Bankruptcy Questionnaire

All questionnaire sections 18

1. Name and residence
2–3. Prior bankruptcies
4. Occupation and income
5. Taxes
6. Debts repaid
7–8. Suits, garnishment & sheriff’s sales
9–12. Repossessions, property held by others, transfers & losses
13–18. Attorneys, counselors, accounts & leases
19–21. Support, accidents & cosigners
22–23. Credit cards, payday loans & evictions
24. Secured debts
25. Unsecured debts & creditors
26A–B. Real property
26C–D. Personal property & vehicles
26E. Other property
27A–N. Budget — income & household
27O–S. Monthly expenses
Review & electronic signature

Step 1 of 18 · 1. Name and residence

1. Name and residence

List everyone you owe. If you don’t know an exact amount, give a HIGH estimate. If you and your spouse are not filing together and live apart, skip spouse questions.

Your full name *Your spouse’s full name Your Social Security Number — last 4 digits (Full number collected at the office)Spouse’s Social Security Number — last 4 digits (Full number collected at the office)Your date of birth Spouse’s date of birth Other names used by you or your spouse in the last eight years Current address (street, city, county, ZIP) Telephone *Email *

All addresses in the last three years

AddressDate moved inDate moved outName used

Your answers save on this device until you send. Submitting does not create an attorney-client relationship.