UNITED STATES BANKRUPTCY COURT MIDDLE DISTRICT OF ALABAMA In re Case No. Chapter 13 , Debtor. INTERROGATORIES TO INDIVIDUAL DEBTOR IN LIEU OF ATTENDANCE AT 247 341 MEETING OF CREDITORS Being unable to attend the 247 341(a) meeting of creditors, the debtor sought, by motion, to be excused from that proceeding. The Court, after consideration, granted the debtor222s motion and thereby excused attendance at the 247 341(a) meeting. In lieu of testimony, the debtor responds to the following interrogatories propounded by the Trustee, to-wit: I. GENERAL INFORMATION 1. State your name, age, and current residence address and mailing address. Please provide a photocopy of your current driver222s license or state issued photo identification and your social security card. 2. Are you presently employed? If yes, (a) What is the name and address of your employer? (b) How long have you been employed by this employer? (c) What is your net (take home) pay? If not employed, (a) What is your source of income? (b) Please state the amount of your monthly income. American LegalNet, Inc. www.FormsWorkFlow.com 3. Have you had any change in your income within the last 6 months prior to the filing of this case? If so, please state the nature of the change and the difference in your current income and the income for an average over the 6 months prior to the filing of this case. 4. Have you been self-employed within the last year? If yes, briefly state the nature of the business, your interest in the business and the amount of your net and gross income from the business for the last year. 5. Within the last year, have you had any income from any other source or sources, including the income of your spouse? If yes, describe the source(s) and amount of income. 6. What is your present marital status? If married, what is your spouse222s name? Do you have any minor dependents? If so, please state the age of each dependent and whether or not they are living in the home with you. 7. Have you filed any prior bankruptcy proceeding? If yes, (a) Under what chapter was the petition filed? (b) What was the date of the petition filing? (c) Please state the case number for each prior filing. (d) What was the outcome of your prior filings? (e) Did you receive a discharge in any prior filings within the last 4 years? American LegalNet, Inc. www.FormsWorkFlow.com (f) Have you had any bankruptcy cases which have been dismissed by the court within the one year period prior to the filing of this case? (g) If your case was a chapter 13 proceeding, did you pay unsecured creditors 70% or more of their claims? (h) In what district was your case filed? 8. Have you filed all tax refunds due to any and all taxing authorities within the last 4 years prior to the filing of this case? 9. Do you owe any domestic support obligations such as child support, alimony or any other domestic relations court ordered payments? If so, please state (a) the name, address and telephone number of any domestic support obligation claimant. (b) the amount of arrearage owed to that claimant, if any. (c) whether you are current with any domestic support obligations that have come due since the filing of your case. 10. Have you made all adequate protection payments that have come due to creditors since the filing of this case? Is it your intent to have those payments made thru the office of the chapter 13 Trustee? 11. Have you lived in another other state other than Alabama within the last 2 275 years? If so, please state the place of your prior residence and the duration of your residency in that state. American LegalNet, Inc. www.FormsWorkFlow.com 12. Are the schedules, lists, and statements filed in connection with this case true, correct, and complete to the best of your knowledge and belief? If no, please explain. II. PROPERTY AND PROPERTY INTEREST AS OF THE DATE OF FILING 1. As of the filing, did you own or were you buying any real property (land or buildings)? If yes, (a) Describe the property. (b) What is the date of the purchase? (c) What was the purchase price? (d) What is the value of the property, and how did you determine that value? (e) If the property has been appraised within the last three years, what was the appraised value and who made the appraisal? (f) What is your opinion of the fair market value? (g) If the property is subject to mortgage or lien: (1) Who is (are) the mortgagee(s)? (2) What is the principal balance of each mortgage? (h) Is the property your residence? 2. As of the filing, did you own or were you buying a mobile home? If yes, (a) Describe the property. American LegalNet, Inc. www.FormsWorkFlow.com (b) What is the date of the purchase? (c) What was the purchase price? (d) If the property has been appraised within the last three years, what was the appraised value and who made the appraisal? (e) What is your opinion of the fair market value? (f) If the property is subject to mortgage or lien: (1) Who is (are) the mortgagee(s)? (2) What is the principal balance of the mortgage(s)? (g) Is this property your residence? 3. Did you own or were you buying any vehicles (cars, trucks, motorcycles, boats, etc.)? If yes, (a-1) Describe the property: Make Model Year Date of Purchase Purchase Price Fair market value at the time of the filing Do any liens, if any, encumber this property? If yes, (1) What is the name of the creditor(s)? (2) What is the principal balance(s) owed to lien creditor(s) at the time of filing? Is this vehicle for your personal use? American LegalNet, Inc. www.FormsWorkFlow.com Is this vehicle subject to a purchase money security interest? Was this vehicle purchased within the 910 days prior to the filing of this case? If so, do you intend for this claim to be paid in full as a 247 1325(a) 223no cram down224 claim? (a-2) Describe the property: Make Model Year Date of Purchase Purchase Price Fair market value at the time of the filing Do any liens, if any, encumber this property? If yes, (1) What is the name of the creditor(s)? What is the principal balance(s) owed to lien creditor(s) at the time of filing? Is this vehicle for your personal use? Is this vehicle subject to a purchase money security interest? Was this vehicle purchased within the 910 days prior to the filing of this case? If so, do you intend for this claim to be paid in full as a 247 1325(a) 223no cram down224 claim? (a-3) Describe the property: Make Model Year Date of Purchase American LegalNet, Inc. www.FormsWorkFlow.com Purchase Price Fair market value at the time of the filing Do any liens, if any, encumber this property? If yes, (1) What is the name of the creditor(s)? (2) What is the principal balance(s) owed to lien creditor(s) at the time of filing? Is this vehicle for your personal use? Is this vehicle subject to a purchase money security interest? Was this vehicle purchased within the 910 days prior to the filing of this case? If so, do you intend for this claim to be paid in full as a 2471325(a) 223no cram down224 claim? 4. How much cash did you have on hand at the time of your filing? 5. How much did you have on deposit with banks, savings and loans, credit union, utilities, landlords, etc.? 6. What was the fair market value of your household goods, furnishings and supplies? (a) Did any one item have a value exceeding $1,000.00? (b) Were any items of this sort considered antique? If yes, describe. (c) Does any creditor have a security interest in any of this property? If yes, what is owed to this creditor? American LegalNet, Inc. www.FormsWorkFlow.com 7. Did you have any books, pictures, objects of art, or other collection not mentioned above with your household goods? If yes, (a) Describe the property. (b) Are any of these items subject to the lien of a creditor? If yes, what is (1) Name of creditor(s); (2) Principal balance(s). 8. Please list the value of your wearing apparel, jewelry, firearms, and other personal possessions of that sort? Also, (a) Describe the property. (b) Are any of these items subject to the lien of a creditor? If yes, (1) What is the name of the creditor(s)? (2) What is the principal balance(s) owed to lien creditor(s)? 9. Please list the value of any livestock, poultr