Please answer the following questions completely and to the best of your ability. Have you paid any one creditor that is not your mortgage or car loan, $500.00 or more within the last 4 months? Yes- No Have you been garnished in the last 4 months? Yes- No Have you paid off a credit card balance with a different credit card? Yes- No Have you made purchases with or taken cash from any credit card in the last 3 months? Yes - No Has anyone repossessed or foreclosed on your house or your car within the last year? Are you suing someone or is anyone suing you? Has your Yes No Yes No – – landlord threatened to or started eviction proceedings against you? Yes No Are any – of your debts due to gambling or theft by another? Yes No Have you lost property – due to a fire in the last year? Yes - No Have you given a gift of more than $200.00 within the last two years to any one individual? Yes No Have you given an item of property valued at over $200 to – anyone person within the last two years? Have you paid back any relative Yes No – money borrowed from them in the last 2 years? Yes - No Have you closed any bank accounts within the last year? Yes No Do you have any – safety deposit boxes? Yes No – Have you lived at your address for the last two years? Yes No Have you owned any – real estate (house or land) in the last four years? Yes No Have you ever lived in a – community property state, for example California, Arizona, or Alaska? Yes No – Yes No Have you ever been Do you owe child support, alimony, maintenance? – married? Yes No – Do you have a loan with a check into cash business? Yes No Have you used – personal property (TV, DVD etc.) as collateral for a loan? Yes No – Did you borrow money from anyone to pay for our services? Yes No Is someone – else paying for your bankruptcy fees? Yes - No HOW DID YOU HEAR ABOUT MY OFFICE? Yellow Pages-American Classified-Friend or Family NOTICE: Information that you provide during your case may be audited pursuant to provisions of the Bankruptcy Code. Failure to provide such information may result in dismissal of the case this title or other sanction, including criminal sanctions.
Please answer the following questions completely and to the best of your ability. Have you paid any one creditor that is not your mortgage or car loan, $500.00 or more within the last 4 months? Yes- No Have you been garnished in the last 4 months? Yes- No Have you paid off a credit card balance with a different credit card? Yes- No Have you made purchases with or taken cash from any credit card in the last 3 months? Yes - No Has anyone repossessed or foreclosed on your house or your car within the last year? Yes – No Are you suing someone or is anyone suing you? Yes – No Has your landlord threatened to or started eviction proceedings against you? Yes – No Are any of your debts due to gambling or theft by another? Yes – No Have you lost property due to a fire in the last year? Yes - No Have you given a gift of more than $200.00 within the last two years to any one individual? Yes – No Have you given an item of property valued at over $200 to anyone person within the last two years? Yes – No Have you paid back any relative money borrowed from them in the last 2 years? Yes - No Have you closed any bank accounts within the last year? Yes – No Do you have any safety deposit boxes? Yes – No Have you lived at your address for the last two years? Yes – No Have you owned any real estate (house or land) in the last four years? Yes – No Have you ever lived in a community property state, for example California, Arizona, or Alaska? Yes – No Do you owe child support, alimony, maintenance? Yes – No Have you ever been married? Yes – No Do you have a loan with a check into cash business? Yes – No Have you used personal property (TV, DVD etc.) as collateral for a loan? Yes – No Did you borrow money from anyone to pay for our services? Yes – No Is someone else paying for your bankruptcy fees? Yes - No HOW DID YOU HEAR ABOUT MY OFFICE? Yellow Pages-American Classified-Friend or Family NOTICE: Information that you provide during your case may be audited pursuant to provisions of the Bankruptcy Code. Failure to provide such information may result in dismissal of the case this title or other sanction, including criminal sanctions.
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