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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 both spouses; if no, include information only for yourself.
Name & residence address of spouse #1 _________________________________ _________________________________ _________________________________	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: _____________________________
Name & residence address of spouse #2 _________________________________ _________________________________ _________________________________	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: _____________________________ 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)
Spouse #1's employer: _______________________ ________________________ ________________________	Spouse #2'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: Spouse #1: year-to-date:_________ 2004 _________ 2003 _________	Spouse #2: 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 ____

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