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Attorney Intake Questionnaire: Hiring a Bankruptcy Attorney

A bankruptcy filing can be legally complicated, as well as time-consuming and time-intensive. In many cases, the first time commitment is finding an attorney. While you may already have an attorney, from your business, estate planning, or family matters, he or she might not be experienced in bankruptcy. More often, you will have to find an attorney from scratch. This can be well worth the effort, because lawyers who practice exclusively in bankruptcy tend to do it quickly and cheaply.

You will want to meet with any attorney you are considering hiring, to see if you and the attorney can work together. You will really be interviewing the attorney just like you are interviewing a job applicant. Some bankruptcy attorneys run their offices like an assembly line, and that's not necessarily a bad thing. It means they won't be wasting your time either. You need to decide whether the style of any given attorney is one with which you can work.

In order to do the best possible job on your behalf, your attorney needs your input and cooperation. At your first meeting with your attorney, you should be prepared to provide the following information:

BANKRUPTCY INTAKE INFORMATION

Will this be a joint bankruptcy petition? ( ) Yes ( ) No
If yes, include information for Husband and Wife; if no, include information only for yourself.

Husband's name & residence address
_________________________________
_________________________________
_________________________________
Telephone number(s)
Home: (     )______________
Work: (     )______________
County of residence _________________ Soc. Sec. No.______________
How long at this address?________
Have you used any other name(s) in the last six years?
If yes, please list here: _____________________________
Wife's name & residence address
_________________________________
_________________________________
_________________________________
Telephone number(s)
Home: (     )______________
Work: (     )______________
County of residence _________________ Soc. Sec. No.______________
How long at this address?________

Have you used any other name(s) in the last six years (including maiden name)?
If yes, please list here: _____________________________

Single?______ Separated?______ Married? ______ divorced? ______
If married, how long? _______
If divorced, how long? __________

Note: If you are married, but separated from your spouse, please provide the spouse's name and address here _____________________________
_____________________________
_____________________________
_____________________________

Please provide the names and ages of minor children living with you

Name __________________  age _________________
Name __________________  age _________________
Name __________________  age _________________

Please provide the names, ages, and amount of child support paid
Name _____________  age _______   amount $_______
Name _____________  age _______   amount $_______
Name _____________  age _______   amount $_______

Please list previous addresses for the last two years:

1. ________________________  how long?________
2. ________________________  how long?________
3. ________________________  how long?________

Do you owe any money to the Internal Revenue Service? ( ) no ( ) yes
If yes, for which tax year(s)? ______
Approximately how much?__________

Do you owe any money to state tax authorities? ( ) no ( ) yes
If yes, for what year(s)? ______
Approximately how much?__________

Do you have any unpaid student loans? ( ) no ( ) yes________ (state amount)

Husband's employer:
_______________________
________________________
________________________
Wife's employer:
_______________________
________________________
________________________
How long at this job?_________
Occupation?___________________
How long at this job?________
Occupation?__________________
How often you are paid:
Weekly_____
2x month______
Every 2 weeks_____
 
Weekly_____
2x month______
Every 2 weeks_____
Please provide your income per pay period
Gross: __________   Net:__________
 
Gross: __________   Net:__________
Have you received income from any other source than your job last year (for instance, social security, child support, workers' compensation, etc)? If yes, please provide the source and monthly amount here:____________________________
What amount of income have you made at your job as follows:
Husband: year-to-date:_________
2004 _________
2003 _________
 
Wife: year-to-date:_________
2004 _________
2003 _________

Note: If you have more than one job, please list year-to-date and two-years prior income information here:________________________

MONTHLY EXPENSES

Rent
Real estate taxes
Electric
Home maintenance
Gas
Life insurance
Water
Health insurance
Phone
Auto insurance
Cable
Homeowner/rent ins
Trash
House payment
Other

____________
____________
____________
____________
____________
____________
____________
____________
____________
____________
____________
____________
____________
____________
____________

Do you pay anyone spousal support? (alimony) ( ) yes ( ) no
If yes, to whom and how much?____________________________________

How much is your car payment every month?

Car #1_______________
Car #2_______________
Car #3______________

Car expenses ___________________
Food ___________________
Medical ___________________
Entertainment ___________________
Education ___________________
Clothing ___________________
Laundry ___________________
Child care ___________________

Do you anticipate a substantial change in your expenses in the immediate future? ( ) no ( ) yes
If yes, please explain:
___________________________________________
___________________________________________
___________________________________________

Have you been in a partnership with anyone during the last six years, or have you been an officer in a corporation within the last six years?    ( ) no    ( ) yes
If yes, give name of business and/or corporation, dates of operation, nature of business/corporation, and your approximate yearly income from the business. __________________________

Have you given away, sold or transferred any valuable item (over $1,000) in the last year?    ( ) no    ( ) yes
If yes, please state the nature of the sale or transfer, what was transferred, for how much, and when the transfer occurred:
_____________________________________________________
_____________________________________________________
_____________________________________________________

What amount of income have you received from other sources in the last two years?
_____________________________________________________

Will you be eligible for a tax refund this year?   ( ) no   ( ) yes
If yes, how much? ____________________________________________________

Please list all banks with which you have an account, and indicate whether checking or savings, and the approximate balance.

___________________________
___________________________
___________________________
In your name alone?________
___________________________
___________________________
___________________________
In your name alone?________

Have you had a safe deposit box in the last two years?   ( )no  ( )yes
If yes, please give location and the contents of the safe deposit box
_____________________________________________________
_____________________________________________________
_____________________________________________________

Are you holding valuable property that belongs to another person?    ( ) no  ( ) yes
If yes, please describe
_____________________________________________________
_____________________________________________________
_____________________________________________________

Have you had a prior bankruptcy?   ( ) no  ( ) yes
If yes, list the case #______________, date filed______________,
and the outcome ( ) dismissed ( ) discharged successfully

Is any of your property in the hands of a receiver, trustee, or other liquidating agent?   ( ) no  ( ) yes
If yes, please describe
_____________________________________________________
_____________________________________________________
_____________________________________________________

Are you suing anyone right now?   ( ) no  ( ) yes
If yes, please describe
_____________________________________________________
_____________________________________________________

Have you been involved in a workers' compensation or personal injury lawsuit from which you expect

to recover money?   ( ) no   ( ) yes
If yes, please explain
_____________________________________________________
_____________________________________________________

Have you had any repossessions in your past history?   ( ) no  ( ) yes

Have you suffered any losses by fire, theft, or gambling during the last year?    ( ) no  ( ) yes

Please list the years in which your debt was incurred: ____ to ____

Next Steps
Contact a qualified debt and bankruptcy attorney to find out your options
for navigating the best path forward.
(e.g., Chicago, IL or 60611)

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