Before you begin

Chapter 7 Bankruptcy Intake Questionnaire

This questionnaire collects the facts and documents needed to prepare your Chapter 7 bankruptcy petition, schedules, and statements. It takes most people 30–50 minutes; you don't have to finish in one sitting — just don't close this tab until you submit.

Important disclosure required by federal law (11 U.S.C. §110): Los Angeles Paralegals is a Bankruptcy Petition Preparer, not a law firm or attorney. I can only type up the bankruptcy documents based on the facts you provide below — I cannot give you legal advice, tell you which chapter to file, which exemptions to claim, or whether bankruptcy is the right choice for you. If you need legal advice, please consult a licensed attorney before proceeding.

I have read and understand the disclosure above, and I understand the information I provide will be used only to prepare my bankruptcy documents. *

Step 1 of 15

Your Information

Enter your legal name exactly as it should appear on court documents.

Full legal name *

Other names used in the last 8 years (maiden name, aliases)

Date of birth *

Last 4 digits of SSN *

Phone *

We only ask for the last 4 digits here — your full SSN is taken from the ID/SSN card you upload later in this form, not typed into a web field.

Email *

Current street address *

City *

County *

ZIP *

How long have you lived in this county? *

Have you lived at any other address in the last 3 years?

No Yes

Prior address(es) — include dates

Marital status *

Single Married Separated Divorced

Are you and your spouse filing together (joint petition)?

Yes, joint filing No, filing alone

Spouse information

Spouse full legal name

Spouse date of birth

If not filing jointly, we still need basic spouse info and income for the household calculations.

Step 2 of 15

Household & Dependents

Total number of people in your household (including you) *

Number of dependents you claim

List dependents (relationship + age only — no need for full names)

Step 3 of 15

Employment & Income

We need your income for the last 6 full calendar months for the means test, plus your current employment.

Current employment status *

Employer name

Employer address

Occupation

How long employed there?

Pay frequency

Business name

Nature of business

Average gross monthly income (before taxes), last 6 months *

Other income received in the last 6 months (check all that apply)

Unemployment Social Security Retirement/Pension Rental income Alimony/child support received Side income/gig work Other

Describe other income and monthly amounts

Non-filing spouse's average gross monthly income (if applicable)

Step 4 of 15

Real Property

Do you own any real estate (home, land, timeshare, inherited property)? *

No — I rent or live with someone else Yes

Step 5 of 15

Vehicles

Do you own or lease any vehicles (car, truck, motorcycle, boat, RV)? *

No Yes

Step 6 of 15

Bank Accounts & Cash

Cash on hand (not in a bank)

Step 7 of 15

Other Property & Valuables

Rough estimates are fine for now — give your best guess at what each category would sell for today, not what you paid.

Household goods & furnishings (est. value)

Electronics (est. value)

Clothing (est. value)

Jewelry (est. value)

Firearms, tools, hobby equipment (est. value)

Retirement accounts — 401(k)/IRA (balance)

Life insurance cash value (if any)

Business ownership interest (est. value)

Money owed to you (tax refund expected, pending lawsuit you'd win money from, inheritance, etc.)

Anything else of value not listed above (crypto, collectibles, etc.)

Step 8 of 15

Secured Debts

Secured debts are loans backed by collateral — mortgages, car loans, or anything with a lien on it. If you listed a home or vehicle loan already, add it here too.

Step 9 of 15

Unsecured Debts

Include every creditor you can — credit cards, medical bills, personal loans, payday loans, student loans, utility bills, collection accounts, and any court judgments against you. Missing a creditor means that debt won't be discharged.

Priority unsecured debts (recent taxes owed, child/spousal support arrears, recent wages you owe an employee)

Nonpriority unsecured debts (credit cards, medical, personal loans, etc.)

Is anyone else legally responsible with you for any debt listed above (co-signer, joint account, ex-spouse)?

Step 10 of 15

Monthly Living Expenses

Rent or mortgage

Utilities (electric, gas, water, trash, phone, internet)

Food & household supplies

Transportation (gas, transit, car payment already counted separately)

Insurance (health, auto, home/renters, life)

Medical & dental (out of pocket)

Childcare / child support paid

Other recurring expenses

Notes on any unusual or seasonal expenses

Step 11 of 15

Recent Financial History

These questions cover the last 1–2 years and are required on the Statement of Financial Affairs, even if the answer is no to all of them.

In the last year, have you paid any single creditor $600 or more total (other than normal monthly bills)?

No Yes

In the last year, have you been sued, had wages garnished, or had property repossessed or foreclosed?

No Yes

In the last 2 years, have you given away, sold below value, or transferred any property?

No Yes

In the last year, did you lose property to fire, theft, or gambling?

No Yes

In the last year, have you paid anyone for bankruptcy or debt-relief advice/services (including this intake)?

No Yes

Do you currently keep a safe deposit box or storage unit?

No Yes

Have you filed for bankruptcy in the last 8 years?

No Yes

Have you owned or been a partner/officer in a business in the last 4 years?

No Yes

Step 12 of 15

What You Want to Do With Secured Property

For any home, vehicle, or other property you listed as security for a debt, tell us what you'd like to do. This becomes your Statement of Intention.

This list is generated automatically from the real property and vehicles you entered — go back to Steps 4–5 if something's missing here.

Step 13 of 15

Upload Your Documents

Clear phone photos are fine. Upload what you have now — anything missing can be sent later, but the fewer gaps, the faster your case moves.

Government-issued photo ID Required

Click to upload (driver's license, state ID, or passport)

Social Security card Required

Click to upload

Pay stubs — last 6 months Required if employed

Click to upload (or profit/loss statement if self-employed)

Most recent federal tax return Required

Click to upload

Bank statements — last 6 months, all accounts Required

Click to upload

Vehicle title / registration If you own a vehicle

Click to upload

Mortgage statement / deed If you own real property

Click to upload

Credit counseling certificate Upload if completed; if not, we'll send you where to get one

Click to upload

Lawsuit papers, judgments, or collection letters If any

Click to upload

Anything else you think is relevant Optional

Click to upload

Step 14 of 15

Review & Submit

Review your answers below. You can go back to any step to make a change before submitting.

Certification. By submitting, you certify that the information above is true and complete to the best of your knowledge, and you confirm you understand Los Angeles Paralegals is a Bankruptcy Petition Preparer (not a law firm) and cannot provide legal advice.

I certify the above is true and complete to the best of my knowledge. *

✓

Received — thank you

Your intake and documents have been submitted. Your confirmation number is:

Los Angeles Paralegals will review everything and follow up if anything else is needed. Keep your confirmation number for reference.