Business bankruptcy questionnaire

L A W   O F F I C E S   O F
Wendy Turner Lewis, PLLC
Detroit, Michigan   |   313.832.5555   |   
Business Bankruptcy Questionnaire
C H A P T E R   7    ·    L I Q U I D A T I O N
United States Bankruptcy Court  ·  Eastern District of Michigan
CONFIDENTIAL — ATTORNEY-CLIENT PRIVILEGED
Before you begin
This questionnaire gathers the information needed to prepare a Chapter 7 petition, schedules, and Statement of Financial Affairs
for your business. Every answer is reproduced in documents your authorized representative will sign under penalty of perjury, so
accuracy and completeness protect you.
•
Answer every item. 
Answer every item. If something does not apply, type "None" or "N/A" — do not leave blanks.
•
Estimate when necessary, 
Estimate when necessary, and note figures you are unsure of so we can confirm them together.
•
Please note: 
Please note: a corporation, LLC, or partnership does not receive a discharge in Chapter 7 — the case is an orderly liquidation
by a trustee — and a business entity must be represented by an attorney.
This form is confidential attorney work product. Completing it does not by itself create representation, which begins only under a signed
engagement agreement.
1
Business Identification
Enter the debtor’s exact legal name as it appears on formation documents, plus every other name used in the last 8 years (assumed names
/ DBAs, former names, trade names).
EXACT LEGAL NAME OF BUSINESS (THE "DEBTOR")
OTHER NAMES USED IN LAST 8 YEARS (DBAS, FORMER, TRADE NAMES)
ENTITY TYPE (LLC, CORP, PARTNERSHIP, SOLE PROP)
STATE OF FORMATION / INCORPORATION
DATE FORMED
FEDERAL EIN
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MICHIGAN ENTITY ID (IF KNOWN)
PRIMARY NAICS / NATURE OF BUSINESS
PRINCIPAL PLACE OF BUSINESS (STREET, CITY, STATE, ZIP, COUNTY)
MAILING ADDRESS (IF DIFFERENT)
BUSINESS PHONE
BUSINESS EMAIL
WEBSITE
REGISTERED AGENT — NAME & ADDRESS
2
Ownership, Officers & Related Entities
List everyone who owns an interest and everyone with authority to manage the business. Insiders — officers, directors, managing members,
general partners, and relatives — receive special scrutiny.
Owners / Members / Shareholders
NAME
ADDRESS
TITLE / ROLE
% OWN
INSIDER?
Officers, Directors & Managers (current & past year)
NAME
POSITION
DATES SERVED
COMPENSATION (LAST 12 MO.)
PERSON AUTHORIZED TO SIGN THE PETITION
RELATED, AFFILIATED, PARENT, OR SUBSIDIARY ENTITIES — NAME AND RELATIONSHIP

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3
Nature & Status of Operations
Tell us what the business does and where things stand today. Whether it is still running affects how the trustee handles assets, employees,
and leases.
DESCRIBE THE BUSINESS — PRODUCTS/SERVICES, MAIN CUSTOMERS
STILL OPERATING? (YES / WINDING DOWN / CEASED)
IF CEASED, DATE OPERATIONS STOPPED
CURRENT NUMBER OF EMPLOYEES
WAGES/BENEFITS OWED TO EMPLOYEES? (Y/N)
PRIMARY REASONS FOR FILING
BUSINESS LOCATIONS IN THE LAST 4 YEARS
4
Prior Bankruptcy & Insolvency Matters
Disclose any bankruptcy filed by this business, its affiliates, or its partners in the last 8 years, and any current insolvency proceeding.
HAS THE BUSINESS (OR A PREDECESSOR) FILED BANKRUPTCY BEFORE? (YES/NO)
FILER / DEBTOR NAME
CHAPTER
CASE NUMBER
DISTRICT
DATE / DISPOSITION
CURRENT RECEIVERSHIP, ASSIGNMENT FOR BENEFIT OF CREDITORS, OR STATE INSOLVENCY PROCEEDING?
5
Books, Records & Professionals
The trustee will want the financial records and the people who keep them. Identify your accountant, bookkeeper, and any prior advisor
consulted about this filing.

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WHO KEEPS THE BOOKS AND RECORDS, AND WHERE ARE THEY LOCATED?
ACCOUNTANT / CPA — NAME & PHONE
BOOKKEEPER — NAME & PHONE
AUDITED/REVIEWED FINANCIALS IN LAST 2 YRS? (Y/N)
BANK/CREDITOR GIVEN FINANCIALS IN LAST 2 YRS
OTHER ATTORNEY/PREPARER/ADVISOR CONSULTED ABOUT THIS BANKRUPTCY — AND FEES PAID (LAST YEAR)
6
Financial Snapshot
Give your best estimates. These figures orient the case; the detailed schedules that follow build the full picture.
ESTIMATED TOTAL ASSETS ($)
ESTIMATED TOTAL LIABILITIES ($)
ESTIMATED # OF CREDITORS
GROSS REVENUE — YTD ($)
GROSS REVENUE — PRIOR YEAR ($)
GROSS REVENUE — 2 YRS AGO ($)
CASH ON HAND / IN BANK ($)
NON-BUSINESS INCOME YTD ($)
FISCAL YEAR-END
7
Business Assets
List everything the business owns or has an interest in — even items fully financed, leased, jointly owned, or possibly worthless. Use
estimated CURRENT value, not what you paid.
Bank & financial accounts
INSTITUTION
ACCOUNT TYPE
LAST 4 DIGITS
BALANCE
Accounts receivable & inventory
TOTAL ACCOUNTS RECEIVABLE ($)
AMOUNT LIKELY COLLECTIBLE ($)
INVENTORY ON HAND — DESCRIPTION
ESTIMATED INVENTORY VALUE ($)

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Equipment, machinery, vehicles, furniture & fixtures
DESCRIPTION
EST. CURRENT VALUE
AMOUNT OWED / LIENHOLDER
LOCATION
Real property owned
ADDRESS / DESCRIPTION
EST. VALUE
MORTGAGE BALANCE / LENDER
OWNER OF RECORD
Intangibles & other interests
INTELLECTUAL PROPERTY — TRADEMARKS, PATENTS, COPYRIGHTS, DOMAINS, CUSTOMER LISTS, GOODWILL
INTERESTS IN OTHER BUSINESSES / PARTNERSHIPS / JOINT VENTURES
LICENSES, FRANCHISES, PERMITS, OR APPROVALS HELD
DEPOSITS, PREPAYMENTS, RETAINERS, OR BONDS HELD BY OTHERS
REFUNDS OWED TO THE BUSINESS
CLAIMS OR LAWSUITS THE BUSINESS COULD BRING AGAINST OTHERS (INCL. INSURANCE CLAIMS)
ANY OTHER PROPERTY OF ANY KIND NOT LISTED ABOVE
8
Secured Creditors
A secured creditor holds collateral — a lien on specific property (equipment or vehicle loans, mortgages, UCC filings). List each, the
collateral, and the balance owed.
CREDITOR NAME & ADDRESS
ACCOUNT #
COLLATERAL
BALANCE OWED
COLLATERAL VALUE

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9
Priority Creditors — Taxes & Wages
Priority debts are paid ahead of most others: unpaid taxes, employee wages/benefits earned before filing, and certain deposits. Repeat
taxes in Section 15.
CREDITOR / TAXING AUTHORITY
TYPE OF DEBT
PERIOD / YEAR
AMOUNT OWED
10
General Unsecured Creditors
Everyone else the business owes with no collateral and no priority — suppliers, vendors, credit cards, lines of credit, back rent, judgments.
The court requires the 20 largest, so be thorough.
CREDITOR NAME
ADDRESS
ACCOUNT #
AMOUNT OWED
DISPUTED?
11
Personal Guarantees & Co-Debtors
A business Chapter 7 does NOT erase a personal guarantee — identify each one, because it affects the guarantor directly.
CREDITOR / DEBT
GUARANTOR / CO-DEBTOR
RELATIONSHIP
AMOUNT
12
Leases & Ongoing Contracts
List every lease (real property, equipment, vehicles) and any contract still being performed — supplier, service, or franchise agreements.

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OTHER PARTY
WHAT IT COVERS
MONTHLY / TERMS
EXPIRES
BEHIND?
13
Legal Proceedings, Liens & Collection Actions
Disclose every lawsuit, judgment, garnishment, levy, repossession, or foreclosure involving the business in the last year and any pending
now — whether the business is suing or being sued.
CASE / PARTIES
COURT / AGENCY
CASE NUMBER
NATURE
STATUS
JUDGMENTS, GARNISHMENTS, TAX LEVIES, OR LIENS IN THE LAST YEAR
PROPERTY REPOSSESSED, FORECLOSED, RETURNED, OR SEIZED IN THE LAST YEAR
14
Payments, Transfers & Financial Affairs
The trustee reviews money and property that left the business before filing. These mirror the Statement of Financial Affairs. Answer each, or
type "None."
A. PAYMENTS TO ANY SINGLE CREDITOR OVER ~$7,575 WITHIN THE 90 DAYS BEFORE FILING.
B. PAYMENTS TO INSIDERS (OWNERS, OFFICERS, RELATIVES, RELATED COMPANIES) WITHIN 1 YEAR BEFORE FILING.
C. PROPERTY SOLD, TRANSFERRED, OR GIVEN AWAY OUTSIDE THE ORDINARY COURSE WITHIN THE LAST 2 YEARS.
D. SETOFFS BY ANY BANK OR CREDITOR WITHIN 90 DAYS.

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E. GIFTS OR CHARITABLE CONTRIBUTIONS WITHIN 2 YEARS.
F. LOSSES FROM FIRE, THEFT, CASUALTY, OR GAMBLING WITHIN 1 YEAR.
G. FINANCIAL ACCOUNTS CLOSED, SOLD, OR TRANSFERRED WITHIN 1 YEAR.
H. SAFE DEPOSIT BOXES OR OFF-SITE STORAGE USED WITHIN 1 YEAR.
I. PROPERTY OF THE BUSINESS HELD BY OTHERS, OR PROPERTY OF OTHERS HELD BY THE BUSINESS.
15
Tax Obligations
Taxes carry priority status and can survive a filing. List all unpaid taxes and confirm which returns have been filed. Payroll and sales taxes
are especially important.
FEDERAL INCOME/BUSINESS TAXES OWED ($ & YEARS)
MICHIGAN STATE TAXES OWED ($ & YEARS)
PAYROLL/WITHHOLDING (941) TAXES OWED
SALES/USE TAX OWED
UNEMPLOYMENT (SUTA/FUTA) OWED
LOCAL/PROPERTY/OTHER TAXES OWED
FEDERAL RETURNS — LAST YEAR FILED
STATE RETURNS — LAST YEAR FILED
ANY TAX RETURNS NOT YET FILED, OR TAX LIENS RECORDED?
16
Environmental Information
Answer even if it seems minor — notices, releases, or hazardous materials at any site the business owns, operates, or once used.

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NOTICE FROM A GOVERNMENTAL UNIT ABOUT ENVIRONMENTAL LAW OR A HAZARDOUS RELEASE? (Y/N — EXPLAIN)
STORE, USE, OR HAVE HAZARDOUS MATERIALS, WASTE, OR REGULATED SUBSTANCES ON SITE? (Y/N — EXPLAIN)
17
Insurance Policies
List current and recently expired policies — general liability, property, vehicle, workers’ compensation, professional, and any bonds.
CARRIER
TYPE OF COVERAGE
POLICY #
STATUS / EXPIRATION
18
Employees & Payroll
Details about your workforce help address wage claims and payroll-tax priority, and let us handle final-pay or benefit obligations correctly.
NUMBER OF W-2 EMPLOYEES
NUMBER OF 1099 CONTRACTORS
PAYROLL PROCESSED BY (IN-HOUSE / COMPANY)
DATE OF LAST PAYROLL RUN
UNPAID WAGES, PTO, COMMISSIONS, OR BENEFITS OWED — AND TO WHOM
ANY UNPAID CONTRIBUTIONS TO EMPLOYEE BENEFIT / RETIREMENT PLANS?
19
Anything Else We Should Know
Use this space for anything the earlier sections did not capture — unusual transactions, disputes, expected claims, or questions for the
attorney.

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ADDITIONAL INFORMATION
20
Document Checklist
Formation documents (Articles / Operating Agreement / Bylaws)
Federal & state tax returns — last 3 years
Bank statements — last 6 months (all accounts)
Profit & loss / income statement
Balance sheet (most recent)
Accounts receivable aging report
Accounts payable / vendor list with balances
Loan & financing agreements; promissory notes
Personal guarantee documents
Leases (real property, equipment, vehicles)
Vehicle titles & registrations
Deeds / mortgages for owned real estate
UCC / lien search results (if available)
Recent payroll reports & 941 filings
Insurance policies & declarations pages
Lawsuits, judgments, or collection notices
Tax notices, liens, or levies received
Equipment / asset list with values
Franchise or licensing agreements (if any)
Photo ID & EIN letter for the business

Authorization & Certification
I am an authorized representative of the business named above. I certify that the information provided is true, accurate, and
complete to the best of my knowledge, and I understand it will be used to prepare bankruptcy documents signed under penalty of
perjury. I will promptly notify the firm of any change.
PRINTED NAME OF AUTHORIZED REPRESENTATIVE
TITLE / CAPACITY
SIGNATURE
DATE
For Office Use Only
DATE RECEIVED
REVIEWED BY
MATTER / FILE NO.
ENGAGEMENT SIGNED? (Y/N)
RETAINER RECEIVED
FOLLOW-UP NEEDED
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Chapter 7 Business Questionnaire · Page 11
NOTES
Law Offices of Wendy Turner Lewis, PLLC  ·  Detroit, MI  ·  313.832.5555  ·  
Confidential & privileged — prepared for client intake, not filed with the court.
www.wendyturnerlewis.com