Section A PERSONAL INFORMATION	IF MARRIED
	Full Legal Name: Email address: Telephone Number: Cell Number: Spouse Full Legal Name: Email address: Telephone Number: Cell Number:
	Section B.  BANKRUPTCIES
	Section B.1.   If this section does not apply,  go to Section C. Have you filed bankruptcy in last 8 years? NA No Yes Considering Bankruptcy at this time? NA No Yes
	Section C. REAL PROPERTY
	Section C.1. Legal Descriptions Property Address Tax Parcel Property ID Number Do you hope to keep this Property? Homestead Homestead Homestead Address Homestead NA No Yes Second Property Second Property Second Property Address Second Property  Property 2 NA No Yes Third Property  Third Property  Third Property Address Third Property Property 3  NA No Yes Fourth Property Fourth Property Fourth Property Address Fourth Property  Property 4 NA No Yes Section C.2  List all mortgages encumbering the property. List all mortgage Balances Is Mortgage Current? Has Foreclosure Been started? Home Property Value Home Property  If this section does not apply,  go to Section C.3 First Mortgage Lender Second Mortgage Lender Third Mortgage Lender Fourth Mortgage Lender First Mortgage Amount Owed Second Mortgage Amount Owed Third Mortgage Amount Owed Fourth Mortgage Amount Owed 1st Mortgage NA No Yes 2nd Mortgage  NA No Yes 3rd Mortgage  NA No Yes 4th Mortgage NA No Yes 1st Mortgage NA No Yes 2nd Mortgage NA No Yes 3rd Mortgage NA No Yes 4th Mortgage NA No Yes Section C.3  List all mortgages encumbering the property. List all mortgage Balances Is Mortgage Current? Has Foreclosure Been started? Second Property Value Second Property  If this section does not apply,  go to Section C.5 First Mortgage Lender Second Mortgage Lender Third Mortgage Lender Fourth Mortgage Lender First Mortgage Amount Owed Second Mortgage Amount Owed Third Mortgage Amount Owed Fourth Mortgage Amount Owed 1st Mortgage NA No Yes 2nd Mortgage  NA No Yes 3rd Mortgage  NA No Yes 4th Mortgage NA No Yes 1st Mortgage NA No Yes 2nd Mortgage NA No Yes 3rd Mortgage NA No Yes 4th Mortgage NA No Yes Section C.4  List all mortgages encumbering the property. List all mortgage Balances Is Mortgage Current? Has Foreclosure Been started? Third Property Value Third Property  If this section does not apply,  go to Section C.5 First Mortgage Lender Second Mortgage Lender Third Mortgage Lender Fourth Mortgage Lender First Mortgage Amount Owed Second Mortgage Amount Owed Third Mortgage Amount Owed Fourth Mortgage Amount Owed 1st Mortgage NA No Yes 2nd Mortgage  NA No Yes 3rd Mortgage  NA No Yes 4th Mortgage NA No Yes 1st Mortgage NA No Yes 2nd Mortgage NA No Yes 3rd Mortgage NA No Yes 4th Mortgage NA No Yes Section C.5   Rental/Sales of Home Buyers/Tenants Names Terms Is Buyer/Tenant in default? Rental or Sales of Property 1  If this section does not apply,  go to Section C.6 Type of Agreement Lease Contract for Deed Purchaser Agreement None NA No Yes Section C.6  Rental/Sales of 2nd Property Buyers/Tenants Names Terms Is Buyer/Tenant in default? Rental Property 2  If this section does not apply,  go to Section D.1 Type of Agreement Lease Contract for Deed Purchaser Agreement None NA No Yes Section C.7  Rental/Sales of 3rd Property Buyers/Tenants Names Terms Is Buyer/Tenant in default? Rental or Sales of Property 3  If this section does not apply, go to Section D.1 Type of Agreement Lease Contract for Deed Purchaser Agreement None NA No Yes Section C.8  Rental/Sales of 4th Property Buyers/Tenants Names Terms Is Buyer/Tenant in default? Rental or Sales of Property 4  If this section does not apply, go to Section D.1 Type of Agreement Lease Contract for Deed Purchaser Agreement None NA No Yes
	SECTION D. LIABILITIES
	Section D.1 Judgments against you       Judgments Against You  If this section does not apply,  go to Section D.2 First Judgement Creditor Second Judgement Creditor Third Judgement Creditor Fourth Judgement Creditor Judgment Amount: 2nd Judgment Amount: 3rd Judgment Amount: 4th Judgment Amount: Court File No: 2nd Court File No: 3rd Court File No: 4th Court File No: Date of Judgment: Date of 2nd Judgment: Date of 3rd Judgment: Date of 4th Judgment: Section D.2 Divorce or Custody Liabilities?   If this section does not apply,  go to Section D.3 Describe: Section D.3 List all Credit Card Debt List Credit Card Debtor/s Credit Card Monthly Payments Credit Card Balances Is card current? Credit Cards  If this section does not apply,  go to Section D.4 First Credit Card Company Second Credit Card Company Third Credit Card Company Fourth Credit Card Company Fifth Credit Card Company Sixth Credit Card Company 1st Credit Card Debtor/s Second Credit Card Debtor Third Credit Card Debtor Fourth Credit Card Debtor Fifth Credit Card Debtor Sixth Credit Card Debtor Monthly Payment 2nd Monthly Payment 3rd Monthly Payment 4th Monthly Payment 5th Monthly Payment 6th Monthly Payment Credit Card Amount Owed Second Credit Card Amount Owed Third Credit Card Amount Owed Fourth Credit Card Amount Owed Fifth Credit Card Amount Owed Sixth Credit Card Amount Owed 1st card NA No Yes 2nd card NA No Yes 3rd card NA No Yes 4th card NA No Yes 4th card NA No Yes 6th card NA No Yes Section D.4 List all Student Loan Debt List Student Loan Monthly Payments List Student Loan Balances Is Student Loan Current? Student Loans  If this section does not apply, go to Section D.5 Student Loan Company 2nd Student Loan Company 3rd Student Loan Company 4th Student Loan Company 5th Student Loan Company 6th Student Loan Company Monthly Payment 2n Monthly Payment 3rd Monthly Payment 4th Monthly Payment 5th Monthly Payment 6th Monthly Payment 1st Balance 2nd Balance 3rd Balance 4th Balance  5th Balance 6th Balance 1st card NA No Yes 2nd card NA No Yes 3rd card NA No Yes 4th card NA No Yes 5th card NA No Yes 6th card NA No Yes Section D.5 List all Vehicles Vehicle/s Monthly Payments Vehicle Balances Vehicle/s Fair Market Values Vehicle Debt Current? Vehicles  If this section does not apply,  go to Section D.6 1st Make/Model 2nd Make/Model 3rd Make/Model 4th Make/Model 5th Make/Model 6th Make/Model Monthly Payment 2nd Monthly Payment 3rd Monthly Payment 4th Monthly Payment 5th Monthly Payment 6th Monthly Payment 1st Vehicle Balance 2nd Vehicle Balance 3rd Vehicle Balance 4th Vehicle Balance 5th Vehicle Balance 6th Vehilce Balance Fair Market Value Fair Market Value 2 Fair Market Value 3 Fair Market Value 4 Fair Market Value 5 Fair Market Value 6 1st card NA No Yes 2nd card NA No Yes 3rd card NA No Yes 4th card NA No Yes 5th card NA No Yes 6th card NA No Yes Section D.6 List all Boats, ATV's, Etc. Monthly Payment Boat, ATV, Etc Balance Owed Boat, ATV, Etc Fair Market Value Is Loan current? Boat, ATV, Snowmobile, Etc  If this section does not apply,  go to Section D.7 Brand/Model 2nd Make/Model 3rd Make/Model 4th Make/Model 5th Make/Model 6th Make/Model Monthly Payment 2nd Monthly Payment 3rd Monthly Payment 4th Monthly Payment 5th Monthly Payment 6th Monthly Payment Boat, Etc Balance 2nd Balance Owed 3rd Balance Owed 4th Balance Owed 5th Balance Owed 6th Balance Owed Fair Market Value 2nd Fair Market Value 3rd Fair Market Value 4th Fair Market Value 5th Fair Market Value 6th Fair Market Value 1st Loan NA No Yes 2nd Loan NA No Yes 3rd Loan NA No Yes 4th Loan NA No Yes 5th Loan NA No Yes 6th card NA No Yes Section D.7 Non-Secured Loans Non-Secured Monthly Payments Non-Secured Balances Are the Non-Secured Loans Current? Non-Secured Loans  If this section does not apply,  go to Section D.4 First Lender 2nd Lender 3rd Lender 4th Lender 5th Lender Sixth Lender Monthly Payment 2nd Monthly Payment 3rd Monthly Payment 4th Monthly Payment 5th Monthly Payment 6th Monthly Payment Non-Secured Balance Non-Secured Balance 2 Non-Secured Balance 3 Non-Secured Balance 4 Non-Secured Balance 5 Non-Secured Balance 6 1st Loan NA No Yes 2nd Loan NA No Yes 3rd Loan NA No Yes 4th Loan NA No Yes 5th Loan NA No Yes 6th Loan NA No Yes Section D.8 Guaranteed Debt Debtor of Guaranteed Debt Amount Guaranteed Is Debt Current? Guaranteed Debt  If this section does not apply,  go to Section D.4 First Lender 2nd Lender 3rd Lender 4th Lender 5th Lender Sixth Lender First Debtor 2nd Debtor 3rd Debtor 4th Debtor 5th Debtor 6th Debtor Amount Guaranteed 2nd Amount Guaranteed 3rd Amount Guaranteed 4th Amount Guaranteed 5th Amount Guaranteed 6th Amount Guaranteed 1st debt NA No Yes 2nd debt NA No Yes 3rd debt NA No Yes 4th debt NA No Yes 5th debt NA No Yes 6th debt NA No Yes
	Section E.  PERSONAL PROPERTY AND FINANCIAL ACCOUNTS
	Section E.1 List all sources of income Monthly Income Annual Income Income  If this section does not apply,  go to Section E.1 Source of Income Second Source of Income Third Source of Income Third Source of Income Monthly Income 2nd Monthly Income 3rd Monthly Income 4th Monthly Income Annual Amount Annual Amount Annual Amount Annual Amount Section E.2 Do you own any unusual items of personal property with a value in excess of $500? Owner/s Personal Property Personal Property Value Personal Property Not Listed Above If this section does not apply,  go to Section E.1 Describe Personal Property Describe Personal Property 2 Describe Personal Property 3 Describe Personal Property 4 Describe Personal Property 5 Owners Owners Personal Property 2 Owners Personal Property 3 Owners Personal Property 4 Owners Personal Property 5 Fair Market Value Fair Market Value 2 Fair Market Value 3 Fair Market Value 4 Fair Market Value 5 Section E.3 List all your checking and savings accounts Name/s on Checking/Saving Accounts     Checking/Savings  If this section does not apply,  go to Section E.1 Describe Account 1 Describe Account 2 Describe Account 3 Describe Account 4 Describe Account 5 Name on Account Name/s on Account 2 Name on Account 3 Name on Account 4 Name on Account 5 Account No. Account No. Account No. 3 Account No. 4 Account No. 5 Account Balances Account Balances 2 Account Balance 3 Account Balance 4 Account Balance 5 Account Balance 6 Section E.4 List any 401(k), mutual funds or other financial investments/holdings   Name on Investment Account Investment Account Number Investment Account Balances Investment Funds  If this section does not apply,  go to Section E.1 Describe Retirement Acct 1 Describe Retirement Account 2 Describe Retirement Account 3 Describe Retirement Account 4 Describe Retirement Account 5 Names on Account Names on Account 2 Names on Account 3 Names on Account 4 Names on Account 5 Account Number Account No. 2 Account No. 3 Account No. 4 Account No. 5 Account Balances Account Balances 2 Account Balance 3 Account Balance 4 Account Balance 5
	Section F.  When Finished
	List Assets Not Listed Above