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The attorney will create a sign-in account when you hire him. You will then use this page to enter information for the attorney and to track your case. For now, you can browse if you wish.

Your Information (Please Update as Needed)

Personal Information
Debtor's Personal Information

Debtor NameFirstMiddleLastSuffix
Debtor AddressAddress Ln 1Address Ln 2CityZip

Other names used in the past 8 years
Social Security Number (no dashes)
Occupation
Employer Name
Employer AddressAddress Ln 1Address Ln 2CityZip
Length of Time Employed
General Information



✗ Date FromDate ToName(s) usedAddress Ln 1Address Ln 2CityZip
Add

✗ Date FiledWhich DistrictCase Number
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What date were you released?


Landlord NameFirstMiddleLastSuffix
Landlord AddressAddress Ln 1Address Ln 2CityZip


What are the names (initials only if minors) of your dependents?
What is their relationship to you?
What are the ages of your dependents?

Assets (2016)
REALESTATE
✗ Other Type
AddressCityStateZipCounty$ Total Value
$ Debtors PortionOther Info
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VEHICLES
✗
MakeModelYearMileage
$ Total Value$ Debtors PortionOther Info
Add
PERSONAL
✗ Description and Location$ Value
Add
FINANCIAL
✗ Description and Location$ Value
Add
MONEYOWED
✗ Description and Location$ Value
Add
BUSINESS
✗ Description and Location$ Value
Add
FARMFISH
✗ Description and Location$ Value
Add
OTHER
✗ Description and Location$ Value
Add

Creditors
Credit Report XML
Debtor XMLJoint Debtor XML
Creditors
✗ Creditor NameAddress Ln 1Address Ln 2CityZip$ TotalDebt was For ...$ Monthly$ Past Due
 Start DateAccount #
Add

Creditors (Notice Only)
Creditors - Notice Only
✗ Noticee NameAddress Ln 1Address Ln 2CityZip
Add

Income
Historical Earned Income
✗ $ Debtor 1
Add
Historical Other Income
✗ Other Income Type$ Debtor 1
Add
Debtor's Average Monthly Income (over the last 6 months)
Gross Income
$ Wages$ Overtime$ Business Income$ Rental Income$ Interest Income$ Pension Income$ Child Support or Alimony Income$ Social Security Income$ Welfare Income$ Unemployment Income$ Other IncomeSpecify Other Income if any
Paycheck Deductions
$ Taxes$ Mandatory Retirement$ Voluntary Retirement$ Retirement Loans$ Insurance$ Domestic Support$ UnionDues$ Other DeductionsSpecify Other Deductions if any
Joint Debtor's Average Monthly Income (over the last 6 months)
Gross Income (Monthly)
$ Wages$ Overtime$ Business Income$ Rental Income$ Interest Income$ Pension Income$ Child Support or Alimony Income$ Social Security Income$ Welfare Income$ Unemployment Income$ Other IncomeSpecify Other Income if any
Paycheck Deductions (Monthly)
$ Taxes$ Mandatory Retirement$ Voluntary Retirement$ Retirement Loans$ Insurance$ Domestic Support$ UnionDues$ Other DeductionsSpecify Other Deductions if any
Total Gross Income:
Total Income Deductions:
Total Net Income:
Contributions by Others
$ ContributionsDescription of Contributions by Others
Anticipated Changes of Circumstances
Describe Any Anticipated Increase or Decrease of Income in the Near Future

Expenses
Please finish entering your creditors first.

Contracts
✗ Contract Party NameAddress Ln 1Address Ln 2CityZip
Contract Description
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Codebtors
Please finish entering your creditors first.

Financial History
In the Past 90 Days
What creditors have you paid anything to (don't include if less than $600)?
✗ Who Got Paid (Name, Addr)Date(s)$ Paid$ Balance
Add

Setoffs against deposits made by any creditor, including a bank?
✗ Creditor Name & AddrDate(s)$ Amount
Add

In the Past 120 Days
What property has been placed in the hands of an assignee or receiver for benefit of creditors?
✗ Assignee Name & AddrDateTerms of Assignment or Settlement
Add

In the Past Year
What "insider" creditors have you paid anything to (don't include if less than $600)?
✗ Who Got Paid (Name, Addr, Relationship)Property GivenDate(s)$ Paid$ Balance
Add

What "insider" creditors have you paid debts for (don't include if less than $600)?
✗ Who Got Paid (Name, Addr, Relationship)Property GivenDate(s)$ Paid$ Balance
Add

What lawsuits were you (or are you) a party to?
✗ Caption and Case NumberNature of ProceedingCourt LocationStatus
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What garnishments or seizures of property have occurred?
✗ CreditorDate(s)Property Seized: Description and Value
Add

What losses have you sustained (like fire, theft, casualty, or gambling)?
✗ Property Description and ValueCircumstancesDate(s)
Add

What payments have you made for debt counseling or bankruptcy?
✗ Recipient Name & AddrDate$ Amount
Add

Closed bank accounts?
✗ Bank Name and AddressAccount# (last 4)Date & Amount at Closing
Add

Safe deposit boxes?
✗ Bank Name & AddrPeople with AccessContents DescriptionDate of Surrender or Transfer if Any
Add

Storage Unit?
✗ Bank Name & AddrPeople with AccessContents DescriptionDate of Surrender or Transfer if Any
Add

In the Past Two Years
What gifts to persons have you made?
✗ Recipient Name & AddrRelationshipDateProperty Description and Value
Add

What donations to charity have you made?
✗ Recipient Name & AddrRelationshipDateProperty Description and Value
Add

What other sales, transfers, or other transactions have you made, not listed above?
✗ Transferee Name & AddrDateProperty Description and Value Received
Add

In the Past Two Years if You Were in Business for Yourself
(i.e. officer, director, partner, managing executive, sole proprietor, 5% shareholder)

Bookkeepers and accountants
✗ Name and AddressDates Service Rendered
Add

Persons who audited books
✗ Name and AddressDates Service Rendered
Add

Banks, creditors, or others to whom a financial statement was issued
✗ Name and AddressDates Service Rendered
Add

In the Past Four Years if You Were in Business for Yourself
(i.e. officer, director, partner, managing executive, sole proprietor)

Business Information:
✗ Business NameITIN/SSNAddressBusiness NatureBegin-End Dates
Add

Which if any of these businesses are single asset real estate?
✗ NameAddress
Add

Please enter the following information for the last two inventories taken:
✗ Date of InventorySupervisor$ Dollar AmountCustodian Name and Address
Add

In the Past Eight Years
List the name of any spouse you lived with in a community property state (Alaska, Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin)?
Spouse Name(s)
In the Past Ten Years
What property have you conveyed into a trust that you created?
✗ Trust NameDateProperty Description and Value
Add

At the Present Time
What property do you hold or control that is not your own?
✗ Owner Name and AddressProperty Description and ValueProperty Location
Add

If you are in business for yourself (i.e. officer, director, partner, managing executive, sole proprietor, 5% shareholder), who has possession of the books?
✗ NameAddress
Add
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Phone
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$ Annual Household Income

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