Legal Solutions to Financial Challenges

Bankruptcy, Chapter 13, Chapter 7, Reorganization

Serving clients throughout western Washington
Offices in Seattle, Marysville, Federal Way, Edmonds, Southcenter & Tacoma.

TOLL FREE: 1-888-830-0350

Bankruptcy Questionnaire

Fill out this form as best you can and then press SUBMIT. It will be emailed to me directly. I will then review it and contact you.

Thank you,
Travis A. Gagnier

Please don't let the length of the Questionnaire bother you, most of the questions are simply Yes or No questions.

Home Address
Single, Married, Married but living separately, Defacto Relationship
Have you (or your spouse) been previously married in the last 8 years?
Spouse's Name
Have you been involved in a Bankruptcy in the last 8 years?
Have you lived in Western Washington the preceding 3 years?
Are you self employed?
Do you owe money on a home, land or any real estate?
Do you owe money on a car, boat, motorcycle, airplane, etc?
Do you owe any money to the IRS or any other taxing authority?
Do you owe any money to a finance company or credit union?
Do you owe any student loans?
Do you owe any money to a payday loan company?
Do you have any judgments against you?
Do you owe any current or back due child support, alimony, maintenance or property settlement?
Have you cosigned a debt for anyone?
Has anyone cosigned a debt for you?
Do you owe money to any relative?
Have you repaid any money to a relative in the past 12 months?
Does anyone claim you defrauded them?
Do you have copies of the last 2 federal income tax returns you have filed?
Have you filed all required federal income tax returns?
Have any tax liens been filed against you?
Have you made any balance transfers between credit cards within the last 90 days?
Do you owe money to a financial institution in which you have funds(checking, savings, cd, etc.)?
Within the last 12 months have you been involved in any lawsuit, court action or administrative proceeding?
Within the last 12 months has any of your property been repossessed, foreclosed upon, garnished, attached, seized or levied upon?
Within the last 90 days has any creditor set off or otherwise taken anything from any account?
Within the last 24 months have you made a gift to anyone of more than $600?
Within the last 24 months have you given any money or property to a charity totaling more than $600?
Within the last 12 months did you lose anything because of fire, theft, or other disaster or gambling?
Do you have any money , property, furniture, etc.that belongs to another person or that you are holding for the benefit of someone else?
Did you purchase or refinance a car, truck or other vehicle in the past year?
Is any of your property in possession of a pawnbroker, storage company or repairman?
Within the last 12 months have you transferred any property or money to anyone concerning the filing of a bankruptcy proceeding?
Within the last 12 months did you transfer any property or money to anyone who promised to help you deal with creditors?
Within the last 24 months did you sell, trade or otherwise transfer any property to anyone? For example, did you sell a car, a house etc?
Within the last 10 years did you transfer any property or money into a self-settled trust?
Now or within the last 12 months have you had a safety deposit box?
Within the last year have you had a storage unit?
Do you hold or control any property belonging to anyone else?
Has any governmental unit notified you that you might be liable for any violation of any environmental law?
Within the last 4 years have you owned a business as a sole proprietorship, LLC, partnership, corporation or have you been an officer, managing executive of a corporation?
Have you or any of your children been involved in an automobile accident or injured for any reason in the last 2 years?
Is you or spouse's driver's license suspended?
Do you have an interest in a timeshare or vacation plan?
In the last 90 days have you gotten cash advances on your credit cards of more than $750?
In the last 6 months have you borrowed any money from any finance company, pay day loan company or lender?
Have you ever been issued an Employer Identification Number (EIN)?
If you are renting has your landlord obtained an eviction judgment against you?