Kennedy & Associates,  Attorneys At Law
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Bankruptcy Questionnaire

This questionnaire is intended for the sole purpose of helping us make a preliminary determination as to whether you qualify to file for Bankruptcy protection. The information you provide will be evaluated by one of our attorneys to decide if you are eligible to file. More information may be required before a final determination can be made. The answers you provide will not be used for any other purpose and will not be disclosed to any third parties. After your questionnaire is submitted, an associate at Kennedy & Associates, Co. L.P.A. will contact you within two business days to discuss this matter further. We will not charge you a fee for reviewing and responding to your questionnaire.
 
Name:
Spouse Name:
Phone Number:
E-mail Address:
Question 1: What was your average monthly income from all sources for the last 6 months,
including yours and your spouse’s?
Question 2: How many people live in your household who are dependent on your
above stated average income?
Question 3: Have you filed bankruptcy within the last 8 years?
If so when did you file it and was it a Chapter 7 or 13 Bankruptcy?
Question 4: Do you own a home? If so how much is the home worth
and how much do you owe on the home?
Question 5: If you own a home are you current on your monthly payments?
Question 6: How many vehicles do you own and are any of them paid off?
Question 7: If your vehicles are paid off how much are they worth?
Question 8: Do you own any stocks, bonds, cash or bank accounts worth more than $1000.00?
Question 9: What is your total amount of debt, excluding mortgages and vehicle loans?
Norton, OH Office: 4071 S. Cleveland-Massillon Road | P.O. Box 1080 Norton, Ohio, 44203 | 330-825-2477 | Fax: 330-825-2029
Canton, OH Office: 122 Central Plaza | Canton, Ohio, 44702 | 330-868-6400
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