Form 010 - Trustee Questionnaire Page 2
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311.
YES
NO
(a) Are you at present required to pay child support or spousal support, for
either an ongoing obligation or an obligation that would have ended by now
if you had made all your payments on time? (If this is a joint case, whose
obligation is this:
HUSBAND
WIFE
)
(c) If “yes,” the amount of my support payment is $ ______________ per
month. Of that amount, $_____________ per month is to pay arrears.
(d) If “yes,” the name of the person to whom I owe support is _________________
__________________________________________________, his/her full address is _______
_________________________________________________________________________________,
and his/her phone number is (
) _______ - __________________.
YES
NO
(d) If “yes,” were you behind in your support payments as of the date your case
was filed? If behind, the amount I was behind as of filing is $ ______________.
12.
YES
NO
(a) Has your attorney advised you, or are you otherwise aware, that any of your
debts are “non-dischargeable” in this bankruptcy case? (In other words, if
you don’t pay the debt in full in this case, you will have to finish paying it off
after your case is over)
(b) If “yes,” please list each non-dischargeable debt: ____________________________
__________________________________________________________________________________
__________________________________________________________________________________.
13.
YES
NO
(a) Are you still paying on your home (mortgage, equity line, deed of trust, etc.) ?
YES
NO
(b) If “yes,” have you missed any monthly mortgage payment that you
should have paid since your case was filed?
14.
YES
NO
(a) Are you renting where you live?
YES
NO
(b) If “yes,” have you missed any monthly rent payment that you should
have paid since your case was filed?
15.
YES
NO
Do you expect your income to increase in the upcoming year? If “yes,” explain:
_______________________________________________________________________________________
16.
YES
NO
Do you expect your income to decrease in the upcoming year? If “yes,” explain:
_______________________________________________________________________________________
should
17.
YES
NO
(a) For all prior tax years for which you
have filed federal or state
income tax returns, is there any year for which you have not filed a return?
(b) If “yes,” list the years that were not filed: Federal: ___________________________
_____________________; State: _____________________________________________________
18.
YES
NO
(a) Did you receive a federal or state income tax refund for the last year that you
filed your personal income tax returns?
(b) If “yes”: year: ____________; fed. refund: $_____________; state refund: $___________
19.
YES
NO
(a) At this time do you contribute regularly to a church or other religious
organization?
(b) If “yes,” how much, on average, did you contribute each month in the year
before you filed this case? $____________ per month
20.
YES
NO
(a) Do you have any student loans for which you are liable?
(b) If “yes”: amount still owed: $________________; required payment: $_________/mo.
Future payments to be made: DIRECTLY BY ME
THROUGH THE PLAN
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Form 010; 02/19/08 (version #6)
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