Questionnaire #8 - Vehicles

Please enter all vehicles that you own or titled in your name. 

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Questionnaire 8 - Vehicles
Name
Phone
Email Address
*
This questionnaire is for:
No vehicle. Check and submit No vehicle I own has a lien. Check and submit. My vehicle(s) with a lien/loan.
Vehicle Make
Vehicle Model
Vehicle Year
Color
Estimated Mileage
List Any Repairs Needed
Who has interest in the property?
Debtor 1 only Debtor 2 only Debtor 1 or 2 only At least one of the debtors and others
Current Value of the Entire Property ---- Do not deduct secured claims or exemptions.
Current Value of the portion YOU own? If you are joint owner, do not include their share.
Is this community property
Yes. No.
Agreement
Lease Purchase
Date Debt Incurred
Lienholder Name
Lienholder Address
Lien Holder Zip Code
Balance owed the lein holder.
Will you claim this property as exempt on Schedule C?
NO YES.
Amount of exemption you claim (100% or amount) & Specific laws that allow exemption
My intentions for a vehicle I am purchasing
I am leasing - this is not a purchase. I will surrender the property. Retain the property and redeem it. Retain the property and enter into a reaffirmation agreement. Retain the property and reaffirm the debt for fair market value.
Please enter the word that you see below.

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