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
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 currently self employed--have your own business, real estate agent or work on 1099?
Do you have any other claims like a personal injury case (like from a car accident), class action claim or other lawsuit you could bring? Answer "yes" even if you have not filed suit or filed a claim, but you could do so.
Do you owe money on a home, land or any real estate?
Do you owe money on a car, boat, truck, motorcycle? Anything with a title?
Is one or more of your vehicles in danger of being repo'd or have one recently been repo'd?
Do you owe any money to the IRS or any other taxing authority?
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?
Are you being garnished currently?
Do you have any judgments against you?
Does anyone claim you defrauded them?
Is your home mortgage behind?
If you home mortgage or property taxes are behind, have you received a Notice of Default, Notice of Trustee Sale or lawsuit to foreclose?
Do you owe any current or back due child support, alimony, maintenance or property settlement?
Has anyone cosigned a debt for you (like a car loan)?
Do you owe money to any relative?
In the last 12 months, have you repaid any money to a relative, transferred or sold any property to a relative?
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?
In the last 90 days have you gotten cash advances on your credit cards of more than $750 or take out any new payday loans?
Within the last 24 months have you made a gift of money or property to any person or institution of more than $600? This includes charitable contributions like tithing.
Do you owe money to a financial institution in which you have funds(checking, savings, cd, etc.)?
Is your primary checking/savings account(s) with a credit union?
If your primary checking/savings is with a credit union, do you owe money to that same credit union?
Within the last 12 months did you lose anything because of fire, theft, or other disaster?
Within the last 12 months, have you spent any money gambling? (showing on bank statements or tax returns)
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?
Do you have a vehicle loan with a credit union AND other debt with the same credit union (like a credit card or credit line)?
Is any of your property in possession of a pawnbroker, storage company or repairman?
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 two (2) years did you sell, trade or otherwise transfer any property to anyone? For example, did you sell or trade in a vehicle, transfer title to a vehicle or other property to a friend or relative?
Have you sold or transferred any interest in real estate, like a house, in the last two (2) years? This includes sales or transfers incident to a divorce.
Do you now have or have you had in the last one (1) year a safety deposit box?
Do you now have or have you had in the last one (1) year a storage unit?
Do you hold or control any property belonging to anyone else?
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 been self-employed in the last three (3) years?
Have you ever been issued an Employer Identification Number (EIN)?
Do you have an interest in a timeshare or vacation plan?
If you are renting has your landlord obtained an eviction judgment against you?
Have you been divorced in the last six (6) years?
Is you or spouse's driver's license suspended?
Is your driver's license suspended due to uninsured vehicle accident(s)?
Is your driver's license suspended due to unpaid tickets and/or fines?
If you driver's license is suspended due to unpaid tickets and/or fines and/or uninsured accidents, are all the unpaid tickets, fines and accidents from within the state of Washington?