GREENLEE LAW OFFICES

 

ITEMS NEEDED FOR YOUR CONSULTATION

 

q    ANY PERSONAL  INCOME (I.E. PART-TIME JOB, SOCIAL SECURITY, SSI, ETC)

q    ANY CHILD SUPPORT BEING PAID OR RECEIVED, INCOME DEDUCTED OR PAY DIRECT, NAMES AND AGES OF CHILDREN THAT CHILD SUPPORT IS FOR

q    ANY CASH ADVANCES OR LOANS IN THE LAST 90 DAYS OR ANY TRANSFERS OF BALANCES FROM ONE CREDITOR TO ANOTHER

q    MARKET VALUE OF HOMESTEAD (PROPERTY TAX STATEMENT), WHO HAS THE MORTGAGE, AMOUNT OF MORTGAGE, AND ANY SECOND MORTGAGES

q    LEGAL DESCRIPTION(S) OF HOMESTEAD AND ALL OTHER REAL PROPERTY FROM DEED OR MORTGAGE  

q    ALL OTHER ASSET INFORMATION – LOANS FOR OTHER ASSETS (GUNS, JEWELRY, ATV, COMPUTER, INVENTORY, ETC)

q    LIST OF MONTHLY LIVING EXPENSES (ELECTRICITY, FOOD, CLOTHING, ETC)

q    NAME, CURRENT ADDRESS, ACCOUNT NUMBER, AND CURRENT AMOUNT OWED TO EACH CREDITOR

q    ANY CO-SIGNED DEBTS OR LOANS

q    NAME, YEAR, STYLE OF VEHICLE(S), AMOUNT OWED, WHO HOLDS THE LIEN

q    THE AMOUNT YOUR LAST TAX REFUND WAS FOR (FEDERAL, STATE, AND OTHER TAX REBATES)

q    INCOME OR OTHER TAXES OWED

q    TYPES AND AMOUNTS IN RETIREMENT PROGRAMS (PENSIONS, IRA’S 401(K), MUTUAL FUNDS, STOCKS)

q    INFORMATION CONCERNING REPOSSESSIONS, GARNISHMENTS, OR JUDGMENTS

q    TAX RETURNS FROM LAST 2 YEARS,  PROFIT AND LOSS STATEMENT YTD

 

 

CREDITOR LIST

NAME:
	First		M.I.			Last		Spouse		Maiden
CREDITOR #__ Name / Address		BALANCE		PAYMENT	MONTHS/AMT PAST DUE		INTEREST RATE		COSIGNER / COLLATERAL		FOR OFFICE USE ONLY
ACCOUNT NUMBER
CREDITOR #__ Name / Address		BALANCE		PAYMENT	MONTHS/AMT PAST DUE		INTEREST RATE		COSIGNER / COLLATERAL		FOR OFFICE USE ONLY
ACCOUNT NUMBER
CREDITOR #__ Name / Address		BALANCE		PAYMENT	MONTHS/AMT PAST DUE		INTEREST RATE		COSIGNER / COLLATERAL		FOR OFFICE USE ONLY
ACCOUNT NUMBER
CREDITOR #__ Name / Address		BALANCE		PAYMENT	MONTHS/AMT PAST DUE		INTEREST RATE		COSIGNER / COLLATERAL		FOR OFFICE USE ONLY
ACCOUNT NUMBER
CREDITOR #__ Name / Address		BALANCE		PAYMENT	MONTHS/AMT PAST DUE		INTEREST RATE		COSIGNER / COLLATERAL		FOR OFFICE USE ONLY
ACCOUNT NUMBER

 

 

In re:		Case No.
Chapter

 

FINANCIAL REVIEW OF THE DEBTOR’S BUSINESS

(Note: ONLY INCLUDE information directly related to

One business operation on each form)

 

Type of Business					Business Name
PART A – GROSS BUSINESS INCOME FOR PREVIOUS 12 MONTHS:
		1.    Gross Income for 12 Months Prior to Filing				$
PART B- ESTIMATED AVERAGE FUTURE GROSS MONTHLY INCOME:
		2.    Gross Monthly Income				$
PART C – ESTIMATED AVERAGE FUTURE MONTHLY EXPENSES:
		3.    Payroll (paid to others)				$
		4.    Payroll Taxes				$
		5.    Unemployment Taxes				$
		6.    Worker’s Compensation				$
		7.    Employee Benefits (e.g., pension, medical, etc.)				$
		8.   Other Taxes				$
		9.   Inventory Purchases (including raw materials)				$
		10. Purchase of Feed/Fertilizer/Seed/Spray				$
		11. Rent (other than debtor’s principal residence)				$
		12. Utilities				$
		13. Office Expenses and Supplies				$
		14. Repair and Maintenance				$
		15. Vehicle Expenses				$
		16. Travel and Entertainment				$
		17. Advertising and Promotion				$
		18. Equipment Rental and Leases				$
		19. Legal/Accounting/Other Professional Fees				$
		20. Insurance				$
		21. Payment to be Made Directly by
			Debtor to Secured Creditors			$
			For Pre-Petition Business			$
			Debts (specify)			$
	22. Other (describe)					$
	23. Total Monthly Expenses (add items (3-22))					$
PART D – ESTIMATED AVERAGE NET MONTHLY INCOME:
	24. Average Net Monthly Income (subtract line 22 from line 2)						$
	Net Monthly Income					$

 

Verification.  I, __________________________, the debtor(s) named in the foregoing financial review form, declared under penalty of perjury that the foregoing is true and correct according to the best of my knowledge, information and belief.

 

Executed on		Signed:
		Address:
			Name and Address of Subscriber