Have you ever filed bankruptcy before? Have you ever filed bankruptcy before? Yes No

Do you own or rent your home? Do you own or rent your home? Own Rent

If you own or are buying your home, are your current mortgage payments current? If you own or are buying your home, are your current mortgage payments current? Yes No N/A

Have all your federal income tax returns been filed as required? Have all your federal income tax returns been filed as required? Yes No

Do you have any unpaid taxes? Do you have any unpaid taxes? Income Taxes Property Taxes Other

Do you have any secured debts? (Debts secured by your home, automobile, or other tangible property?)

What are your sources of income?

What is your annual combined income from ALL sources?

Do you own any real estate other than your residence? Do you own any real estate other than your residence? Yes No

What is the estimated total of all your unsecured debt?

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