en-GB"><![endif]-->
<!--[if gt IE 9]><!-->
<html xmlns="http://www.w3.org/1999/xhtml" lang="en-GB" class="no-js">
<!--<![endif]-->
<head>
<meta charset="utf-8" />
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>SFS Summary</title>
<link rel="stylesheet" href="assets/css/sfs-form.css">
</head>
<!--
If rendering to screen use class 'screen'
If rendering as PDF use class 'a4'
-->
<body class="screen">
<div id="container">
<div class="sfs-form">
<!-- Page 1 -->
<div class="sfs-page page">
<div class="sfs-form__section">
<div class="sfs-col sfs-col--half">
<div class="sfs__row sfs__row--special-padding">
<p class="sfs__label">Name:</p>
<p class="sfs__text sfs__output" id="client-name"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">D.O.B.:</p>
<p class="sfs__text sfs__output" id="client-date-of-birth"></p>
</div>
<!-- Add the class 'checked' to applicable option below -->
<div class="sfs__row">
<p class="sfs__label">Application:</p>
<p class="sfs__checkbox" id="is-joint-application__no">Single</p>
<p class="sfs__checkbox" id="is-joint-application__yes">Joint</p>
</div>
<div class="sfs__row">
<p class="sfs__label">Partner:</p>
<p class="sfs__text">(if applicable):</p>
<p class="sfs__text sfs__output" id="partner-name"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Partner D.O.B.:</p>
<p class="sfs__text">(if applicable):</p>
<p class="sfs__text sfs__output" id="partner-date-of-birth"></p>
</div>
<div class="sfs__row sfs__row--address">
<p class="sfs__label">Address:</p>
<p class="sfs__text sfs__output" id="client-address"></p>
</div>
<div class="sfs__row sfs__row--dependents">
<p class="sfs__label">Dependent children:</p>
<p class="sfs__text">Under 16:</p>
<p class="sfs__text sfs__output" id="dependent-children-under-16"></p>
<p class="sfs__text">16-18:</p>
<p class="sfs__text sfs__output" id="dependent-children-16-18"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Other dependants:</p>
<p class="sfs__text sfs__output" id="other-dependents"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Number in household:</p>
<p class="sfs__text sfs__output" id="total-number-in-household"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Number of vehicles in household:</p>
<p class="sfs__text sfs__output" id="vehicles"></p>
</div>
<!-- Add the class 'checked' to all applicable options -->
<div class="sfs__row">
<p class="sfs__label">Housing tenure:</p>
<p class="sfs__checkbox" id="housing-tenure__owner">Owner</p>
<p class="sfs__checkbox" id="housing-tenure__mortgage">Mortgage</p>
<p class="sfs__checkbox" id="housing-tenure__private-tenant">Tenant – private</p>
<p class="sfs__checkbox" id="housing-tenure__social-tenant">Tenant – social</p>
<p class="sfs__checkbox" id="housing-tenure__living-with-parents">Living with parents</p>
<p class="sfs__checkbox" id="housing-tenure__other">Other</p>
</div>
<div class="sfs__row">
<div class="sfs-col sfs-col--main">
<p class="sfs__label">Please confirm you have considered
<br> (or discussed with an adviser) the use of
<br> any assets to make lump sum payments</p>
</div>
<!-- Add the class 'checked' to the field below -->
<div class="sfs-col sfs-col--side">
<p class="sfs__label">Tick to confirm ✓
<br>
<span class="sfs__whitebox" id="asset-use-considered"></span>
</p>
</div>
</div>
</div>
<div class="sfs-col sfs-col--half">
<div class="sfs__logo-wrap">
<img class="sfs__logo" src="assets/images/sfs-logo.png" />
</div>
<div class="sfs__row">
<p class="sfs__label">Contact/team name:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Agency:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row sfs__row--address">
<p class="sfs__label">Agency address:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Membership code number:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Case reference number:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Date of statement:</p>
<p class="sfs__text sfs__output"></p>
</div>
<div class="sfs__row">
<p class="sfs__label">Date of review:</p>
<p class="sfs__text">(if applicable):</p>
<p class="sfs__text sfs__output"></p>
</div>
<!-- Add the class 'checked to all applicable options' -->
<div class="sfs__row">
<p class="sfs__label">Employment:</p>
<p class="sfs__checkbox" id="client-employment-status__full-time">Full-time</p>
<p class="sfs__checkbox" id="client-employment-status__part-time">Part-time</p>
<br>
<p class="sfs__checkbox" id="client-employment-status__unemployed">Unemployed</p>
<p class="sfs__checkbox" id="client-employment-status__not-working-due-to-illness">Not working due to illness / disability</p>
<br>
<p class="sfs__checkbox" id="client-employment-status__self-employed">Self-employed</p>
<p class="sfs__checkbox" id="client-employment-status__retired">Retired</p>
<p class="sfs__checkbox" id="client-employment-status__Carer">Carer</p>
<p class="sfs__checkbox" id="client-employment-status__student">Student</p>
<p class="sfs__checkbox" id="client-employment-status__other">Other</p>
</div>
<!-- Add the class 'checked to all applicable options' -->
<div class="sfs__row">
<p class="sfs__label">Partner's employment:</p>
<p class="sfs__checkbox" id="partner-employment-status__full-time">Full-time</p>
<p class="sfs__checkbox" id="partner-employment-status__part-time">Part-time</p>
<br>
<p class="sfs__checkbox" id="partner-employment-status__unemployed">Unemployed</p>
<p class="sfs__checkbox" id="partner-employment-status__not-working-due-to-illness">Not working due to illness / disability</p>
<br>
<p class="sfs__checkbox" id="partner-employment-status__self-employed">Self-employed</p>
<p class="sfs__checkbox" id="partner-employment-status__retired">Retired</p>
<p class="sfs__checkbox" id="partner-employment-status__Carer">Carer</p>
<p class="sfs__checkbox" id="partner-employment-status__student">Student</p>
<p class="sfs__checkbox" id="partner-employment-status__other">Other</p>
</div>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">
<strong>Overview</strong>
</th>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__label">Total income</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-monthly-income"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__label">Total outgoings</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-monthly-outgoings"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">(Income – outgoings)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="income-minus-outgoings"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">(Savings contribution)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="savings-contribution"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Debt admin fee (if applicable):</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="debt-admin-fee"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total available for priority creditors</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-available-for-priority-debts"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total available for non-priority creditors</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-available-for-non-priority-debts"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Monthly Income</strong>
</th>
</tr>
<tr>
<th class="sfs__label sfs__label--heading">Earnings</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Salary or wages (take home)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="client-salary-or-wages"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Partner salary or wages (take home)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="partner-salary-or-wages"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other earnings (including self employment)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-earnings"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total salary and wages per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-earnings"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Benefits and tax credits</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Universal Credit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="tax-credits-universal-credit"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Jobseeker’s Allowance (income based)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="jobseekers-allowance-income-based"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Jobseeker’s Allowance (contribution based)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="jobseekers-allowance-contribution-based"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Income Support</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="income-support"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Working Tax Credit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="working-tax-credit"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Child Tax Credit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="child-tax-credit"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Child Benefit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="child-benefit"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Employment and Support Allowance or Statutory Sick Pay</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="employment-support-allowance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Disability benefits</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="disability-benefits"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Carer’s Allowance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="carers-allowance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Local Housing Allowance / Housing Benefit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="local-housing-allowance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Council Tax support</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="council-tax-support"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other benefits/tax credits (e.g. maternity benefits)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-benefits"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total benefits and tax credits per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-benefits"></td>
<td></td>
</tr>
<tr class="sfs__total">
<td></td>
<td></td>
<td class="sfs__text--italic sfs__text--right sfs__text--right-pad">(continued overleaf)</td>
</tr>
</table>
</div>
</div>
</div>
<!-- Page 2 -->
<div class="sfs-page page">
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Monthly Income</strong>
<span class="sfs__text--italic">(continued)</span>
</th>
</tr>
<tr>
<th class="sfs__label sfs__label--heading">Pensions</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">State pensions</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="state-pensions"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Private or work pensions</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="private-work-pensions"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Pension credit</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="pension-credit"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other pensions</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-pensions"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
<tr class="sfs__total last">
<td class="sfs__label">Total pensions per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-pensions"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Other income</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Maintenance or child support</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="maintenance-child-support"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Boarders or lodgers</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="boarders-lodgers"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Non-dependants’ contributions</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="non-dependants-contributions"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Student loans and grants</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="student-loans-grants"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other income</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-other-income"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total other income per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-other-income"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<p> </p>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Monthly Outgoings: Fixed Costs</strong>
</th>
</tr>
<tr>
<th class="sfs__label sfs__label--heading">Home and contents</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Rent</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="rent"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Ground rent & service charges (factor fees if you live in Scotland)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="ground-rent-service-charges"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Mortgage</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="mortgage"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Mortgage endowment</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="mortgage-endowment"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Secured loans</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="secured-loans"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Council tax/rates (including water charge if you live in Scotland and rates in NI)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="council-tax-rates"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Appliance & furniture rental (including appliance and furniture HP, conditional sale and so on)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="appliance-furniture-rental"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">TV licence</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="tv-licence"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-home-contents"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total home & contents costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-home-contents"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Utilities</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Gas</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="gas"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Electricity</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="electricity"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs (including coal, oil, calor gas and so on)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-utilities"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other expenditure</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-utilities-expenditure"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total utilities costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-utilities"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Water</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Water supply</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="water-supply"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Water waste</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="water-waste"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total water costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-water"></td>
</tr>
<tr class="sfs__total">
<td></td>
<td></td>
<td class="sfs__text--italic sfs__text--right sfs__text--right-pad">(continued overleaf)</td>
</tr>
</table>
</div>
</div>
</div>
<!-- Page 3 -->
<div class="sfs-page page">
<div class="sfs-form__section">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Monthly Outgoings: Fixed Costs</strong>
<span class="sfs__text--italic"> (continued)</span>
</th>
</tr>
<tr>
<th class="sfs__label sfs__label--heading">Care and health costs</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Childcare costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="childcare-costs"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Adult-care costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="adult-care-costs"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Child maintenance or child support</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="child-maintenance-child-support"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Prescriptions and medicines</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="prescriptions-medicines"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Dentistry and opticians</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="dentistry-opticians"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-care-health"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total care and health costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-care-health"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Transport and travel</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Public transport (e.g. work, school, shopping)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="public-transport"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Hire Purchase or conditional sale vehicle</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="hire-purchase-conditional-sale-vehicle"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Car insurance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="car-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Road tax</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="road-tax"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">MOT and ongoing maintenance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="mot-ongoing-maintenance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Breakdown cover</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="breakdown-cover"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Fuel, parking and toll road charges</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="fuel-parking-toll-road-charges"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs (including taxis)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-transport-travel"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total transport and travel costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-transport-travel"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">School costs</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">School uniform</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="school-uniform"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">After-school clubs and school trips</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="after-school-clubs-school-trips"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-school"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total school costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-school"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Pensions and insurances</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Pension payments</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="pension-payments"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Life insurance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="life-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Mortgage payment protection insurance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="mortgage-payment-protection-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Buildings and contents insurance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="buildings-contents-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Health insurance (medical or accident or dental)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="health-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-pensions-insurances"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total pensions and insurance costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-pensions-insurances"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Professional costs</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Professional courses</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="professional-courses"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Union fees</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="union-fees"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Professional fees</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="professional-fees"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-professional"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total professional costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-professional"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Other essential costs</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Other essential costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-essential-costs"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text"></td>
<td class="sfs__table-highlight sfs__output sfs__number_box"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text"></td>
<td class="sfs__table-highlight sfs__output sfs__number_box"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text"></td>
<td class="sfs__table-highlight sfs__output sfs__number_box"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total other essential costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-other-essential"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
</div>
<!-- Page 4 -->
<div class="sfs-page page">
<div class="sfs-form__section">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Monthly Outgoings: Flexible Costs</strong>
</th>
</tr>
<tr>
<th class="sfs__label sfs__label--heading">Communications and leisure</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Home phone, internet, TV package (including film subscriptions)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="home-phone-internet-tv"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Mobile phone</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="mobile-phone"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Hobbies, leisure or sport (e.g. socialising, eating out, outings, clubs, leisure courses)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="hobbies-leisure-sport"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Gifts (e.g. birthdays, festivals, charity donations)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="gifts"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Pocket money</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="pocket-money"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Newspapers, magazines, stationery and postage</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="newspapers-magazines-stationery-postage"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-communications-leisure"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total communications and leisure costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-communications-leisure"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Food and housekeeping</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Groceries (e.g. food, pet food, non-alcoholic drinks, cleaning)</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="groceries"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Nappies and baby items</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="nappies-baby-items"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">School meals and meals at work</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="school-work-meals"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Laundry and dry cleaning</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="laundry-dry-cleaning"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Alcohol</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="alcohol"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Smoking products</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="smoking-products"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Vet bills & pet insurance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="vet-bills-pet-insurance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">House repairs and maintenance</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="house-repairs-maintenance"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-food-housekeeping"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total food and housekeeping costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-food-housekeeping"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--full">
<table class="sfs__table">
<tr>
<th class="sfs__label sfs__label--heading">Personal costs</td>
<th class="sfs__label">Amount(£)</th>
<th class="sfs__label sfs__label--heading">Notes</th>
</tr>
<tr>
<td class="sfs__text">Clothing and footwear</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="clothing-footwear"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Hairdressing</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="hairdressing"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Toiletries</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="toiletries"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr>
<td class="sfs__text">Other costs</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="other-personal"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
<tr class="sfs__total last">
<td class="sfs__label">Total personal costs per month</td>
<td class="sfs__table-highlight sfs__output sfs__number_box" id="total-personal"></td>
<td class="sfs__table-notes sfs__text sfs__output"></td>
</tr>
</table>
</div>
</div>
<div class="sfs-form__section sfs-form__section--data-entry">
<div class="sfs-col sfs-col--half">
<table class="sfs__table">
<tr>
<th colspan="3" class="sfs__label sfs__label--heading">
<strong>Total Monthly Outgoings: (fixed and flexible)</strong>
</th>
</tr>
<tr>
<td class="sfs__text"></td>
<td class="sfs__label sfs__output">Amount(£)</td>
</tr>
<tr class="sfs__total">
<td class="sfs__label">Total costs per month</td>