{"id":386,"date":"2026-01-28T16:13:05","date_gmt":"2026-01-28T16:13:05","guid":{"rendered":"https:\/\/partnershipone.com\/DDC\/?page_id=386"},"modified":"2026-06-19T15:10:51","modified_gmt":"2026-06-19T14:10:51","slug":"ct-payment-arrangement","status":"publish","type":"page","link":"https:\/\/partnershipone.com\/DDC\/ct-payment-arrangement\/","title":{"rendered":"Council Tax special payment arrangement income &amp; expenditure"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_43' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_43'  action='\/DDC\/wp-json\/wp\/v2\/pages\/386#gf_43' data-formid='43' novalidate><div id='gf_page_steps_43' class='gf_page_steps'><div id='gf_step_43_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Using the form<\/span><\/div><div id='gf_step_43_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Declaration<\/span><\/div><div id='gf_step_43_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>About you<\/span><\/div><div id='gf_step_43_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Your arrangement<\/span><\/div><div id='gf_step_43_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>Your work<\/span><\/div><div id='gf_step_43_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'>Your income<\/span><\/div><div id='gf_step_43_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'>Your fixed outgoings<\/span><\/div><div id='gf_step_43_8' class='gf_step gf_step_pending'><span class='gf_step_number'>8<\/span><span class='gf_step_label'>Your flexible outgoings<\/span><\/div><div id='gf_step_43_9' class='gf_step gf_step_pending'><span class='gf_step_number'>9<\/span><span class='gf_step_label'>Your loans or debts<\/span><\/div><div id='gf_step_43_10' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>10<\/span><span class='gf_step_label'>Other info<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_43_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_43' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_5\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Only complete this form if you have already submitted an offer of payment and have been asked to do so by the Council Tax team.<\/p>\n\n<h2>This form will ask you to provide<\/h2>\n\n<ul>\n\t<li>your details<\/li>\n\t<li>your Council Tax account reference number<\/li>\n<li>your National Insurance number<\/li>\n\t<li>the amount you&#8217;re offering to pay and how often<\/li>\n<li>the date you will be making your first payment.<\/li>\n<\/li><\/ul>\n<p><\/p>\n<p><\/p>\n<p>Depending on your answers, this form may also ask you to provide:<\/p>\n<ul>\n\t<li>if you work, information about your employer and employment<\/li>\n\t<li>if you don&#8217;t work, information about any benefits you receive<\/li>\n\t<li>details of your full income and outgoings<\/li>\n\t<li>details of any loans or debts you have.\u202f <\/li>\n<\/ul><\/p>\n<p>Please have this information ready as pages time-out after one hour.<\/p>\n\n<p>Do not use your browser back button &#8211; if you need to go to a previous page click on the previous button at the bottom of each page.<\/p>\n\n<h2>Privacy Statement<\/h2>\nDover District Council is a Data Controller under GDPR.  In submitting this form we will collect and process your personal data.  For information about your rights and how the Council uses your data,  please view our Corporate and relevant service privacy notice which can be found on our <a href=\"https:\/\/www.dover.gov.uk\/Website\/Privacy-and-Cookies.aspx\"target=\"_blank\">Privacy page<\/a>.<\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_43_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_844\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Declaration<\/h3><div class='gsection_description' id='gfield_description_43_844'><p>Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<\/p>\n\n<ul>\n\t<li>I confirm the details I will give on this form will be correct and true.<\/li>\n\t<li>I confirm that I will notify you of any relevant changes straight away.<\/li>\n\t<li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.<\/li>\n\t<li>I understand my data may be shared with other departments as permitted by law.<\/li>\n<\/ul><\/div><\/div><fieldset id=\"field_43_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Declaration<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_11'><div class='gchoice gchoice_43_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='I understand and accept the above declaration'  id='choice_43_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_11_1' id='label_43_11_1' class='gform-field-label gform-field-label--type-inline'>I understand and accept the above declaration<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_22' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_22' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_3' class='gform_page' data-js='page-field-id-22' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you<\/h3><\/div><div id=\"field_43_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_24'><span class='gform-field-label__text'>Title (for example Mr, Mrs, Ms, Miss)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_43_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_25'><span class='gform-field-label__text'>First name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_43_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_26'><span class='gform-field-label__text'>Last name(s)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_43_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_512\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_512'><span class='gform-field-label__text'>Contact phone number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_512' id='input_43_512' type='text' value='' class='large'    placeholder='99999 999999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99999 999999\"\/><\/div><\/div><fieldset id=\"field_43_37\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Email address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_43_37'>We will use your email address to send the receipt of your form, including the form reference number. This may include personal data. We will also use your email address to contact you about your Council Tax account.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_43_37_container'>\n                                <span id='input_43_37_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_43_37' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_37' id='input_43_37' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_43_37\" \/>\n                                <\/span>\n                                <span id='input_43_37_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_43_37_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_37_2' id='input_43_37_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_43_37\" \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_43_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you like to receive your Council Tax bills by email?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_43_38'>You can receive your Council Tax bills by email rather than post. We will send all future Council Tax bills to the email address you have given above. If you change your email address you must let us know straight away. You can opt out of this at any time at dover.gov.uk\/paperless<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_43_38'>\n\t\t\t<div class='gchoice gchoice_43_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_43_38_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_43_38\"   \/>\n\t\t\t\t\t<label for='choice_43_38_0' id='label_43_38_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_43_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_38_1' id='label_43_38_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_28'><span class='gform-field-label__text'>Council Tax account reference number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_43_28' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_29'><span class='gform-field-label__text'>National Insurance number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_43_29' type='text' value='' class='large'    placeholder='aa999999a' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"aa999999a\"\/><\/div><\/div><div id=\"field_43_513\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your address<\/h3><\/div><fieldset id=\"field_43_575\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full custom-address-field d-block gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gform-grid-row' id='input_43_575' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_43_575_1_container' >\n                                        <label for='input_43_575_1' id='input_43_575_1_label' class='gform-field-label gform-field-label--type-sub '>Address line 1<\/label>\n                                        <input type='text' name='input_575.1' id='input_43_575_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_43_575_2_container' >\n                                        <label for='input_43_575_2' id='input_43_575_2_label' class='gform-field-label gform-field-label--type-sub '>Address line 2<\/label>\n                                        <input type='text' name='input_575.2' id='input_43_575_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_43_575_3_container' >\n                                    <label for='input_43_575_3' id='input_43_575_3_label' class='gform-field-label gform-field-label--type-sub '>Town or city<\/label>\n                                    <input type='text' name='input_575.3' id='input_43_575_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_575.4' id='input_43_575_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_43_575_5_container' >\n                                    <label for='input_43_575_5' id='input_43_575_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_575.5' id='input_43_575_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_575.6' id='input_43_575_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_49' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_49' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_4' class='gform_page' data-js='page-field-id-49' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_50\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your arrangement<\/h3><\/div><div id=\"field_43_541\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_541'><span class='gform-field-label__text'>How much are you offering to pay?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_541' id='input_43_541' type='text' step='any'   value='' class='large'    placeholder='\u00a30.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_43_539\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Every<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_43_539'>\n\t\t\t<div class='gchoice gchoice_43_539_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='26'  id='choice_43_539_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_539_0' id='label_43_539_0' class='gform-field-label gform-field-label--type-inline'>Week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_539_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='13'  id='choice_43_539_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_539_1' id='label_43_539_1' class='gform-field-label gform-field-label--type-inline'>Two weeks<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_539_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='6.5'  id='choice_43_539_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_539_2' id='label_43_539_2' class='gform-field-label gform-field-label--type-inline'>Four weeks<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_539_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='6'  id='choice_43_539_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_539_3' id='label_43_539_3' class='gform-field-label gform-field-label--type-inline'>Month<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_43_540\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When will you be making your first payment?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_43_540'>Please make your first payment while awaiting confirmation of your arrangement<\/div><div id='input_43_540' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_43_540_2_container'><label for='input_43_540_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_540[]' id='input_43_540_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_43_540_1_container'><label for='input_43_540_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_540[]' id='input_43_540_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_43_540_3_container'><label for='input_43_540_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_540[]' id='input_43_540_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_832' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_832' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_5' class='gform_page' data-js='page-field-id-832' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_834\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your work<\/h3><\/div><fieldset id=\"field_43_543\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you work?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_43_543'>\n\t\t\t<div class='gchoice gchoice_43_543_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_543' type='radio' value='Yes'  id='choice_43_543_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_543_0' id='label_43_543_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_543_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_543' type='radio' value='No'  id='choice_43_543_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_543_1' id='label_43_543_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_833\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">About any benefits you claim<\/h3><\/div><fieldset id=\"field_43_835\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What benefit(s) do you claim?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_835'><div class='gchoice gchoice_43_835_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.1' type='checkbox'  value='Disability Living Allowance (DLA)'  id='choice_43_835_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_1' id='label_43_835_1' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance (DLA)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.2' type='checkbox'  value='Employment and Support Allowance'  id='choice_43_835_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_2' id='label_43_835_2' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.3' type='checkbox'  value='Housing Benefit'  id='choice_43_835_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_3' id='label_43_835_3' class='gform-field-label gform-field-label--type-inline'>Housing Benefit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.4' type='checkbox'  value='Income Support'  id='choice_43_835_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_4' id='label_43_835_4' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.5' type='checkbox'  value='Jobseeker&#039;s Allowance'  id='choice_43_835_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_5' id='label_43_835_5' class='gform-field-label gform-field-label--type-inline'>Jobseeker&#8217;s Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.6' type='checkbox'  value='Pension Credit guarantee credit'  id='choice_43_835_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_6' id='label_43_835_6' class='gform-field-label gform-field-label--type-inline'>Pension Credit guarantee credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.7' type='checkbox'  value='Personal Independence Payment (PIP)'  id='choice_43_835_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_7' id='label_43_835_7' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment (PIP)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.8' type='checkbox'  value='Universal Credit'  id='choice_43_835_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_8' id='label_43_835_8' class='gform-field-label gform-field-label--type-inline'>Universal Credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_835_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_835.9' type='checkbox'  value='None of the above'  id='choice_43_835_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_835_9' id='label_43_835_9' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_43_836\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If you and your partner claim benefit jointly, which of you receives payment?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_43_836'>\n\t\t\t<div class='gchoice gchoice_43_836_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_836' type='radio' value='You'  id='choice_43_836_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_836_0' id='label_43_836_0' class='gform-field-label gform-field-label--type-inline'>You<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_836_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_836' type='radio' value='Your partner'  id='choice_43_836_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_836_1' id='label_43_836_1' class='gform-field-label gform-field-label--type-inline'>Your partner<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_837\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_837'><span class='gform-field-label__text'>Total amount of any other income you get<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_837' id='input_43_837' type='text' step='any'   value='' class='large'    placeholder='0.00'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_838\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_838'><span class='gform-field-label__text'>How often do you get paid this income?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_838' id='input_43_838' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Weekly' >Weekly<\/option><option value='Two weekly' >Two weekly<\/option><option value='Four weekly' >Four weekly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/div><div id=\"field_43_59\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">About your work<\/h3><\/div><div id=\"field_43_545\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_545'><span class='gform-field-label__text'>Name of employer<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_545' id='input_43_545' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_546\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_546'><span class='gform-field-label__text'>Address of employer<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_546' id='input_43_546' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_43_547\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_547'><span class='gform-field-label__text'>Employer&#039;s phone number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_547' id='input_43_547' type='text' value='' class='large'    placeholder='99999 999999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99999 999999\"\/><\/div><\/div><div id=\"field_43_548\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_548'><span class='gform-field-label__text'>Payroll number<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_548' id='input_43_548' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_43_840\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_840'><span class='gform-field-label__text'>Wages\/salary (after tax and National Insurance contributions)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_840' id='input_43_840' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_841\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_841'><span class='gform-field-label__text'>How often are you paid?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_841' id='input_43_841' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Weekly' >Weekly<\/option><option value='Two weekly' >Two weekly<\/option><option value='Four weekly' >Four weekly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_68' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_68' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_6' class='gform_page' data-js='page-field-id-68' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_6' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_78\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your income<\/h3><div class='gsection_description' id='gfield_description_43_78'>Please tell us about the money coming into the household, the amount and how often. This includes any income you and your partner receive and if any other adults living in the property contribute any money towards the household. If you get any income not listed, please use the &#8216;other income&#8217; section at the bottom of this page.<\/div><\/div><fieldset id=\"field_43_744\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type of income<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_744'><div class='gchoice gchoice_43_744_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.1' type='checkbox'  value='Attendance Allowance'  id='choice_43_744_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_1' id='label_43_744_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.2' type='checkbox'  value='Carer&#039;s Allowance'  id='choice_43_744_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_2' id='label_43_744_2' class='gform-field-label gform-field-label--type-inline'>Carer&#8217;s Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.3' type='checkbox'  value='Child Benefit'  id='choice_43_744_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_3' id='label_43_744_3' class='gform-field-label gform-field-label--type-inline'>Child Benefit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.4' type='checkbox'  value='Child Maintenance'  id='choice_43_744_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_4' id='label_43_744_4' class='gform-field-label gform-field-label--type-inline'>Child Maintenance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.5' type='checkbox'  value='Child Tax Credit'  id='choice_43_744_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_5' id='label_43_744_5' class='gform-field-label gform-field-label--type-inline'>Child Tax Credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.6' type='checkbox'  value='Disability Living Allowance'  id='choice_43_744_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_6' id='label_43_744_6' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.7' type='checkbox'  value='Employment and Support Allowance'  id='choice_43_744_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_7' id='label_43_744_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.8' type='checkbox'  value='Incapacity Benefit'  id='choice_43_744_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_8' id='label_43_744_8' class='gform-field-label gform-field-label--type-inline'>Incapacity Benefit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.9' type='checkbox'  value='Income Support'  id='choice_43_744_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_9' id='label_43_744_9' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.11' type='checkbox'  value='Jobseeker&#039;s Allowance'  id='choice_43_744_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_11' id='label_43_744_11' class='gform-field-label gform-field-label--type-inline'>Jobseeker&#8217;s Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.12' type='checkbox'  value='Money paid to you by any other adults who live with you (not your partner)'  id='choice_43_744_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_12' id='label_43_744_12' class='gform-field-label gform-field-label--type-inline'>Money paid to you by any other adults who live with you (not your partner)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.13' type='checkbox'  value='Pension'  id='choice_43_744_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_13' id='label_43_744_13' class='gform-field-label gform-field-label--type-inline'>Pension<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.14' type='checkbox'  value='Personal Independence Payment'  id='choice_43_744_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_14' id='label_43_744_14' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.15' type='checkbox'  value='Severe Disability Allowance'  id='choice_43_744_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_15' id='label_43_744_15' class='gform-field-label gform-field-label--type-inline'>Severe Disability Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.16' type='checkbox'  value='Wages or salary'  id='choice_43_744_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_16' id='label_43_744_16' class='gform-field-label gform-field-label--type-inline'>Wages or salary<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.17' type='checkbox'  value='Partners wages or salary'  id='choice_43_744_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_17' id='label_43_744_17' class='gform-field-label gform-field-label--type-inline'>Partners wages or salary<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.18' type='checkbox'  value='Working Tax Credit'  id='choice_43_744_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_18' id='label_43_744_18' class='gform-field-label gform-field-label--type-inline'>Working Tax Credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.19' type='checkbox'  value='Universal Credit'  id='choice_43_744_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_19' id='label_43_744_19' class='gform-field-label gform-field-label--type-inline'>Universal Credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_744_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_744.21' type='checkbox'  value='Other income'  id='choice_43_744_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_744_21' id='label_43_744_21' class='gform-field-label gform-field-label--type-inline'>Other income<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_745\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_745'><span class='gform-field-label__text'>Amount &#8211; Attendance Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_745' id='input_43_745' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_746\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_746'><span class='gform-field-label__text'>How often &#8211; Attendance Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_746' id='input_43_746' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_748\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_748'><span class='gform-field-label__text'>Amount &#8211; Carer&#039;s Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_748' id='input_43_748' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_747\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_747'><span class='gform-field-label__text'>How often &#8211; Carer&#039;s Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_747' id='input_43_747' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_751\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_751'><span class='gform-field-label__text'>Amount &#8211; Child Benefit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_751' id='input_43_751' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_749\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_749'><span class='gform-field-label__text'>How often &#8211; Child Benefit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_749' id='input_43_749' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_752\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_752'><span class='gform-field-label__text'>Amount &#8211; Child Maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_752' id='input_43_752' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_750\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_750'><span class='gform-field-label__text'>How often &#8211; Child Maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_750' id='input_43_750' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_753\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_753'><span class='gform-field-label__text'>Amount &#8211; Child Tax Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_753' id='input_43_753' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_754\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_754'><span class='gform-field-label__text'>How often &#8211; Child Tax Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_754' id='input_43_754' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_756\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_756'><span class='gform-field-label__text'>Amount &#8211; Disability Living Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_756' id='input_43_756' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_755\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_755'><span class='gform-field-label__text'>How often &#8211; Disability Living Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_755' id='input_43_755' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_758\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_758'><span class='gform-field-label__text'>Amount &#8211; Employment and Support Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_758' id='input_43_758' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_757\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_757'><span class='gform-field-label__text'>How often &#8211; Employment and Support Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_757' id='input_43_757' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_760\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_760'><span class='gform-field-label__text'>Amount &#8211; Incapacity Benefit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_760' id='input_43_760' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_759\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_759'><span class='gform-field-label__text'>How often &#8211; Incapacity Benefit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_759' id='input_43_759' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_761\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_761'><span class='gform-field-label__text'>Amount &#8211; Income Support<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_761' id='input_43_761' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_762\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_762'><span class='gform-field-label__text'>How often &#8211; Income Support<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_762' id='input_43_762' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_772\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_772'><span class='gform-field-label__text'>Amount &#8211; Jobseeker&#039;s Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_772' id='input_43_772' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_771\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_771'><span class='gform-field-label__text'>How often &#8211; Jobseeker&#039;s Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_771' id='input_43_771' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_773\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_773'><span class='gform-field-label__text'>Amount &#8211; Money paid to you by any other adults who live with you (not your partner)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_773' id='input_43_773' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_770\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_770'><span class='gform-field-label__text'>How often &#8211; Money paid to you by any other adults who live with you (not your partner)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_770' id='input_43_770' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_774\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_774'><span class='gform-field-label__text'>Amount &#8211; Pension<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_774' id='input_43_774' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_769\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_769'><span class='gform-field-label__text'>How often &#8211; Pension<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_769' id='input_43_769' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_775\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_775'><span class='gform-field-label__text'>Amount &#8211; Personal Independence Payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_775' id='input_43_775' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_768\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_768'><span class='gform-field-label__text'>How often &#8211; Personal Independence Payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_768' id='input_43_768' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_776\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_776'><span class='gform-field-label__text'>Amount &#8211; Severe Disability Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_776' id='input_43_776' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_767\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_767'><span class='gform-field-label__text'>How often &#8211; Severe Disability Allowance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_767' id='input_43_767' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_777\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_777'><span class='gform-field-label__text'>Amount &#8211; Wages or salary<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_777' id='input_43_777' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_766\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_766'><span class='gform-field-label__text'>How often &#8211; Wages or salary<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_766' id='input_43_766' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_842\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_842'><span class='gform-field-label__text'>Amount &#8211; Partners wages or salary<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_842' id='input_43_842' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_843\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_843'><span class='gform-field-label__text'>How often &#8211; Partners wages or salary<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_843' id='input_43_843' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_778\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_778'><span class='gform-field-label__text'>Amount &#8211; Working Tax Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_778' id='input_43_778' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_765\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_765'><span class='gform-field-label__text'>How often &#8211; Working Tax Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_765' id='input_43_765' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_779\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_779'><span class='gform-field-label__text'>Amount &#8211; Universal Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_779' id='input_43_779' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_764\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_764'><span class='gform-field-label__text'>How often &#8211; Universal Credit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_764' id='input_43_764' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Every four weeks' >Every four weeks<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_780\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please tell us about any other income, what it is, the amount and how often<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_43_780'>Enter the information and then click on the + sign to add another row for each type of other income.\n<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Other income type<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount \u00a30.00<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">How often  (weekly or monthly)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_780_cell1 gform-grid-col' data-label='Other income type'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_43_780\" aria-label='Other income type, Row 1' data-aria-label-template='Other income type, Row {0}' type='text' name='input_780[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_780_cell2 gform-grid-col' data-label='Amount \u00a30.00'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_43_780\" aria-label='Amount \u00a30.00, Row 1' data-aria-label-template='Amount \u00a30.00, Row {0}' type='text' name='input_780[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_780_cell3 gform-grid-col' data-label='How often  (weekly or monthly)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_43_780\" aria-label='How often  (weekly or monthly), Row 1' data-aria-label-template='How often  (weekly or monthly), Row {0}' type='text' name='input_780[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_123' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_123' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_7' class='gform_page' data-js='page-field-id-123' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_7' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_124\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your fixed outgoings<\/h3><div class='gsection_description' id='gfield_description_43_124'>We need to know about all of your fixed outgoings, such as rent and bills.  Please select all of your household outgoings and tell us the amount and how often. If you have any outgoings not listed, please use the other outgoings section at the bottom of this page.<\/div><\/div><fieldset id=\"field_43_581\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Home and contents<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_581'><div class='gchoice gchoice_43_581_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.1' type='checkbox'  value='Rent'  id='choice_43_581_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_1' id='label_43_581_1' class='gform-field-label gform-field-label--type-inline'>Rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.2' type='checkbox'  value='Mortgage'  id='choice_43_581_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_2' id='label_43_581_2' class='gform-field-label gform-field-label--type-inline'>Mortgage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.3' type='checkbox'  value='Mortgage endowment'  id='choice_43_581_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_3' id='label_43_581_3' class='gform-field-label gform-field-label--type-inline'>Mortgage endowment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.4' type='checkbox'  value='Council tax'  id='choice_43_581_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_4' id='label_43_581_4' class='gform-field-label gform-field-label--type-inline'>Council tax<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.5' type='checkbox'  value='TV licence'  id='choice_43_581_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_5' id='label_43_581_5' class='gform-field-label gform-field-label--type-inline'>TV licence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.6' type='checkbox'  value='Secured loans'  id='choice_43_581_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_6' id='label_43_581_6' class='gform-field-label gform-field-label--type-inline'>Secured loans<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.7' type='checkbox'  value='Help to Buy loan'  id='choice_43_581_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_7' id='label_43_581_7' class='gform-field-label gform-field-label--type-inline'>Help to Buy loan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.8' type='checkbox'  value='Board'  id='choice_43_581_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_8' id='label_43_581_8' class='gform-field-label gform-field-label--type-inline'>Board<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.9' type='checkbox'  value='Ground rent and service charges'  id='choice_43_581_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_9' id='label_43_581_9' class='gform-field-label gform-field-label--type-inline'>Ground rent and service charges<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.11' type='checkbox'  value='Household appliance hire purchase'  id='choice_43_581_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_11' id='label_43_581_11' class='gform-field-label gform-field-label--type-inline'>Household appliance hire purchase<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_581_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_581.12' type='checkbox'  value='Household appliance rental'  id='choice_43_581_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_581_12' id='label_43_581_12' class='gform-field-label gform-field-label--type-inline'>Household appliance rental<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_588\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_588'><span class='gform-field-label__text'>Amount &#8211; rent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_588' id='input_43_588' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_179\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_179'><span class='gform-field-label__text'>How often &#8211; rent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_179' id='input_43_179' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_592\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_592'><span class='gform-field-label__text'>Amount &#8211; mortgage<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_592' id='input_43_592' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_594\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_594'><span class='gform-field-label__text'>How often &#8211; mortgage<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_594' id='input_43_594' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_616\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_616'><span class='gform-field-label__text'>Amount &#8211; mortgage endowment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_616' id='input_43_616' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_615\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_615'><span class='gform-field-label__text'>How often &#8211; mortgage endowment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_615' id='input_43_615' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_596\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_596'><span class='gform-field-label__text'>Amount &#8211; Council tax<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_596' id='input_43_596' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_595\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_595'><span class='gform-field-label__text'>How often &#8211; Council tax<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_595' id='input_43_595' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_598\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_598'><span class='gform-field-label__text'>Amount &#8211; TV licence<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_598' id='input_43_598' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_597\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_597'><span class='gform-field-label__text'>How often &#8211; TV licence<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_597' id='input_43_597' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_605\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_605'><span class='gform-field-label__text'>Amount &#8211; secured loans<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_605' id='input_43_605' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_603\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_603'><span class='gform-field-label__text'>How often &#8211; secured loans<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_603' id='input_43_603' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_606\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_606'><span class='gform-field-label__text'>Amount &#8211; help to Buy loan<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_606' id='input_43_606' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_604\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_604'><span class='gform-field-label__text'>How often &#8211; help to Buy loan<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_604' id='input_43_604' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_607\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_607'><span class='gform-field-label__text'>Amount &#8211; board<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_607' id='input_43_607' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_608\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_608'><span class='gform-field-label__text'>How often &#8211; board<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_608' id='input_43_608' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_610\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_610'><span class='gform-field-label__text'>Amount &#8211; ground rent and service charges<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_610' id='input_43_610' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_609\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_609'><span class='gform-field-label__text'>How often &#8211; ground rent and service charges<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_609' id='input_43_609' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_612\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_612'><span class='gform-field-label__text'>Amount &#8211; household appliance hire purchase<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_612' id='input_43_612' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_611\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_611'><span class='gform-field-label__text'>How often &#8211; household appliance hire purchase<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_611' id='input_43_611' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_614\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_614'><span class='gform-field-label__text'>Amount &#8211; household appliance rental<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_614' id='input_43_614' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_613\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_613'><span class='gform-field-label__text'>How often &#8211; household appliance rental<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_613' id='input_43_613' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_583\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Transport and travel<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_583'><div class='gchoice gchoice_43_583_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.1' type='checkbox'  value='Car insurance'  id='choice_43_583_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_1' id='label_43_583_1' class='gform-field-label gform-field-label--type-inline'>Car insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.2' type='checkbox'  value='Road tax'  id='choice_43_583_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_2' id='label_43_583_2' class='gform-field-label gform-field-label--type-inline'>Road tax<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.3' type='checkbox'  value='Fuel, parking and toll road charges'  id='choice_43_583_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_3' id='label_43_583_3' class='gform-field-label gform-field-label--type-inline'>Fuel, parking and toll road charges<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.4' type='checkbox'  value='Breakdown cover'  id='choice_43_583_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_4' id='label_43_583_4' class='gform-field-label gform-field-label--type-inline'>Breakdown cover<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.5' type='checkbox'  value='MOT and ongoing vehicle maintenance'  id='choice_43_583_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_5' id='label_43_583_5' class='gform-field-label gform-field-label--type-inline'>MOT and ongoing vehicle maintenance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.6' type='checkbox'  value='Vehicle hire purchase'  id='choice_43_583_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_6' id='label_43_583_6' class='gform-field-label gform-field-label--type-inline'>Vehicle hire purchase<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.7' type='checkbox'  value='Vehicle lease'  id='choice_43_583_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_7' id='label_43_583_7' class='gform-field-label gform-field-label--type-inline'>Vehicle lease<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.8' type='checkbox'  value='Public transport'  id='choice_43_583_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_8' id='label_43_583_8' class='gform-field-label gform-field-label--type-inline'>Public transport<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_583_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_583.9' type='checkbox'  value='Logbook loan'  id='choice_43_583_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_583_9' id='label_43_583_9' class='gform-field-label gform-field-label--type-inline'>Logbook loan<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_618\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_618'><span class='gform-field-label__text'>Amount &#8211; car insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_618' id='input_43_618' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_617\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_617'><span class='gform-field-label__text'>How often &#8211; car insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_617' id='input_43_617' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_629\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_629'><span class='gform-field-label__text'>Amount &#8211; road tax<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_629' id='input_43_629' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_627\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_627'><span class='gform-field-label__text'>How often &#8211; road tax<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_627' id='input_43_627' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_628\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_628'><span class='gform-field-label__text'>Amount &#8211; fuel, parking and toll road charges<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_628' id='input_43_628' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_626\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_626'><span class='gform-field-label__text'>How often &#8211; fuel, parking and toll road charges<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_626' id='input_43_626' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_634\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_634'><span class='gform-field-label__text'>Amount &#8211; breakdown cover<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_634' id='input_43_634' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_625\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_625'><span class='gform-field-label__text'>How often &#8211; breakdown cover<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_625' id='input_43_625' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_632\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_632'><span class='gform-field-label__text'>Amount &#8211; MOT and ongoing vehicle maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_632' id='input_43_632' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_624\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_624'><span class='gform-field-label__text'>How often &#8211; MOT and ongoing vehicle maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_624' id='input_43_624' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_633\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_633'><span class='gform-field-label__text'>Amount &#8211; vehicle hire purchase<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_633' id='input_43_633' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_623\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_623'><span class='gform-field-label__text'>How often &#8211; vehicle hire purchase<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_623' id='input_43_623' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_620\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_620'><span class='gform-field-label__text'>Amount &#8211; vehicle lease<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_620' id='input_43_620' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_619\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_619'><span class='gform-field-label__text'>How often &#8211; vehicle lease<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_619' id='input_43_619' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_631\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_631'><span class='gform-field-label__text'>Amount &#8211; public transport<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_631' id='input_43_631' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_622\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_622'><span class='gform-field-label__text'>How often &#8211; public transport<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_622' id='input_43_622' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_630\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_630'><span class='gform-field-label__text'>Amount &#8211; logbook loan<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_630' id='input_43_630' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_621\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_621'><span class='gform-field-label__text'>How often &#8211; logbook loan<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_621' id='input_43_621' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_580\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Utilities<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_580'><div class='gchoice gchoice_43_580_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.1' type='checkbox'  value='Dual fuel'  id='choice_43_580_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_1' id='label_43_580_1' class='gform-field-label gform-field-label--type-inline'>Dual fuel<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_580_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.2' type='checkbox'  value='Electricity'  id='choice_43_580_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_2' id='label_43_580_2' class='gform-field-label gform-field-label--type-inline'>Electricity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_580_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.3' type='checkbox'  value='Gas'  id='choice_43_580_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_3' id='label_43_580_3' class='gform-field-label gform-field-label--type-inline'>Gas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_580_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.4' type='checkbox'  value='Water supply'  id='choice_43_580_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_4' id='label_43_580_4' class='gform-field-label gform-field-label--type-inline'>Water supply<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_580_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.5' type='checkbox'  value='Water waste'  id='choice_43_580_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_5' id='label_43_580_5' class='gform-field-label gform-field-label--type-inline'>Water waste<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_580_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_580.6' type='checkbox'  value='Other fuel'  id='choice_43_580_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_580_6' id='label_43_580_6' class='gform-field-label gform-field-label--type-inline'>Other fuel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_638\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_638'><span class='gform-field-label__text'>Amount &#8211; dual fuel<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_638' id='input_43_638' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_637\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_637'><span class='gform-field-label__text'>How often &#8211; dual fuel<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_637' id='input_43_637' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_643\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_643'><span class='gform-field-label__text'>Amount &#8211; electricity<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_643' id='input_43_643' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_648\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_648'><span class='gform-field-label__text'>How often &#8211; electricity<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_648' id='input_43_648' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_642\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_642'><span class='gform-field-label__text'>Amount &#8211; gas<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_642' id='input_43_642' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_647\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_647'><span class='gform-field-label__text'>How often &#8211; gas<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_647' id='input_43_647' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_641\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_641'><span class='gform-field-label__text'>Amount &#8211; water supply<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_641' id='input_43_641' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_646\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_646'><span class='gform-field-label__text'>How often &#8211; water supply<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_646' id='input_43_646' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_640\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_640'><span class='gform-field-label__text'>Amount &#8211; water waste<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_640' id='input_43_640' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_645\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_645'><span class='gform-field-label__text'>How often &#8211; water waste<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_645' id='input_43_645' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_639\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_639'><span class='gform-field-label__text'>Amount &#8211; other fuel<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_639' id='input_43_639' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_644\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_644'><span class='gform-field-label__text'>How often &#8211; other fuel<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_644' id='input_43_644' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_582\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Care and health costs<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_582'><div class='gchoice gchoice_43_582_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.1' type='checkbox'  value='Prescriptions and medicine'  id='choice_43_582_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_1' id='label_43_582_1' class='gform-field-label gform-field-label--type-inline'>Prescriptions and medicine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_582_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.2' type='checkbox'  value='Dentistry'  id='choice_43_582_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_2' id='label_43_582_2' class='gform-field-label gform-field-label--type-inline'>Dentistry<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_582_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.3' type='checkbox'  value='Opticians'  id='choice_43_582_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_3' id='label_43_582_3' class='gform-field-label gform-field-label--type-inline'>Opticians<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_582_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.4' type='checkbox'  value='Childcare'  id='choice_43_582_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_4' id='label_43_582_4' class='gform-field-label gform-field-label--type-inline'>Childcare<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_582_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.5' type='checkbox'  value='Child maintenance or child support'  id='choice_43_582_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_5' id='label_43_582_5' class='gform-field-label gform-field-label--type-inline'>Child maintenance or child support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_582_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_582.6' type='checkbox'  value='Adult care'  id='choice_43_582_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_582_6' id='label_43_582_6' class='gform-field-label gform-field-label--type-inline'>Adult care<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_649\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_649'><span class='gform-field-label__text'>Amount &#8211; prescriptions and medicine<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_649' id='input_43_649' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_650\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_650'><span class='gform-field-label__text'>How often &#8211; prescriptions and medicine<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_650' id='input_43_650' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_658\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_658'><span class='gform-field-label__text'>Amount &#8211; dentistry<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_658' id='input_43_658' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_654\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_654'><span class='gform-field-label__text'>How often &#8211; dentistry<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_654' id='input_43_654' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_657\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_657'><span class='gform-field-label__text'>Amount &#8211; opticians<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_657' id='input_43_657' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_653\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_653'><span class='gform-field-label__text'>How often &#8211; opticians<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_653' id='input_43_653' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_656\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_656'><span class='gform-field-label__text'>Amount &#8211; childcare<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_656' id='input_43_656' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_652\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_652'><span class='gform-field-label__text'>How often &#8211; childcare<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_652' id='input_43_652' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_655\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_655'><span class='gform-field-label__text'>Amount &#8211; child maintenance or child support<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_655' id='input_43_655' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_651\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_651'><span class='gform-field-label__text'>How often &#8211; child maintenance or child support<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_651' id='input_43_651' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_659\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_659'><span class='gform-field-label__text'>Amount &#8211; adult care<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_659' id='input_43_659' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_662\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_662'><span class='gform-field-label__text'>How often &#8211; adult care<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_662' id='input_43_662' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_584\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Pension and insurances<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_584'><div class='gchoice gchoice_43_584_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_584.1' type='checkbox'  value='Buildings and contents insurance'  id='choice_43_584_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_584_1' id='label_43_584_1' class='gform-field-label gform-field-label--type-inline'>Buildings and contents insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_584_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_584.2' type='checkbox'  value='Life insurance'  id='choice_43_584_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_584_2' id='label_43_584_2' class='gform-field-label gform-field-label--type-inline'>Life insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_584_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_584.3' type='checkbox'  value='Mortgage payment protection insurance'  id='choice_43_584_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_584_3' id='label_43_584_3' class='gform-field-label gform-field-label--type-inline'>Mortgage payment protection insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_584_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_584.4' type='checkbox'  value='Health insurance'  id='choice_43_584_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_584_4' id='label_43_584_4' class='gform-field-label gform-field-label--type-inline'>Health insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_584_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_584.5' type='checkbox'  value='Pension payment'  id='choice_43_584_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_584_5' id='label_43_584_5' class='gform-field-label gform-field-label--type-inline'>Pension payment<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_661\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_661'><span class='gform-field-label__text'>Amount &#8211; buildings and contents insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_661' id='input_43_661' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_660\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_660'><span class='gform-field-label__text'>How often &#8211; buildings and contents insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_660' id='input_43_660' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_663\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_663'><span class='gform-field-label__text'>Amount &#8211; life insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_663' id='input_43_663' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_664\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_664'><span class='gform-field-label__text'>How often &#8211; life insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_664' id='input_43_664' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_665\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_665'><span class='gform-field-label__text'>Amount &#8211; mortgage payment protection insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_665' id='input_43_665' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_666\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_666'><span class='gform-field-label__text'>How often &#8211; mortgage payment protection insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_666' id='input_43_666' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_668\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_668'><span class='gform-field-label__text'>Amount &#8211; health insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_668' id='input_43_668' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_667\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_667'><span class='gform-field-label__text'>How often &#8211; health insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_667' id='input_43_667' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_670\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_670'><span class='gform-field-label__text'>Amount &#8211; pension payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_670' id='input_43_670' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_669\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_669'><span class='gform-field-label__text'>How often &#8211; pension payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_669' id='input_43_669' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_585\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Professional costs<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_585'><div class='gchoice gchoice_43_585_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_585.1' type='checkbox'  value='Professional courses'  id='choice_43_585_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_585_1' id='label_43_585_1' class='gform-field-label gform-field-label--type-inline'>Professional courses<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_585_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_585.2' type='checkbox'  value='Professional fees'  id='choice_43_585_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_585_2' id='label_43_585_2' class='gform-field-label gform-field-label--type-inline'>Professional fees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_585_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_585.3' type='checkbox'  value='Union fees'  id='choice_43_585_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_585_3' id='label_43_585_3' class='gform-field-label gform-field-label--type-inline'>Union fees<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_671\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_671'><span class='gform-field-label__text'>Amount &#8211; professional courses<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_671' id='input_43_671' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_672\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_672'><span class='gform-field-label__text'>How often &#8211; professional courses<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_672' id='input_43_672' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_676\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_676'><span class='gform-field-label__text'>Amount &#8211; professional fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_676' id='input_43_676' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_674\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_674'><span class='gform-field-label__text'>How often &#8211; professional fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_674' id='input_43_674' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_675\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_675'><span class='gform-field-label__text'>Amount &#8211; union fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_675' id='input_43_675' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_673\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_673'><span class='gform-field-label__text'>How often &#8211; union fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_673' id='input_43_673' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_587\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>School costs<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_587'><div class='gchoice gchoice_43_587_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_587.1' type='checkbox'  value='School uniform'  id='choice_43_587_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_587_1' id='label_43_587_1' class='gform-field-label gform-field-label--type-inline'>School uniform<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_587_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_587.2' type='checkbox'  value='After school clubs and school trips'  id='choice_43_587_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_587_2' id='label_43_587_2' class='gform-field-label gform-field-label--type-inline'>After school clubs and school trips<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_677\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_677'><span class='gform-field-label__text'>Amount &#8211; school uniform<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_677' id='input_43_677' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_678\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_678'><span class='gform-field-label__text'>How often &#8211; school uniform<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_678' id='input_43_678' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_680\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_680'><span class='gform-field-label__text'>Amount &#8211; after school clubs and school trips<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_680' id='input_43_680' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_679\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_679'><span class='gform-field-label__text'>How often &#8211; after school clubs and school trips<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_679' id='input_43_679' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_586\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Other essential costs<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_586'><div class='gchoice gchoice_43_586_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_586.1' type='checkbox'  value='Criminal fine'  id='choice_43_586_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_586_1' id='label_43_586_1' class='gform-field-label gform-field-label--type-inline'>Criminal fine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_586_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_586.2' type='checkbox'  value='Loan from family member or friend'  id='choice_43_586_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_586_2' id='label_43_586_2' class='gform-field-label gform-field-label--type-inline'>Loan from family member or friend<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_586_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_586.3' type='checkbox'  value='Legal fees'  id='choice_43_586_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_586_3' id='label_43_586_3' class='gform-field-label gform-field-label--type-inline'>Legal fees<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_681\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_681'><span class='gform-field-label__text'>Amount &#8211; criminal fine<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_681' id='input_43_681' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_682\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_682'><span class='gform-field-label__text'>How often &#8211; criminal fine<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_682' id='input_43_682' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_686\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_686'><span class='gform-field-label__text'>Amount &#8211; loan from family member or friend<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_686' id='input_43_686' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_684\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_684'><span class='gform-field-label__text'>How often &#8211; loan from family member or friend<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_684' id='input_43_684' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_685\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_685'><span class='gform-field-label__text'>Amount &#8211; legal fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_685' id='input_43_685' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_683\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_683'><span class='gform-field-label__text'>How often &#8211; legal fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_683' id='input_43_683' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_839' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_839' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_8' class='gform_page' data-js='page-field-id-839' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_8' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_43_689\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your flexible outgoings<\/h3><div class='gsection_description' id='gfield_description_43_689'>We need to know about all of your flexible outgoings, such as food and clothes.  Please select all of your household outgoings and tell us the amount and how often.  If you have any outgoings not listed, please use the other outgoings section at the bottom of this page.<\/div><\/div><fieldset id=\"field_43_690\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Food and housekeeping<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_690'><div class='gchoice gchoice_43_690_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.1' type='checkbox'  value='Alcohol'  id='choice_43_690_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_1' id='label_43_690_1' class='gform-field-label gform-field-label--type-inline'>Alcohol<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.2' type='checkbox'  value='Groceries'  id='choice_43_690_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_2' id='label_43_690_2' class='gform-field-label gform-field-label--type-inline'>Groceries<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.3' type='checkbox'  value='Household repairs and maintenance'  id='choice_43_690_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_3' id='label_43_690_3' class='gform-field-label gform-field-label--type-inline'>Household repairs and maintenance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.4' type='checkbox'  value='Laundry and dry cleaning'  id='choice_43_690_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_4' id='label_43_690_4' class='gform-field-label gform-field-label--type-inline'>Laundry and dry cleaning<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.5' type='checkbox'  value='Meals at work'  id='choice_43_690_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_5' id='label_43_690_5' class='gform-field-label gform-field-label--type-inline'>Meals at work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.6' type='checkbox'  value='Nappies and baby items'  id='choice_43_690_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_6' id='label_43_690_6' class='gform-field-label gform-field-label--type-inline'>Nappies and baby items<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.7' type='checkbox'  value='School meals'  id='choice_43_690_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_7' id='label_43_690_7' class='gform-field-label gform-field-label--type-inline'>School meals<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.8' type='checkbox'  value='Smoking products'  id='choice_43_690_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_8' id='label_43_690_8' class='gform-field-label gform-field-label--type-inline'>Smoking products<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_690_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_690.9' type='checkbox'  value='Vet bills and pet insurance'  id='choice_43_690_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_690_9' id='label_43_690_9' class='gform-field-label gform-field-label--type-inline'>Vet bills and pet insurance<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_691\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_691'><span class='gform-field-label__text'>Amount &#8211; alcohol<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_691' id='input_43_691' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_692\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_692'><span class='gform-field-label__text'>How often &#8211; alcohol<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_692' id='input_43_692' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_694\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_694'><span class='gform-field-label__text'>Amount &#8211; groceries<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_694' id='input_43_694' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_693\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_693'><span class='gform-field-label__text'>How often &#8211; groceries<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_693' id='input_43_693' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_711\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_711'><span class='gform-field-label__text'>Amount &#8211; household repairs and maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_711' id='input_43_711' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_695\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_695'><span class='gform-field-label__text'>How often &#8211; household repairs and maintenance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_695' id='input_43_695' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_712\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_712'><span class='gform-field-label__text'>Amount &#8211; laundry and dry cleaning<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_712' id='input_43_712' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_697\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_697'><span class='gform-field-label__text'>How often &#8211; laundry and dry cleaning<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_697' id='input_43_697' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_713\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_713'><span class='gform-field-label__text'>Amount &#8211; meals at work<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_713' id='input_43_713' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_700\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_700'><span class='gform-field-label__text'>How often &#8211; meals at work<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_700' id='input_43_700' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_714\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_714'><span class='gform-field-label__text'>Amount &#8211; nappies and baby items<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_714' id='input_43_714' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_701\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_701'><span class='gform-field-label__text'>How often &#8211; nappies and baby items<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_701' id='input_43_701' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_715\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_715'><span class='gform-field-label__text'>Amount &#8211; school meals<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_715' id='input_43_715' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_703\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_703'><span class='gform-field-label__text'>How often &#8211; school meals<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_703' id='input_43_703' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_716\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_716'><span class='gform-field-label__text'>Amount &#8211; smoking products<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_716' id='input_43_716' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_705\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_705'><span class='gform-field-label__text'>How often &#8211; smoking products<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_705' id='input_43_705' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_717\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_717'><span class='gform-field-label__text'>Amount &#8211; vet bills and pet insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_717' id='input_43_717' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_707\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_707'><span class='gform-field-label__text'>How often &#8211; vet bills and pet insurance<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_707' id='input_43_707' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_718\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Communications and leisure<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_718'><div class='gchoice gchoice_43_718_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.1' type='checkbox'  value='Home phone, internet and TV package'  id='choice_43_718_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_1' id='label_43_718_1' class='gform-field-label gform-field-label--type-inline'>Home phone, internet and TV package<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.2' type='checkbox'  value='Mobile phone'  id='choice_43_718_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_2' id='label_43_718_2' class='gform-field-label gform-field-label--type-inline'>Mobile phone<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.3' type='checkbox'  value='Hobbies, leisure or sport'  id='choice_43_718_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_3' id='label_43_718_3' class='gform-field-label gform-field-label--type-inline'>Hobbies, leisure or sport<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.4' type='checkbox'  value='Gifts'  id='choice_43_718_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_4' id='label_43_718_4' class='gform-field-label gform-field-label--type-inline'>Gifts<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.5' type='checkbox'  value='Newspapers, magazines, stationery and postage'  id='choice_43_718_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_5' id='label_43_718_5' class='gform-field-label gform-field-label--type-inline'>Newspapers, magazines, stationery and postage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.6' type='checkbox'  value='Pocket money'  id='choice_43_718_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_6' id='label_43_718_6' class='gform-field-label gform-field-label--type-inline'>Pocket money<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.7' type='checkbox'  value='Charitable donation'  id='choice_43_718_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_7' id='label_43_718_7' class='gform-field-label gform-field-label--type-inline'>Charitable donation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_718_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_718.8' type='checkbox'  value='Religious contribution'  id='choice_43_718_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_718_8' id='label_43_718_8' class='gform-field-label gform-field-label--type-inline'>Religious contribution<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_720\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_720'><span class='gform-field-label__text'>Amount &#8211; home phone, internet and TV package<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_720' id='input_43_720' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_719\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_719'><span class='gform-field-label__text'>How often &#8211; home phone, internet and TV package<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_719' id='input_43_719' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_723\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_723'><span class='gform-field-label__text'>Amount &#8211; mobile phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_723' id='input_43_723' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_721\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_721'><span class='gform-field-label__text'>How often &#8211; mobile phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_721' id='input_43_721' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_724\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_724'><span class='gform-field-label__text'>Amount &#8211; hobbies, leisure or sport<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_724' id='input_43_724' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_722\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_722'><span class='gform-field-label__text'>How often &#8211; hobbies, leisure or sport<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_722' id='input_43_722' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_731\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_731'><span class='gform-field-label__text'>Amount &#8211; gifts<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_731' id='input_43_731' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_734\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_734'><span class='gform-field-label__text'>How often &#8211; gifts<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_734' id='input_43_734' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_725\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_725'><span class='gform-field-label__text'>Amount &#8211; newspapers, magazines, stationery and postage<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_725' id='input_43_725' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_726\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_726'><span class='gform-field-label__text'>How often &#8211; newspapers, magazines, stationery and postage<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_726' id='input_43_726' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_727\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_727'><span class='gform-field-label__text'>Amount &#8211; pocket money<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_727' id='input_43_727' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_728\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_728'><span class='gform-field-label__text'>How often &#8211; pocket money<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_728' id='input_43_728' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_730\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_730'><span class='gform-field-label__text'>Amount &#8211; charitable donation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_730' id='input_43_730' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_733\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_733'><span class='gform-field-label__text'>How often &#8211; charitable donation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_733' id='input_43_733' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_729\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_729'><span class='gform-field-label__text'>Amount &#8211; religious contribution<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_729' id='input_43_729' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_732\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_732'><span class='gform-field-label__text'>How often &#8211; religious contribution<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_732' id='input_43_732' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><fieldset id=\"field_43_735\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Personal costs<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_735'><div class='gchoice gchoice_43_735_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_735.1' type='checkbox'  value='Clothing and footwear'  id='choice_43_735_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_735_1' id='label_43_735_1' class='gform-field-label gform-field-label--type-inline'>Clothing and footwear<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_735_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_735.2' type='checkbox'  value='Toiletries'  id='choice_43_735_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_735_2' id='label_43_735_2' class='gform-field-label gform-field-label--type-inline'>Toiletries<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_735_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_735.3' type='checkbox'  value='Hairdressing'  id='choice_43_735_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_735_3' id='label_43_735_3' class='gform-field-label gform-field-label--type-inline'>Hairdressing<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_736\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_736'><span class='gform-field-label__text'>Amount &#8211; clothing and footwear<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_736' id='input_43_736' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_737\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_737'><span class='gform-field-label__text'>How often &#8211; clothing and footwear<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_737' id='input_43_737' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_741\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_741'><span class='gform-field-label__text'>Amount &#8211; toiletries<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_741' id='input_43_741' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_738\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_738'><span class='gform-field-label__text'>How often &#8211; toiletries<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_738' id='input_43_738' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_740\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_740'><span class='gform-field-label__text'>Amount &#8211; hairdressing<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_740' id='input_43_740' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_739\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_739'><span class='gform-field-label__text'>How often &#8211; hairdressing<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_739' id='input_43_739' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Every week' >Every week<\/option><option value='Every month' >Every month<\/option><\/select><\/div><\/div><div id=\"field_43_742\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Any other outgoing costs<\/h3><\/div><fieldset id=\"field_43_743\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please tell us about any other outgoing costs, what they are, the amount and how often<\/span><\/legend><div class='gfield_description' id='gfield_description_43_743'>Enter the information and then click on the + sign to add another row for each other outgoing cost.\n<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Type of outgoing cost<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount \u00a30.00<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">How often  (weekly or monthly)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_743_cell1 gform-grid-col' data-label='Type of outgoing cost'><input aria-invalid='false'  aria-describedby=\"gfield_description_43_743\" aria-label='Type of outgoing cost, Row 1' data-aria-label-template='Type of outgoing cost, Row {0}' type='text' name='input_743[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_743_cell2 gform-grid-col' data-label='Amount \u00a30.00'><input aria-invalid='false'  aria-describedby=\"gfield_description_43_743\" aria-label='Amount \u00a30.00, Row 1' data-aria-label-template='Amount \u00a30.00, Row {0}' type='text' name='input_743[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_743_cell3 gform-grid-col' data-label='How often  (weekly or monthly)'><input aria-invalid='false'  aria-describedby=\"gfield_description_43_743\" aria-label='How often  (weekly or monthly), Row 1' data-aria-label-template='How often  (weekly or monthly), Row {0}' type='text' name='input_743[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_43_240' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_43_240' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_43_9' class='gform_page' data-js='page-field-id-240' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_43_9' class='gform_fields top_label form_sublabel_above description_above validation_below'><fieldset id=\"field_43_203\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have any outstanding loans or debts (including rent arrears)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_43_203'>\n\t\t\t<div class='gchoice gchoice_43_203_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_203' type='radio' value='Yes'  id='choice_43_203_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_203_0' id='label_43_203_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_203_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_203' type='radio' value='No'  id='choice_43_203_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_43_203_1' id='label_43_203_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_241\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your loans and debts<\/h3><div class='gsection_description' id='gfield_description_43_241'>Please tell us about your loans and debts including the monthly amount payable and the total amount outstanding or owed.<\/div><\/div><fieldset id=\"field_43_783\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col_vertical field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type of loan or debt<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_783'><div class='gchoice gchoice_43_783_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.1' type='checkbox'  value='Catalogue(s)'  id='choice_43_783_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_1' id='label_43_783_1' class='gform-field-label gform-field-label--type-inline'>Catalogue(s)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.2' type='checkbox'  value='Credit card 1'  id='choice_43_783_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_2' id='label_43_783_2' class='gform-field-label gform-field-label--type-inline'>Credit card 1<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.3' type='checkbox'  value='Credit card 2'  id='choice_43_783_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_3' id='label_43_783_3' class='gform-field-label gform-field-label--type-inline'>Credit card 2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.4' type='checkbox'  value='Credit card 3'  id='choice_43_783_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_4' id='label_43_783_4' class='gform-field-label gform-field-label--type-inline'>Credit card 3<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.5' type='checkbox'  value='Court fines'  id='choice_43_783_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_5' id='label_43_783_5' class='gform-field-label gform-field-label--type-inline'>Court fines<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.6' type='checkbox'  value='Loan 1'  id='choice_43_783_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_6' id='label_43_783_6' class='gform-field-label gform-field-label--type-inline'>Loan 1<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.7' type='checkbox'  value='Loan 2'  id='choice_43_783_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_7' id='label_43_783_7' class='gform-field-label gform-field-label--type-inline'>Loan 2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.8' type='checkbox'  value='Loan 3'  id='choice_43_783_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_8' id='label_43_783_8' class='gform-field-label gform-field-label--type-inline'>Loan 3<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.9' type='checkbox'  value='Loans from friends\/family'  id='choice_43_783_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_9' id='label_43_783_9' class='gform-field-label gform-field-label--type-inline'>Loans from friends\/family<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.11' type='checkbox'  value='Store card(s)'  id='choice_43_783_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_11' id='label_43_783_11' class='gform-field-label gform-field-label--type-inline'>Store card(s)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.12' type='checkbox'  value='Utility (for example gas, water, electricity) arrears'  id='choice_43_783_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_12' id='label_43_783_12' class='gform-field-label gform-field-label--type-inline'>Utility (for example gas, water, electricity) arrears<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.13' type='checkbox'  value='Rent arrears'  id='choice_43_783_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_13' id='label_43_783_13' class='gform-field-label gform-field-label--type-inline'>Rent arrears<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_783_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_783.14' type='checkbox'  value='Other loans or debts'  id='choice_43_783_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_783_14' id='label_43_783_14' class='gform-field-label gform-field-label--type-inline'>Other loans or debts<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_784\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_784'><span class='gform-field-label__text'>Amount payable monthly &#8211; Catalogue(s)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_784' id='input_43_784' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_787\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_787'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_787' id='input_43_787' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_791\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_791'><span class='gform-field-label__text'>Amount payable monthly &#8211; Credit card 1<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_791' id='input_43_791' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_789\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_789'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_789' id='input_43_789' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_794\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_794'><span class='gform-field-label__text'>Amount payable monthly &#8211; Credit card 2<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_794' id='input_43_794' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_792\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_792'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_792' id='input_43_792' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_797\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_797'><span class='gform-field-label__text'>Amount payable monthly  &#8211; Credit card 3<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_797' id='input_43_797' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_795\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_795'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_795' id='input_43_795' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_800\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_800'><span class='gform-field-label__text'>Amount payable monthly &#8211; Court fines<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_800' id='input_43_800' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_798\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_798'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_798' id='input_43_798' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_803\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_803'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Loan 1<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_803' id='input_43_803' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_801\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_801'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_801' id='input_43_801' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_806\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_806'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Loan 2<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_806' id='input_43_806' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_804\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_804'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_804' id='input_43_804' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_809\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_809'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Loan 3<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_809' id='input_43_809' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_807\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_807'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_807' id='input_43_807' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_812\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_812'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Loans friends\/family<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_812' id='input_43_812' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_810\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_810'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_810' id='input_43_810' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_815\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_815'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Store card(s)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_815' id='input_43_815' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_813\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_813'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_813' id='input_43_813' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_818\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_818'><span class='gform-field-label__text'>Amount payable monthly &#8211;  Utility<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_818' id='input_43_818' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_816\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_816'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_816' id='input_43_816' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_821\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_821'><span class='gform-field-label__text'>Amount payable monthly &#8211; Rent arrears<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_821' id='input_43_821' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_819\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_43_819'><span class='gform-field-label__text'>Total amount outstanding or owed<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_819' id='input_43_819' type='text' step='any'   value='' class='large'    placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_825\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About other loans or debts<\/h3><\/div><fieldset 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