Debtor:
Last:
First:
Middle:
Bankruptcy Statement of Financial Affairs Questionnaire
This statement is to be completed by every debtor. Spouses filing a joint petition may file a single statement on which the information for both spouses is combined. If the case is filed under Chapter 12 or 13, a married debtor must furnish information for both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed. If you have a question about a legal term used on this form please click on our Bankruptcy Dictionary and a separate window will open. These questions are for your protection to assist the Trustee in recovering any assets if the case warrants.
1)
Income from employment or operation of Business:
Income from employment or operation of Business: State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of the debtor's business, including part-time activities either as an employee or in independent trade or business, from the beginning of this calendar year to the date this case was filed. State also the gross amounts received during the two years immediately preceding this calendar year. If a joint petition is filed state income for each spouse separately. (Married debtors filing chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless spouses are separated and a joint petition is not filed.2008 Debtor
Debtor Joint Debtor 2007Debtor
Debtor Joint Debtor2006Debtor
Debtor Joint Debtor2)Income other than employment or business:
Income other than employment or business: State the amount of income received by the debtor other than from employment, trade, profession, operation of the debtor's business during the last two years immediately preceding the date of filing. (Married debtors filing under Chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed). If $0.00 so state.2008 Debtor
Debtor Joint Debtor 2007Debtor
Debtor Joint Debtor2006Debtor
Debtor Joint Debtor3)Payment to Creditors:
Payment to Creditors: a)Individual or joint( debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods or services, and other debts to any creditor made within 90 days immediately preceding the filing of this case over $600.00. Include domestic Support and/or creditor counseling agency. (Married debtors filing under Chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed).
Individual or joint( debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods or services, and other debts to any creditor made within 90 days immediately preceding the filing of this case over $600.00. Include domestic Support and/or creditor counseling agency. (Married debtors filing under Chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed). Dates ofAmountAmount Name and Address of Creditor Payments PaidStill Owing
Payments PaidStill Owing3)b)Debtor whose debts are NOT primarily consumer debts: List each payment or other transfer to any creditor made within 90 days immediately preceding the filing of this case valued at $5,000.00 and above. (Married debtors filing under Chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed).
b)Debtor whose debts are NOT primarily consumer debts: List each payment or other transfer to any creditor made within 90 days immediately preceding the filing of this case valued at $5,000.00 and above. (Married debtors filing under Chapter 12 or 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed). Dates ofAmountAmount Name and Address of Creditor Payments/Transfers PaidStill Owing
Payments/Transfers PaidStill OwingCopyright by Legal Made Easy LLC @2007-2009
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