In order to prepare your petition, please complete the following Questionnaire and provide ALL of the applicable documents listed in the Document Checklist. Upon receipt, your paralegal will schedule an intake interview with you to prepare your petition. Please be absolutely candid and provide as much information as possible; too much information is better than too little. As your Attorneys, we ask that you be open and candid, so that we can give you the best advice possible. If you withhold information from us because you are embarrassed or don’t want to disclose all of your assets and/or debts, we cannot effectively represent you. Further, it is a crime if you don’t list all your assets and debts. It’s simply not worth the jail time to withhold information. In addition, providing false information is grounds for us to withdraw from your case. We will take every measure to ensure that your information is strictly confidential and protected by the attorney- client privilege and the attorney work-product privilege. The information and documents will be used for the sole purpose of drafting your Petition, Statements, Schedules, and related documents. PLEASE ANSWER ALL QUESTIONS: IF NOT APPLICABLE, PUT N/A. DO NOT LEAVE QUESTIONS UNANSWERED. It is critical that you list ALL of you creditors. TO ENSURE THAT ALL YOUR CREDITORS ARE LISTED, OBTAIN A FREE COPY OF YOUR CREDIT REPORT If you move, you must provide our office and the Trustee with the updated contact information. Some bankruptcies can last years. As a result, your attorney must always be able to contact you, especially in case of a deadline. Because people sometimes forget to update contact information, we ask that you provide us with long-term contact information. These people will only be contacted if we cannot locate you directly. These people will not be told the nature or purpose for the contact.

By signing this form you assert that the information provided is complete, accurate, and true.