Atrium Mediation

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Statement of Means

Private & Confidential – for personal use in mediation

(Weekly = Monthly ÷ 4.3)

Person

Full Name Email Phone Address

Household

Dependants Accommodation

Income (Monthly)

Expenditure (Monthly)

Assets

Liabilities

On phones: use Share → Print (iOS) or ⋮ → Share → Print (Android)

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