(Copy & Paste-legibly print is ok)
Questionnaire:
To file Chapter 7 must be 8 yrs since last bankruptcy if recieved discharge before
Name: ______________________________________
Address: ________________________________________________
1. Property-House, Land, Timeshares, Car(s)-
2. Individual/Joint Filing-
3. All other names used-
4. Business Owner in last 6 years ?-
5. Employer
6. Employer address-
7. Occupation-
8. How long-
9. Annual Income - 2010-$ /2011-$
10. Monthly Income, Deductions? & Source -
11. Previous Address -(if less than 3 years)-
12. Marital Status-
13. No. of dependents and ages-
14. Lawsuits/Judgments/Garnishments/Repossessions
15. Bank name-
16. Rent/Mortgage-
17. Utilities
18. Vehicle(s) description-
19. Car Insurance-
20. All Other Expenses-
21. Tax Refund- $ ?