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Bankruptcy Questionnaire

Below is a sample of questions that we ask our clients to prepare their bankruptcy petition.

– First name:     

– Middle name:     

– Last name:     

– Email Address:      

– Phone Number:     

– List all other names or aliases you have used in the past 8 years:     

– Spouses First Name:     

– Spouses Middle Name:     

– Spouses Last Name:                   

– List all other names or aliases your spouse has used in the last 8 years:     

– Marital Status:     

– Have you been married in the last 8 years? If so, list previous spouse’s names and addresses?     

– How many dependents do you have that live with you, who are under 18?     

– Do you support anyone in your household that is over 18?     

– Do you support anyone else that does not live with you?     

– Have you used any other names in the last 8 years?     

– What is your social security number?     

– Have you ever used any other social security numbers?     

– What is your Spouse’s social security number?     

– Has your spouse ever used any other social security numbers?     

– What is your home address?     

– In the last three years have you lived anywhere else?      Please provide address and information below.

                – Address 1:     

                – Date Moved In:     

                – Date Moved out:     

                – Address 2:     

                – Date Moved In:     

                – Date Moved out:     

                – Address 3:

                – Date Moved In:     

                – Date Moved out:     

– Have you ever filed any other bankruptcy cases?      

– Case Number:      

PROPERTY (List everything that you and your spouse own)

– List the addresses and value of all real estate, including houses, condos, vacation homes, burial plots, land or times shares etc, in this country or any other country:     

– List all businesses that you own. What is the value of the business? The Value is how much you can sell the business for. Sometimes you can determine value by adding up all the inventory. Other times you can value a business by the amount of money it makes     

– List all vehicles that you own, pay for, drive, insure and maintain.

                – Vehicle 1

– Year:     

– Make:     

– Model:     

– Trim:     

– Color:     

– Mileage:     

– Loan Balance:     

                – Vehicle 2

– Year:     

– Make:     

– Model:     

– Trim:     

– Color:     

– Mileage:     

– Loan Balance:     

                – Vehicle 3

– Year:     

– Make:     

– Model:     

– Trim:     

– Color:     

– Mileage:     

– Loan Balance:     

– Do you own any other vehicles, watercraft, recreational vehicles, aircraft, or other vehicles:

                – Other Vehicle 1

– Year:     

– Make:     

– Model:     

– Trim:     

– Color:     

– Mileage:     

– Loan Balance:     

                – Other Vehicle 2

– Year:     

– Make:     

– Model:     

– Trim:     

– Color:     

– Mileage:     

– Loan Balance:     

– List any personal property, including collections, artwork, paintings, sculptures, fur, leathers, jewelry, diamonds, gold, firearms, hobby equipment, machinery, tools supplies or inventory, etc., that you own worth over $400. Please also provide their values

– List all Checking accounts even if the balance is $0. Please provide the name of the financial institution and the balance.

– List all Savings accounts even if the balance is $0. Please provide the name of the financial institution and the balance.

– List all accounts being held for children or other people, if any. What are the balances?

– List all retirements, pensions, 401ks, and IRA’s etc., if any. What are the balances?

– List all brokerage accounts, stocks, bonds, CDs, annuities. What are the balances?     

– List all copyrights, patents, trademarks or trade secrets. Do they have a value?     

– List all claims or lawsuits that you filed or can file against other people or entities. Is there a specific value or damages for these lawsuits?     

– List all life insurance policies. Can you cash out? If so, how much?     

– Do you have cash on your person, at your house or anywhere other than your financial accounts? If so, how much?     

– List all trusts that you created, or are the beneficiary of. How much money is in the trust? What property is in the trust and what are their values(House? Everything that you own? A Bank Account?)     

– List all other personal property, real property, real estate, personal items or financial accounts that you can sell for at least $500 or cash out.     

-List all business assets, including inventory, cash accounts, deposit accounts, and accounts receivables etc.     

DEBT

– Secured Debts – list the finance company and the amount owed for all debts that are secured on a home (e.g. mortgage), car or any other property.      

– Priority debts – list all tax debt, child support, alimony, debts to the government, etc. and the amount owed.     

– List all unsecured debts and the amount owed. (e.g. credit cards, personal loans, pay day loans, cash loans etc.)     

– Provide the name of the finance company for all leased vehicles.     

– Provide the name and address of your landlord if you are renting your residence.     

INCOME

– What is your occupation?     

– Please provide the name and address of your employer?     

– How long have you been employed with your current employer?     

– What is your Annual Salary?     

– What is your Hourly Wage?     

– Do you receive bonuses? How much and how often?     

– Do you receive commission? How much and how often?     

– What is your gross monthly income (income before taxes and deductions)?     

– What is your Spouses occupation?     

– Please provide the name and address of your spouse’s employer:     

– How long has your spouse been employed with your current employer?     

– What is your Spouse’s Annual Salary?     

– What is your Spouse’s Hourly Wage?     

– Does your Spouse receive bonuses? How much and how often?     

– Does your Spouse receive commission? How much and how often?     

– What is your Spouse’s gross monthly income (income before taxes and deductions)?     

– Besides income from your employer listed above, do you or your spouse receive income from any other source (e.g. support payments, Social Security, disability, unemployment, and/or worker’s compensation etc.)? If so, how much and how often?     

– Do you own a business? If you own a business, please provide the businesses monthly average net income (income after business expenses). Provide profit and loss statements BY INDIVIDUAL MONTHs, for the past 12 months.     

EXPENSES

– How many dependents do you have?     

– List your dependents age and their relationship to you (e.g. son, daughter, mother, father etc.). If the dependent is over 18, please provide the reasons that the adult is still a dependent     

(Please list the amount you pay on average per month for each expense below)

-Rent/Mortgage:     

-Real estate taxes if separate from mortgage payment:     

-Real estate insurance if separate from mortgage payment:     

-Homeowners association dues:     

-Home maintenance, repair and upkeep:     

-Home Electricity:     

-Home Gas:     

-Home Water:     

-Home Sewer/Trash:     

-Home Telephone:     

-Cell Phone:     

-Home Internet:     

-Home Cable or Satellite:     

-Other Utilities (please list the utility and the amount paid):     

-Food:     

-Housekeeping supplies:     

-Child Care:     

-Children’s education costs:     

-Clothing, laundry and or dry cleaning:     

-Personal Care Products and services:     

-Medical and Dental expenses:     

-Transportation (gas maintenance and registration):     

-Entertainment, clubs, recreation, subscriptions:     

-Charitable contributions and religious donations:     

-Life Insurance:     

-Health Insurance:     

-Vehicle Insurance:     

-Other Insurance:     

-Additional taxes that are not deducted from paychecks:     

-Car Payment1:     

-Car Payment2:     

-Other car or installment payments on secured debts:     

-Child Support:     

-Alimony Support:     

-Support of any other people that don’t live with you:     

-Other mortgages, real estate taxes, rental property expense:     

-Other Expenses (Please list the type of expense and the amount):     

FINANCIAL AFFAIRS

-List your gross employment income year to date:     

-List your gross employment income for last year:     

-List your gross employment income for the year before last:     

-List your gross business income year to date:     

-List your gross business income for last year:     

-List your gross business income for the year before last:     

-List gross income from any other source year to date:     

-List gross income from any other source last year:     

-List gross income from any other source for the year before last:     

-List your spouse’s gross employment income year to date:     

-List your spouse’s gross employment income for last year:     

-List your spouse’s gross employment income for the year before last:     

-List your spouse’s gross business income year to date:     

-List your spouse’s gross business income for last year:     

-List your spouse’s gross business income for the year before last:     

-List gross spouse’s income from any other source year to date:     

-List gross spouse’s income from any other source last year:     

-List gross spouse’s income from any other source for the year before last:     

-Did you pay any creditors in the last 90 days? Did they receive over $600 in total over the last 90 days?   If so, list the creditors name and the amount that you paid them in the last 90 days.     

-Did you pay back any loans to friends or family members in the last year? If so, list their names, addresses and the amount that you paid them and the amount that you still owe.     

-Did you make any payments on behalf of friends or family members because you owe them? If so, please list their names, addresses and what you paid for them and how much.     

-List all lawsuits, court actions or administrative proceedings that you were a part of in the past year. If so, Please provide the Case Name, Case Number, Court Name and Court Address. Explain the status of the case.     

-In the last year, have you had any property or money, repossessed, foreclosed, garnished, attached, seized or levied?     

-In the last year, have any of your creditors owed you money?      

-Have you assigned/given any of your property or belongings to your creditors?     

-In the last two years have you made any gifts or charitable contributions, totaling over $600, to a single entity or individual. If so, who and how much in total over the last two years.     

-In the last year, have you lost any property or money from fire, theft, disaster or gambling? If so, please list the property or money, the value of the property or the amount of money lost, an explanation of what happened, and if there was any insurance coverage or reimbursement.     

-In the last year, have you paid anyone else for bankruptcy or debt relief services?     

-In the last 4 years, have you transferred, sold, changed title or given away any property or money worth over $500? If so, what was transferred, sold, changed title or given away? What was the value or how much? please list who received the property, their address.      

-List all vehicles that you were on title of in the last 4 years. What happened or what is the status of all the vehicles. Did you sell any? Did you give any away? Did you transfer title? If you did, provide the amount received in return, if anything and the name and address of the person or company that received the vehicle.     

-Have you ever created a trust, or are you the beneficiary of a trust? What is the name of the trust? What property is in the trust?      

-Have you closed any financial accounts in the last year? If so, what type of account was it, what is the last four of the account number, what was the balance prior to closing the account?     

-Have you owned a safe deposit box in the last year? What were the contents? Where are they now if the box was closed.     

-Are you storing your belongings, property , or personal items anywhere other than your home? If so, Please provide the name and location of where your property is being stored.      

-Are you holding any property for anyone else?     

-Do you have any issues regarding environmental law or hazardous material?     

-List all Businesses, dates that you operated them, the nature of each business, and the formation of the business (e.g. sole prop, corporation, LLC etc).