Screening Disclosure Flyers

REAL ESTATE

FORECLOSURE & SALE DISCLOSURE

MUST READ • MUST ANSWER • MUST SIGN

Please complete this form even if you discussed this with an attorney or staff member. Your answers help us protect your rights and make sure we meet any important deadlines.

1

Do you own or have an ownership interest in any real estate property?

This includes a house, condo, land, rental property, or any other real estate.

If you do not own any real estate property, mark NO and proceed to the signature at the bottom.
2

Is any of your real estate involved in an active foreclosure case filed with the court?

This includes a case that has been filed, even if a sale date has not yet been scheduled.

If YES or UNSURE, you must provide the court case information and a copy of the court documents.
3

Property Information (If Applicable)

Property Address:
County:
State:
Court Case Number:
Name of Plaintiff/Lender:

Is this property also subject to any of the following? (Check all that apply)

4

Is a foreclosure sale scheduled?

Sale Date (Month / Day / Year):
IF YOU CHECKED YES, YOU MUST PROVIDE A COPY OF THE OFFICIAL COURT NOTICE, DOCKET, OR ORDER SHOWING THE SALE DATE. We do not rely on unofficial dates, phone calls, or verbal information. We must review the actual court documents to confirm the deadline.
!

IMPORTANT: DO NOT WAIT! If you have a scheduled sale date, notify us immediately. Delays can result in the loss of your property, and there may be limited options if the sale has already occurred.

VEHICLE

REPOSSESSION DISCLOSURE

MUST READ • MUST ANSWER • MUST SIGN

Please complete this form even if you discussed this with an attorney or staff member. Your answers help us protect your rights and make sure we address any time-sensitive issues.

1

Do you have any financed or leased vehicles?

This includes cars, trucks, motorcycles, RVs, or any other vehicle.

If you do not have any financed or leased vehicles, mark NO and proceed to the signature at the bottom.
2

Are you currently behind on any vehicle payment?

If you are not behind on any payments, mark NO and proceed to the signature at the bottom.
3

If YES, how many payments behind are you?

Check one

4

Have you been contacted by your lender, finance company, or a repossession company about repossessing your vehicle?

This includes phone calls, letters, emails, or any other communication.

5

Has your vehicle already been repossessed (taken)?

Date repossessed (if known): ____ / ____ / ____ (Month/Day/Year):
6

Vehicle Information (If applicable)

Year:
Make:
Model:
Color:
Lender / Finance Company:
Account Number (if known):

VEHICLE ALREADY REPOSSESSED

Filing bankruptcy does NOT guarantee that a vehicle already repossessed will be returned. Whether the vehicle can be recovered may depend on the timing, applicable law, the creditor's actions, and the circumstances of your case. If your vehicle has already been taken, please notify us immediately. Even if the vehicle cannot be recovered, bankruptcy may still allow us to eliminate the remaining debt, if applicable.

REPOSSESSION RISK - ACT NOW

If preventing repossession is one of the reasons you are seeking bankruptcy protection, do NOT wait until the vehicle is taken to notify us. Retaining an attorney does not stop a repossession, and filing bankruptcy relief typically requires a case to be officially filed with the court. Please provide any notices, letters, or communications you have received from the lender or repossession company.

GARNISHMENT & BANK LEVY

DISCLOSURE

MUST READ • MUST ANSWER • MUST SIGN

Please complete this form even if you discussed this with an attorney or staff member. Your answers help us protect your rights and address any time-sensitive issues.

1

Are you currently subject to a wage garnishment?

This means money is being withheld from your paycheck by your employer.

If you are not currently subject to a wage garnishment, mark NO and proceed to the next question.
2

Has your employer been notified or served with garnishment papers?

This includes any recent notice that a wage garnishment will begin soon.

IF YES or UNSURE, you must provide a copy of the garnishment paperwork you received or that was served on your employer.
3

Do you have a bank account that is currently frozen, levied, or subject to a bank garnishment?

This includes any bank levy, bank hold, or restriction on your funds.

If you do not have a bank account subject to a levy or garnishment, mark NO and proceed to the next question.
4

Have you received a court summons, lawsuit, or other documents indicating that a garnishment or bank levy may begin soon?

If YES or UNSURE, you must provide a copy of the court documents.
5

Case Information (If Available)

Creditor / Plaintiff:
State Court Case Number:
County:
Employer Name:
Bank Name:
Date Garnishment/Levy Began or Is Expected (M/D/Y):

Type of Garnishment

PRIOR BANKRUPTCY

CASE DISCLOSURE

MUST READ • MUST ANSWER • MUST SIGN

Please complete this form even if you discussed this with an attorney or staff member. Prior filings can affect your eligibility, the automatic stay, and your options.

1

Have you filed any bankruptcy case within the last 12 months?

A YES or UNSURE requires attorney review of your case history.
2

Has any bankruptcy case involving you been dismissed within the last 12 months?

A YES or UNSURE creates the highest-priority prior-bankruptcy alert. Stay limitations under 11 U.S.C. § 362(c)(3)/(c)(4) may apply.
3

Do you currently have a bankruptcy case pending?

4

Have you ever filed bankruptcy at any other time?

If YES, provide the case information below for each prior case, if known.
5

Prior Case Information (If Applicable)

Case Number:
District / State:
Chapter:
Filing Date:
Dismissal Date (if applicable):
Discharge Date (if applicable):

Status (check one per case)