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Disclosure of financial position IR590

(published July 2014)

About this form

If you wish to apply for relief from debt you will need to provide us with details of your financial position. This form enables you to provide us with those details so that we can assess your situation when applying for relief from debt.

PDF | 272kb | 6 pages

This form can be completed on-screen by typing content directly into the PDF document. Once you have completed the form it is important that you print it out as you will not be able to save the information you enter into the form.

When to use this form

This form is to be completed by individuals and attached as supporting information when you are making an application for relief from payment of a debt. It is important that you send this form in as soon as you can. We can only consider and/or accept an arrangement when we receive your application.

What you will need

To sucessfully complete and submit this form you will need:

  • Your IRD number - if you do not have this call us on 0800 227 774.
  • Details of your income after tax.
  • Details of your weeky and monthly expenses.
  • Details of any assets or liabilities.

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After you finish

Please print and sign the completed form and send to your nearest Inland Revenue office along with any supporting information.
You may wish to keep a copy for your personal records.

List of postal addresses for Inland Revenue >