Application for suspension of a
warrant and/or variation of an order
Name of court Claim no.
Fee account no.
(if applicable)
Help with Fees – Ref. no.
(if applicable)
H W F
Warrant no. Local no.
Claimant’s name
(including ref.)
Defendant’s name (including ref.)
Read these notes carefully before completing the form.
• Tic
k the correct boxes and give as much information as
you can. It will help the court make a fair decision about
how much you can afford to pay if the claimant refuses
your offer.
• If you do not complete all the details and sign the form, the
court will not be able to deal with your application.
• The form will be sent to the claimant to consider your offer.
• The court will send you an order giving details of how and
when to pay or will tell you when to come to court. You will
be informed of the courts decision.
• You will have to pay a fee for your application. You can get
details of the fee to pay and information about what to do
if you cannot pay all or part of a fee from any county court
ofce.
I cannot pay the amount ordered and
I wish to apply for
suspension of the warrant
and/or
a reduction in the instalment order
1 Personal details
Surname
Forename
Mr Mrs Miss Ms
Married Single Other
(specify)
Age
Address
Postcode
2 Dependants (people you look after nancially)
Children (under 19)
Age Date of Birth
Others (give details)
Daytime telephone
(If more continue on a separate sheet)
3 Employment
I am employed as a
My employer is
Jobs other than
main job
(give details)
I am self employed as a
Annual turnover is
I am not in arrears with my national insurance
contributions, income tax and VA
T
I am in arrears and I owe
Give details of:
(a)
(b)
contracts and
other work in hand
any sums due
for work done
£
£
I have been unemployed for
years months
I am a pensioner
4 Bank account and savings
I have a bank account
The account is in credit by
£
The account is overdrawn by
£
I have a savings account or building society account
The amount in the account is
£
5 Property
I live in
my own property
jointly owned property
rented property
lodgings
council
property
N245 Application for suspension of a warrant and/or variation of an order (01.19) © Crown copyright 2019
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6 Income
My usual take home pay (including
overtime, commission, bonuses etc.)
£ per
Income support
£ per
Child benet(s)
£ per
Other state benet(s)
£ per
My pension(s)
£ per
Others living in my home give me
£ per
Other income (give details below)
£ per
£ per
£ per
Total income
£ per
7 Expenses
(Do not include any payments made by other members of
the household out of their own income)
I have regular expenses as follows:
Mortgage (including second mortgage)
£ per
Rent
£ per
Council tax
£ per
Gas
£ per
Electricity
£ per
Water charges
£ per
TV rental and licence
£ per
HP repayments
£ per
Mail order
£ per
Housekeeping, food, school meals
£ per
Travelling expenses
£ per
Children’s clothing
£ per
Maintenance payments
£ per
Others
(not court orders or credit
debts listed in boxes 9 and 10)
£ per
£ per
£ per
Total expenses
£ per
8 Priority debts
(This section is for arrears only. Do not
include regular expenses listed in box 7)
Rent arrears
£ per
Mortgage arrears
£ per
Council tax arrears
£ per
Water charge arrears
£ per
Fuel debts: Gas
£ per
Electricity
£ per
Other
£ per
Maintenance arrears
£ per
Others (give details below)
£ per
£ per
Total priority debts
£ per
9 Court orders
Court Claim No.
£ per
Total court order instalments
£ per
Of the payments above,
I am behind with
payments to (please list)
10 Credit debts
Loans and credit card debts (please list)
£ per
£ per
£ per
Of the payments above,
I am behind with
payments to (please list)
11 Offer of Payment
If you take away the totals of boxes 7, 8 and 9 and the payments
you are making in box 10 from the total in box 6, you will get
some idea of the sort of sum you should offer. The offer you
make should be one you can afford.
I can pay a month
£
(and I enclose )
£
I also enclose the fee of
£
12 Declaration
I declare that the details I have given above are true to the best of my knowledge
Signed Date
Please return your completed form to the court that made the order or warrant.
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