INTAKE FORM - MARRIED/SEPARATED PEOPLE 
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Throughout this form reference will be made to "Spouse 1" and "Spouse 2."   Designate between yourselves who is Spouse 1 and who is Spouse 2. 

ALL questions must be answered as to BOTH spouses, even if only ONE spouse wants to file for bankruptcy.  This is because Washington is a "community property" state.  

(This item does not require an answer.)
What is Spouse 1's first and last name?  (List the first name you like to be called *
What is Spouse 2's first and last name?  (List the first name you like to be called.) *
What is "Spouse 1s" email address ? *
What is "Spouse 2's" email address ? *
What is Spouse 1's phone number? *
What is Spouse 2's phone number? *
In what city or cities and state or states do each of you reside? Not your mailing address, but where you physically reside.  (Reminder that I only service Western WA. The specific counties are listed on the Home page of my website.) *
Have you lived in the state of Washington continuously for at least the last two years? *
Required
What is your marital status? *
Required
If either of you has been divorced:  Does your *Divorce Decree* say that YOU are responsible to pay any debts that have your ex-spouse's name on them?  Either directly or indirectly?  Or did you incur any debt to your ex-spouse as part of the divorce other than child support or alimony?  
If either of you have ever been divorced:  In what year was your divorce final?
If either of you have ever filed a bankruptcy before:  How many bankruptcies have you filed in the past, grand total? 
If either of you ever filed a bankruptcy before:  When was the most recent one it FILED? (Not discharged, but FILED.)

If your previous bankruptcy was filed LESS THAN eight years ago:  What CHAPTER was it that you filed? 

Clear selection

If your previous bankruptcy was filed LESS THAN eight years ago:  On what DATE was it filed?   

Do both of you want to file for bankruptcy together, or just one of you file for bankruptcy? *
Required
How many people TOTAL live in your household, including yourself?  Include every single person who lives under the roof, even if not your dependent.   *
In general, no need to name names, who are the other people who live in your household? For example your children, other people's children, boyfriend, girlfriend, parents, roommates, etc.  IF CHILDREN - ALSO LIST THEIR AGES.

 

If any of your other household members, other than the two of you, are adults:  Do they contribute to the mortgage, rent, utilities, groceries, or other joint household expenses?  Do they give you any money for room, board, food, etc.?  If yes, about how much money per month on average?  An estimate is fine. 

SPOUSE 1:  If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):  What are your approximate gross wages (not take home, but gross) from your job?  For example, "$2,500 every two weeks," or "$2,500 twice per month," or "$1,500 every two weeks plus around $300 per week in tips," or "$55,000 per year straight salary" or "$17.48 per hour."  Do NOT include overtime, bonuses, commissions, or tips.
SPOUSE 1:  If you listed an hourly wage in response to the question above:  Approximately how many "regular" hours per week do you work on average?  (If you did not list an hourly wage in response to the question above leave blank or type "N/A."
SPOUSE 1:    If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):   Do you ever get overtime, bonuses, commissions, or tips?  If you do, about how much money do you gross per week, month or year on average from just the overtime, bonuses,  commissions, or tips?   Please state the approximate amount of money, how often, and whether it is overtime, bonuses, commissions or tips.
SPOUSE 1:  If you have lost a job during the last six months:  What was your gross income (not take home, but gross) from this job?  Either your hourly, # of hours, your annual, however you know it. Include bonuses, commissions, and tips.
SPOUSE 1:  If you have received unemployment benefits or FMLA during the last six months:  What is/was your weekly gross unemployment benefit?  
SPOUSE 1:  If you have received FMLA during the last six months:  Approximately how much money total have you received in FMLA during the last six months?
SPOUSE 1: If you have a “side-gig” like driving for Uber or anything else you do for money:   What is it that you do AND how much money do you make every month or every year, on average?  (Specify if you are listing monthly or annual amount.  Do not deduct your expenses.)
SPOUSE 2:   If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):  What are your approximate gross wages (not take home, but gross) from your job?  For example, "$2,500 every two weeks," or "$2,500 twice per month," or "$875 per week," or "$55,000 per year straight salary," or "$17.48 per hour."  Do NOT include overtime, bonuses, commissions, or tips.  
SPOUSE 2:  If you listed an hourly wage in response to the question above:  Approximately how many "regular" hours per week do you work on average?  (If you did not list an hourly wage in response to the question above leave blank or type "N/A."
SPOUSE 2:   If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):   Do you ever get overtime, bonuses, commissions, or tips?  If you do, about how much money do you gross per week, month or year on average from just the overtime, bonuses,  commissions, or tips?   Please state the approximate amount of money,  how often,  and whether it is overtime, bonuses, commissions or tips.
SPOUSE 2:  If you have lost a job during the last six months: What was your gross income (not take home, but gross) from this job?  Either your hourly, # of hours, your annual, however you know it. Include bonuses, commissions, and tips.
SPOUSE 2:  If you have received unemployment benefits during the last six months:  What is/was your weekly gross unemployment benefit?  
SPOUSE 2:  If you have received FMLA during the last six months:  Approximately how much money total have you received in FMLA over the last six months?

SPOUSE 2:  If you have a “side-gig” like driving for Uber or anything else you do for money:  What is it that you do AND how much money do you make every month or every year, on average?  (Specify if you are listing monthly or annual amount.  Do not deduct your expenses.)

If either of you own a business as a sole proprietor:  What is the name AND nature of the business?

If either of you own an LLC, PLLC or corporation:  What is the name AND nature of the business?

If either of you are a sole proprietor or own an LLC, PLLC or corporation:  Is your business currently operating, or have you stopped operating?  

If either of you are a sole proprietor or own an LLC, PLLC or corporation:  Do you want to close the business, or keep it going? 

If either of you are a sole proprietor or own an LLC, PLLC or corporation: Do you currently have any employees?

If either of you are a sole proprietor or own an LLC, PLLC or corporation:  If you are still operating, about how much money do you "gross" per year? (“Gross" means the total amount of money you bring in before you deduct any expenses.)

If you are a sole proprietor or own an LLC, PLLC or corporation: If you are still operating, about how much are your annual expenses?  (Do not count income tax or self-employment tax you need to pay.  Only include expenses you incur 100% for business - do not include expenses which are part personal and part business.)  

If either of you own any sort of business:  Are there any business assets? Such as tools, vehicles, supplies, inventory, real estate, etc.? Please answer "yes" or "no."   If yes, what is the approximate value of the assets?  (If you were to sell them.) 

If either of you RECEIVE child support or spousal maintenance:  How much do you receive per month?
If either of you PAY child support or maintenance:  How much do you pay per month?
Do either of you receive Social Security retirement, Social Security disability,  VA disability,  or any other money from Social Security or the VA? *
Required

NOT COUNTING anything either of you receive from Social Security or the VA, and not counting anything you already listed, if either of you receive a monthly pension or money from a retirement money or annuity:  Who, what is it and what is the gross monthly amount?

Do either of you receive private disability?  (Not SS or VA.) If yes, who and what is the monthly amount?

In the last six months, if either of you have received income from ANY OTHER SOURCE in addition to your "normal" sources of income:  1)  Approximately how much did you receive?  2)  What was the source of the money? (Examples include money from selling something, gift money from family or friends, gambling winnings, anything!)
If you OWN your residence (where you or your dependents actually, currently live):  Approximately how much could it be sold for today, as is?   Include mobile home, RV, etc. if it is where you reside.    (Check here: www.zillow.com.)
If either of you OWN your residence (where you or your dependents actually, currently live):  Approximately how much do you owe on it?  List the grand total of first mortgage, second mortgage, home equity line of credit.
If either of you OWN your residence (where you or your dependents actually, currently live):  Approximately how much are you BEHIND on your payments, if at all? State the dollar amount.
Not counting your residence, if you own any real estate anywhere in the world (for example rental property, vacation property, a property you own where family member are living, etc.):   1) How much is the property worth?  2)  How much do you owe on it?
For each car, truck, motorcycle, boat, RV, trailer, camper, etc. EITHER of you own, whether it is fully paid for or not,  please list the year, make & model.  Do not list anything else, just list year, make & model.  If you do not have any vehicles please type "None."
For EACH vehicle listed in your previous answer, how much is it worth?  A guesstimate is fine.  If you have no idea just Google it!  Or do a Kelly Blue Book, "Private Party" value.  (You must answer this question for EVERY vehicle you listed above.)
For EACH vehicle listed in your previous answer, list the balance of any loan. Include "regular" vehicle loans and any other loans if the vehicle was used for collateral.  (Not the monthly payment, but how much total you owe on the loan.)  If there is no loan, type "paid in full."  
Not counting retirement accounts, and not counting money you currently have to pay this month's living expenses, do either of you have "other money" in cash, in the bank, in apps (Venmo, PayPal, etc.,) in a safe, under the mattress, in gift cards, or any other form?  If yes, about how much do you have?  Ballpark guesstimate is fine. *
Not counting retirement accounts, do either of you have investments, stocks, bonds, crypto, mineral rights, anything like this?  If yes, what is it and about how much is it worth? Ballpark guesstimate is fine. *
Do either of you own any items of personal property that are very valuable/expensive?  In the thousands of dollars?  Big diamonds, jewelry, antiques, paintings, collections, anything? If yes, what is it and how much is it worth? *
Is there anything either of you can sue anybody over, or make a claim against, even if you do not plan to?  Such as a car accident, medical malpractice, wrongful termination, anything?  If yes, please state:  1)  What happened; 2)  how much money you think it is worth; 3) if you have spoken with a lawyer; and 4) whether you intend to pursue it.  (It does not matter if you want to pursue a claim or not, you must provide an honest answer.) *
Does anybody owe either of you money?  Do either of you have any money coming to you?  If yes, how much?  (List the amount even if you think you will never get the money back.)  *
Are either of you the beneficiary of a trust?  (Not a WILL, but a TRUST.) *
Are the any lawsuits, garnishments, judgments against either of you, anything like that?   *
Required
If either of you owe the IRS any money, for which tax years do you owe? (If you do not know simply create an online account at IRS.gov to find out.  It's a great resource.) *
Required
If either of you owe the IRS any money:  About how much do you owe?  If you know, please list the amount for each year.  If you do not know you may list the grand total, or an estimate of the grand total.
If either of you currently have student loans:  Approximately how much grand total is owed?  (Note:  If the ONLY reason you may want to file a bankruptcy is to  try to wipe out student loan debt then I am not the right lawyer for you.  I would be happy to refer you elsewhere.)
If either of you currently owe money on tickets, fines or tolls:  About how much grand total is owed?
Do either of you currently owe money on a DUI or anything criminal in nature?   *
Required
If you added up all of your other combined unsecured debts (such as credit cards, personal loans, medical/dental bills, payday loans, broken leases, vehicle repossessions, etc.) in what range do you think your grand total would be?  $20,000?  $50,000?  $100,000?  Just a ballpark guesstimate is fine.  (Do not include  mortgages, vehicle loans, tickets/tolls/fines,   student loans or taxes.) *
If there are any cosigners on any of your combined debts, contracts or leases, know that the bankruptcy will not wipe it out as to them, so they will still be on the hook.  Your bankruptcy may hit their credit report.  They will be notified that you filed for bankruptcy.  Are you okay with  all of this?  (Note:  This only applies to actual cosigners.  It does not apply to "authorized users."   If you have "authorized users" on credit cards you can simply remove them before you file your bankruptcy.) *
Required
OPTIONAL:  If there is anything you would like to tell me feel free to do so below.
A copy of your responses will be emailed to the address you provided.
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