Bankruptcy Questionnaire

When you are ready to pay the fees and set up an appointment or just bring by the documents just let us know. In the meantime, if you have any questions about anything in the questionnaire or do not know the answer to a certain question, just leave the question blank and you can ask the attorney later on.

We know this questionnaire is long. Preparing your bankruptcy papers properly takes a significant amount of time and a great deal of information. If we work together to do so, we can protect your family from great hardship and give you the fresh start the law intends you to have. Remember, if you have any questions just call us or email us at devin@theharrisfirmllc.com.

THE HARRIS FIRM LLC - BANKRUPTCY QUESTIONNAIRE

ARE YOU MARRIED OR SINGLE?*
If you and your spouse are not living together and are seeking a divorce or separation, and there is no possibility that your spouse will file bankruptcy along with you, you don't have to answer the questions about your spouse. Otherwise, your spouse’s information will be necessary to fill out.
- Single
- Married and Living Together
- Married and Living Separately
Your Full Name*
Your Spouse Full Name
Only if spouse is filing with you
Your Address (including County that you live in)*
Your Phone Number*
Your Email Address*
You and Your Spouse's Date of Birth*
Only put spouse if they are filing with you.
You and Your Spouse Social Security Numbers*
Only put spouse if they are filing with you.
List any other names used by you or your spouse (including maiden name), or other ways you have signed your names to papers and checks during the last eight years
You and your spouse, if any
List all addresses you have had in the last three years, the dates when you lived there, and the name you used while living there. If you and your spouse are filing bankruptcy together, list addresses for each for the last three years (include street, town, and zip code).
If married, do you currently have a pending divorce or are you contemplating filing a divorce in the near future
Have you or your spouse ever been involved before in a bankruptcy (chapter 7, 11, 12, or 13)?*
Please list what type of bankruptcy you filed and when you filed it.
You and Spouse's Occupation*
What type of work do you do? Are you employed?
Name and address of you (and spouse's) employer and how long you have been working there*
Have you or spouse owned a business during the last five years?*
If so please list name of business, address, and any assets business currently has. If business no longer operating then list dates when it was operating and whether there are any debts from it.
Taxes*
Have you received a tax refund? Is so how much and when did you get it?
Are you (or spouse) currently suing anyone for any reason?*
Do either of you have any claims or lawsuits against anyone you could bring or are currently bringing? Please list them here if so.
Do you have any lawsuits against you pending? Any garnishments?*
Please let us know if you have any lawsuits or garnishments pending that you know about.
Have you paid off any relatives on any debts over $1000 in the last year?*
If so please list amount of debt paid off and to whom.
Have you transferred any property (land or vehicles) to anyone within last two years?*
If so please list details.
Do you have any repossessions or foreclosures in the last year?*
Please list details here.
Secured Debts (Vehicle loans, mortgages, or any property you have financed and the debt is secured by property)*
Please list name (and address if know it) of creditor, the type of debt (car loan, mortgage, etc.), type of property securing it (model of vehicle, home, etc.), and an estimate of how much you think you owe.
Unsecured Debts (medical bills, credit cards, personal loans, deficiency amounts from repossessions, old tax debts, payday loans, loans from relatives, business debts, old utility bills, broken lease agreements, traffic tickets, overpayment of social security, etc.)*
These are debts with no property attached. Please list name (and address if know it) of creditor and estimate of amount owed.
Real Property (Your Home or other land/house)*
Please list address of any land or homes you are on the deed to, whether you live in it or not, and an estimate of amount it is worth (we usually use the tax appraisal amount to determine your home's value. You can find this on the tax appraisal card you get in the mail each year when you pay taxes on property). Also please tell us if anyone else is on the deed with you. Lastly, tell us if there is a lien or mortgage on property and if so how much (estimate is fine) it is.
Do you have any bank accounts or credit union accounts?*
If so, please list the name of the institution/bank and the estimated amount currently in it.
Have you given a security deposit to any landlord, utility, or anyone else?*
If so just list estimate of how much deposit was, when made it, and to whom.
Do you have any cars, trucks, mobile homes, boats, trailers, or motorcycles*

If so please list year, make, model, and estimated value. Also, please put if there is a loan on the vehicle and if so estimate how much and whether loan is current or not.
Do you own any stocks or bonds? Please list details and amounts below if so*
List your major property items such as stove, beds, refrigerator, TV, sewing machine, furniture, guns, etc., giving approximate value (what you could get for it if you sold it). (These goods usually can be protected, but you must list them to protect them.)*
If it is only old appliances and furniture you can just put a low amount for all your used furnishings, like $500 or some low number like that since old furnishings cannot be sold for very much in most cases.
Do you own any machinery, tools, or fixtures used in your business or work?*
Please list an estimated value of them as well.
Please list all members of your household and their relationship to you*
List name, age, and relationship (spouse, son/daughter, etc.)
Do you, your spouse, or your dependents receive income from any source other than paystubs you provided?*
Please list any income received during the last six months other than from work pay stubs of you and spouse such as alimony, child support, 401(k) withdrawals, public assistance, unemployment compensation, social security, SSI, pension, retirement, military retirement, private disability, or any other income.
List below your average monthly expenses for you and your family. If you pay any of these expenses weekly, bi-weekly, quarterly, semi-annually, or annually, you will need to adjust the amount to show it as a monthly amount*
Please list your rent or mortgage, cell phone, cable, internet, water, power, heat, food/groceries, medications (prescription and over the counter), gasoline and transportation, vehicle loan payments, student loan payments, payments to IRS/Alabama Taxes, Any insurance that doesn't come out of your paycheck (homeowners, life, health, vehicle, etc.), Daycare/Babysitting expenses, Alimony, Child Support, Diapers or Formula for infants, Security/Alarm Systems, Birthday and Holiday Expenses for Family, Pet Food/Expenses, and any other expenses you can think of.
Please list any additional information concerning your income, property/assets, or debts.
Phone
This field is for validation purposes and should be left unchanged.

What is Bankruptcy?

Bankruptcy was created to give individuals and entities an opportunity to have get financial relief, potentially get a fresh start by resolving their serious debt issues. For example, by filing Chapter 7 you could eliminate... Read more

How much does it costs?

We charge $1050 for our attorney fees in most simple Chapter 7 cases. In addition to this, there is a court filing fee that is $335 in a Chapter 7 bankruptcy. There is also a $30 fee to pull your credit report and incorporate it into... Read more

Will anyone know I have filed bankruptcy?

Other than the creditors and persons you tell, it is unlikely others will know that you filed. It is public record, but not easily accessible by the general public. Some possible exceptions to this would be if... Read more

more Bankruptcy FAQs

Quick Contact

Choose from the office locations above for contact details

Phone

CALL NOW

Fill Out a Questionnaire

Get started

MAKE A PAYMENT ONLINE

Make Payment

THE HARRIS FIRM LLC - BANKRUPTCY QUESTIONNAIRE

Bankruptcy Services

Locations

Harris Firm LLC Proud Member of

Bankruptcy FAQs

Quick Contact

Phone

Fill Out a Questionnaire

MAKE A PAYMENT ONLINE