Bankruptcy Questionnaire Template (Page 12 of 26) in pdf

Bankruptcy Questionnaire Template Page 12

Did the agency have you sign up for a plan to repay or settle your debts? YES _____ NO _____. If YES, give the

amount and terms of the plan (and bring a copy of the plan with you to our office):

G. How much have you paid the agency or company? $

H. Have you consulted anyone else about your debts in the past year? YES _____ NO _____. If YES, give name,

address, and amount(s) paid for the service:

Did any of your debts result from a refinancing or a consolidation loan? YES ___ NO ___. If YES, which ones?

Please be sure to bring all papers for these loans with you.

14. Closed Bank Accounts:

Have you or your spouse had your name on any bank account (such as savings, checking, certificates of deposit)

during the past 12 months that is now closed? YES __ NO __. If YES, state:

Bank’s Name

Type of Account

Other Names

Date

Final

and Address

Acct No.

(Savings/Checking)

on Account

Closed

Balance

15. Safe Deposit Boxes:

Have you or your spouse had a safe deposit box during the last year? YES _____ NO _____.

If YES, list the name and address of the bank, the name and address of everyone who had access to the box, the

contents of the box and, if you no longer have the box, the date it was closed:

16. Property Held for Another Person:

Do you have any money, property, furniture, etc. that belongs to another

person or that you are holding for the benefit of someone else (in trust)? YES ____ NO____. If YES, what is the

property, who owns it, and what is it worth? Include name and address of the owners:

Type of

Relative?

Property

Value

Owned By

Address

(Yes or No)

At what address are you keeping this property?

Bankruptcy Questionnaire Template Page 12