Personal Information
Step 1 of 10Includes personal injury claims, malpractice (medical, legal, professional), work injuries, accident claims, contract disputes, or any situation where you may be entitled to money damages.
Include inheritances you are currently entitled to, anything expected at any point in the future, and any life insurance proceeds you expect to receive.
Include all real property you own or have any interest in, regardless of where it is located — including your home, a second home or vacation property, rental property, vacant or undeveloped land, timeshares, co-ops, condominiums, mobile homes on land, or any other real estate anywhere in the world.
Include any interest in real property of any kind: sole or joint ownership, an interest acquired by being added to a deed, inherited interests later transferred away, life estates, contract-for-deed interests, or any other form of real-property interest you no longer hold.
Please list each property you previously owned, how it was transferred, and approximately when.
Include any warrant or judgment, even if it has been stayed.
Items typically included
Sofas & loveseats · Chairs & recliners · Coffee & end tables · Dining table & chairs · China cabinet · Beds & bed frames · Dressers & nightstands · Desks · Televisions · Entertainment centers · Stereo / speakers · Video game systems · Computers & printers · Refrigerator / freezer · Stove / range · Microwave · Dishwasher · Washing machine · Clothes dryer · Dishes, cookware & flatware · China & silverware · Lamps & accessories · Lawnmower · Yard & landscaping tools · Other common household items
Please list each item separately with a description and its estimated current resale value.
List each item separately — these get exempted differently than ordinary clothing.
List each piece separately with its estimated current resale value — these get exempted differently.
Most pets are listed at $1 unless you are a breeder or have specialty animals — list each animal, the kind, and its value.
Include any trust, whether revocable or irrevocable.
You answered Yes in Essential Items. List each inheritance below — include inheritances you are currently entitled to, anything you expect to inherit in the future, and any life insurance proceeds.
You answered Yes in Essential Items. List each claim below — personal injury, malpractice, work injuries, accident claims, contract disputes, or any situation where you may be entitled to money damages.
Examples: boats, motorcycles, ATVs, trailers, tools, musical instruments, sports equipment, collectibles, artwork, antiques, electronics, or anything else of value you own not already listed.
For each item, provide the value you believe you could get for it today in its current condition — not what you paid for it or what it would cost to replace it.
List each friend / family member you've repaid in the last 5 years.
List each transfer — gift, sale below market value, adding someone to a deed/title, transferring an account, or any other conveyance.
List each bill, expense, or debt belonging to someone else that you paid.
List each business you've owned, operated, or had any interest in.
List the name of your spouse or former spouse and the dates you lived in the community property state.
(if separate)
List any monthly expenses not covered above. Enter a description and the monthly amount for the debtor and/or spouse.
A co-debtor is anyone else who is legally responsible for paying back a debt with you — for example someone who co-signed a loan, a co-borrower on a mortgage or car loan, or a guarantor.
List each co-debtor below, or use the narrative box at the bottom if you'd rather just describe it in your own words.