Joint Bankruptcy Questionnaire

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Bankruptcy Questionnaire (Joint)

Online Bankruptcy Questionnaire for Joint Filing

"*" indicates required fields

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III. Your Debts

Your attorney will obtain a tri-merge credit report which will provide a list of your consumer debts. The credit report will provide the names, addresses, account numbers, and balances of each consumer account reported in your name. The credit report typically shows all mortgages, car loans, credit cards, department store cards, and most debts being serviced by a collection company.

However, some debts are typically not reported to the credit bureaus (i.e., doctor bills, old utility bills, personal loans from private individuals, etc.). Prior to filing your case, your attorney will review the final list of creditors with you to make sure they are all properly listed and included.

Non-Consumer Debts

Please provide a list of your and your spouse's non-consumer debts (i.e., doctor bills, hospital bills, old utility bills, personal loans from private individuals, etc.). Be sure to include the name of the creditor, the creditor's address, and the approximate amount owed.

Child Support or Alimony*

Are you or your spouse required by court order to pay Child Support, Spousal Support, or Alimony?

Yes

Other

Tax Debt

If you or your spouse owe any taxing authority (i.e., IRS, State, County, or City) back taxes, please describe each debt below. Be sure to include the type of debt, the approximate amount, and the year the debt was incurred.

Some taxes may be dischargeable and your attorney will review the information and advise how your tax debt will be handled in your bankruptcy.

IV. Wage & Employment

Please skip to the next page if any of the following apply to you...

You are self-employed, a sole proprietor, or an independent contractor

You are retired

You are currently unemployed

You are not paid with a pay stub and do not receive a W2

Your Current Employer

Your Spouse's Current Employer

Your Current Occupation

Your Spouse's Current Occupation

Your Approximate Hire Date?

The approximate month and year you began working for the above employer.

Your Spouse's Approximate Hire Date?

The approximate month and year you began working for the above employer.

VI. Other Income

Average monthly income from Rental Property (if any)

Average monthly income from Child Support or Alimony (if any)

Average monthly income from Pension (if any)

Average monthly income from Social Security (if any)

Average "other" monthly income (if any)

VII. Monthly Expenses

Rent or Mortgage

How much do you pay per month for your Rent or Mortgage Payments. If you pay a mortgage, provide the Principal + Interest + Tax + Insurance (PITI) payment. If you have a 2nd mortgage (a.k.a. Home Equity Line of Credit) do not include that payment on this line.

2nd Mortgage / Home Equity Loan / HELOC

If you have a 2nd Mortgage (a.k.a. Home Equity Loan, Home Equity Line of Credit, HELOC) please enter the regular scheduled monthly payment amount here.

Condo/HOA Dues

FPL/Power

Water

Cell Phone

Cable and/or Internet

Food and Housekeeping Supplies

Childcare and Children’s Education Costs

Clothing, Laundry, and Dry Cleaning

Personal Care Products and Services

Medical and Dental Expenses

Transportation

Include gas, maintenance, bus or train fare. Do not include car payments.

Leisure

Entertainment, movies, clubs, recreation, newspapers, magazines, and books.

Charitable Contributions and Religious Donations

Car Insurance

Health Insurance (not deducted from paycheck)

Car Payment(s)

Monthly lease or finance payment(s)

Installment Payments

Tax payment plans, financed vehicle or boat loans, mortgage payments for non-homestead property, etc.

Child Support or Alimony (not deducted from your paycheck)

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