Bankruptcy Questionnaire Template Page 5
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263.
Other Bankruptcies:
Have there been any other bankruptcies filed by someone other than you or your spouse
to stop a foreclosure on your home? YES _____ NO _____. If YES, give details:
4.
Occupation and Income:
A.
Usual type of work:
B.
Name and address of current employer:
C.
Spouse’s usual type of work:
D.
Name and address of spouse’s current employer:
E.
How long have you been at your current job?
Your spouse?
F.
List all income received in the last six months by you and your spouse (do not list your spouse’s income if you are
not filing bankruptcy together and you are legally separated):
(Bring a copy with you to our office of all pay stubs or other records from your employer of all pay received within the
past sixty days.)
Source
(Names and addresses of
employers or specify social security,
Income Received
By Whom
welfare, unemployment, child support,
(Give gross income)
self-employment, investments, etc.)
(Self or Spouse)
1 month ago:
2 months ago:
3 months ago:
4 months ago:
5 months ago:
6 months ago:
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