These interrogatories are to be used only as a guide and cannot be considered appropriate for all litigation. They may also be used as a guide for questioning the debtor at oral deposition. This pattern set of questions is intended to locate the most common kinds of assets. The information already known about the judgment debtor will probably suggest additional questions, which must be specially drafted and included. Care should therefore be exercised in planning and drafting postjudgment interrogatories.
Information developed by these questions may suggest other questions to be asked in subsequent interrogatories or by other kinds of discovery. These questions are phrased to include the spouse to make them suitable for the most likely situation, a personal debt incurred during marriage in which the joint community property is at risk. See discussion at section 27.33 in this manual. The questions should be revised for separate debts or debts of unmarried persons. For interrogatories to a corporate debtor, see form 26-6 (short form) and form 26-8 (long form).
Questions marked with an asterisk (*) are so fundamental that they will be suitable for almost every set; the remaining questions should be considered in light of what is already known about the debtor and should be included as appropriate.
Pattern Interrogatories in Aid of Judgment—Individual Debtor
[Long Form]
* 1.Please state your full legal name and any other name you have used at any time, including each nickname, alias, and (if applicable) married name and name before your marriage.
2.Have you or your spouse filed an assumed name certificate or partnership certificate? If so, for each certificate please state—
a.the full assumed or partnership name used;
b.the full name(s) of the person(s) (you, your spouse, or both) using it; and
c.the city, county, and state in which the assumed or partnership name was primarily used.
3.Have you or your spouse used an assumed name or partnership name without filing a certificate? If so, for each name please state—
a.the full assumed or partnership name used;
b.the full name(s) of the person(s) (you, your spouse, or both) using it; and
c.the city, county, and state in which the assumed or partnership name was primarily used.
* 4.Please state your date and place of birth.
* 5.Please state your Social Security number.
* 6.Please state the license number and issuing state of each driver’s license in any of your names.
* 7.Please state each of your current residential addresses (street address, city, county, state, zip code) and telephone numbers (including area code).
* 8.Please state each of your current business addresses (street address, city, county, state, zip code) and telephone numbers (including area code). Also please state any post office box address used.
* 9.Are you now married? If you are, please state—
a.your spouse’s full name; and
b.your spouse’s complete present address.
* 10.Have you been married to someone to whom you are not now married? If you have, for each prior marriage please state—
a.whether the former spouse is still living;
b.the full present name of the former spouse if still living;
c.the date of the marriage;
d.the date the marriage ended and how it was terminated; and
e.the complete present residential address of the former spouse if still living.
* 11.Is a suit to dissolve your marriage pending? If so, please state the cause number and the name, number, and location of the court in which it is pending and, if you will do so without a court order, attach a copy of any temporary order.
12.Have you and your spouse ever partitioned your community property by written agreement? If so, please state—
a.the date the agreement was signed;
b.the contents of the agreement, copying it verbatim or, if you will do so without a court order, attaching a copy of the agreement to your answers; and
c.whether the agreement has been filed in the records of any county and, if it has, the name of each county in which it has been filed.
13.Regarding your father, please state—
a.his full name;
b.whether he is now living;
c.if he is alive, his complete present address;
d.if he is alive, his present occupation and employer’s name; and
e.if he is not living, the date of his death and his complete residential address when he died.
14.Regarding your mother, please state—
a.her full name;
b.whether she is now living;
c.if she is alive, her complete present address;
d.if she is alive, her present occupation and employer’s name; and
e.if she is not living, the date of her death and her complete residential address when she died.
15.Regarding your spouse’s parents, for each parent please state—
a.the parent’s full name;
b.whether he or she is now living;
c.the complete present address of the parent if living;
d.the present occupation and employer’s name of the parent if living; and
e.the date of death and complete residential address at death if the parent is deceased.
16.Do you have one or more children now living? If you do, for each child please state—
a.the present full name of the child;
b.whether he or she is now married;
c.the date of birth of the child; and
d.the complete present residential address of the child.
17.Is there presently living at your residence anyone who is not your child or spouse? If there is, for each person please state—
a.his or her full name;
b.the person’s relationship to you; and
c.the full name and complete address of the employer of the person.
* 18.Please state the complete address (street address, city, county, state, zip code) of each place where you have lived in the past five years and the dates you lived there.
* 19.Do you own one or more of your residences? If you do, for each residence you own please state—
a.the complete address (street address, city, county, state, zip code) and full legal description of the residence;
b.the full names and complete addresses of any other person who is a co-owner of the property;
c.whether the residence is mortgaged;
d.the full name, complete address, and telephone number of each mortgage holder;
e.the present balance of each mortgage;
f.the complete address to which each mortgage payment is sent;
g.the full name, complete address (street address, city, county, state, zip code), and amount of each escrow account maintained in connection with each mortgage; and
h.the complete address (street address, city, county, state, zip code) of the property that you claim as a homestead.
* 20.Do you rent one or more of the places you use as residences? If you do, for each residence you rent please state—
a.the complete address of the residence;
b.the full name and complete address of your landlord;
c.the amount of each rental payment, the day of the month when it is due, and the date when it is made;
d.the complete address to which rental payments are made; and
e.the amount of each deposit paid to the landlord.
21.Do you have one or more boarders, tenants, or subtenants? If you do, for each one please state—
a.the person’s full name;
b.the amount of rent paid by him or her;
c.the date on which the person began renting from you;
d.the rental agreement you have with him or her; and
e.the amount of any deposit made by the person to you.
* 22.What is your usual occupation?
* 23.Are you presently self-employed, either full time or part time? If you are, please state—
a.the nature of your occupation, in detail;
b.how long you have been self-employed in this business;
c.the full name under which your business is operated;
d.the complete address and telephone number of your place of business;
e.your annual income for each of the last five years or for any portion of that time that you have been self-employed;
f.your average monthly income for the last six months; and
g.whether any money is presently owed you and, if it is, from whom and in what amount it is owed.
* 24.Are you presently employed, either full time or part time, by someone other than yourself? If you are, for each employer please state—
a.the full name, complete address, and telephone number of the employer;
b.your wages or salary and how often you are paid—for example, daily, weekly, monthly;
c.if you work for commissions, the average monthly amount of your commissions;
d.the day of the week on which you are paid or the date or dates on which you are paid every month or the other regular day or dates on which you are paid; and
e.whether any compensation is presently owed you and, if so, from what source and in what amount it is owed.
25.Does your spouse work now? If so, for each job your spouse has, including self-employment, please state—
a.whether any income is from self-employment;
b.the full name, complete address, and telephone number of each employer;
c.the annual compensation that your spouse has received for each of the last five years or for any portion of that time during which your spouse has been employed by another or self-employed;
d.your spouse’s average monthly income for the last six months; and
e.whether any compensation is presently owed your spouse and, if so, from what source and in what amount it is owed.
26.Are you the sole support of your family? If you are not, for each other person who contributes support please state—
a.the full name and complete address of the contributor;
b.your relationship to the contributor;
c.the amount of each contribution and when it is normally made; and
d.the full name and complete address of each person or entity from whom the contributor acquires the assets to make the contribution.
27.Do you receive income or benefits from any source other than your employment or family contributions listed above? If you do, for each source please state—
a.the full name and complete address of the source;
b.the amount of the income or benefits;
c.precisely when each payment is received throughout the year; and
d.the full name, complete address, and telephone number of each person, financial institution, or other entity with which you deposit the payments.
28.For each of your expenses that recurs on a monthly or other regular basis and exceeds $100, please state—
a.the frequency with which payments are made;
b.the amount of each payment and either that this amount is the same for each payment or that this amount is an average for the past year;
c.the full name and complete address of the recipient of the payments; and
d.the full name and complete address of each person or entity from whom you acquire the assets to make payments.
29.For each of your spouse’s expenses that recurs on a monthly or other regular basis and exceeds $100, please state—
a.the frequency with which payments are made;
b.the amount of each payment and either that this amount is the same for each payment or that this amount is an average for the past year;
c.the full name and complete address of the recipient of the payments; and
d.the full name and complete address of each person or entity from whom your spouse acquires the assets to make payments.
30.For each of your family’s expenses that recurs on a monthly or other regular basis and exceeds $100, please state—
a.the frequency with which payments are made;
b.the amount of each payment and either that this amount is the same for each payment or that this amount is an average for the past year;
c.the full name and complete address of the recipient of the payments;
d.the full name and complete address of each person or entity from whom the assets to make payments are acquired; and
e.the full name of the person who pays the expense and, if not you, your relationship to that person.
* 31.Have you or your spouse made any payment exceeding $500 to any person or entity during the last four months? If so, for each payment please state—
a.the date and amount of the payment;
b.the full name and complete address of the recipient;
c.the total amount owed the recipient before the payment was made;
d.the date on which the payment was due;
e.the balance due the recipient after the payment was made; and
f.the name(s) of the person(s) (you, your spouse, or both) who made the payment.
* 32.Have you or your spouse received any real estate or personal property by inheritance? Do you or your spouse expect to receive any inheritance? If the answer to either question is yes, for each property or inheritance please state, to the greatest extent possible—
a.a complete description of the property or inheritance;
b.the present estimated market value of the property or inheritance;
c.the complete present location of the property or inheritance;
d.the full name of the estate or person from whom the property or inheritance was or will be inherited;
e.the full name and complete address of the executor or administrator of the estate;
f.the name, number, and location of the court administering the estate;
g.the name(s) of the person(s) (you, your spouse, or both) who inherited or will inherit the property or inheritance; and
h.whether there has been a final distribution of the estate and, if so, when it was made.
33.Within the last year, have you or your spouse received as a gift any money or property worth more than $100? If so, for each gift please state—
a.the full name, complete address, and telephone number of the person or entity that made the gift;
b.the date it was received;
c.the name(s) of the person(s) (you, your spouse, or both) who received it;
d.a complete description of the gift;
e.the present estimated market value of the gift;
f.the gift’s present location; and
g.a detailed description of what was done with the gift if the recipient(s) (you, your spouse, or both) does not still have it.
* 34.Do you or your spouse have an ownership interest in, option to purchase, contract to sell, leasehold in, or other interest in any real estate not identified in answer to question 19.? If so, for each property please state—
a.the legal and common descriptions and the location of the property;
b.the size of the property;
c.a description of every improvement on the property;
d.the name of the person (you, your spouse, or both) having the interest;
e.the full name and complete address of every other person or entity having any kind of interest in the property;
f.the present value of your or your spouse’s equity in the property;
g.Whether the property is encumbered; if it is, also please state—
(1)the nature of the encumbrance;
(2)the full name and complete address of the holder of the encumbrance; and
(3)the amount of the encumbrance;
h.the cost of the property, excluding improvements;
i.when and how the property was bought or acquired;
j.whether any part of the property is within the corporate limits of a town and, if so, the name of the town; and
k.whether any money or property has been placed in escrow; if it has, also please state—
(1)the full name and complete address of the person or entity now having possession of the escrow amount or property; and
(2)the amount of money or value of the property in escrow.
* 35.Is there any checking account, savings account, trust fund, pension plan, profit-sharing plan, mutual fund, or other account or fund of money in which you, your spouse, or any family member now residing with you either owns an interest or has a right of withdrawal or deposit? If there is, for each account please state—
a.the full name and relationship to you of each person owning an interest in the account or having access to it;
b.the name (or title) and number of the account;
c.the full name and complete address of the person or entity holding the fund;
d.the present balance in the account; and
e.the full names and complete addresses of all authorized signatories to the account.
* 36.Do you or does your spouse or any family member now residing with you have access to any depository, including but not limited to safes, vaults, and safe-deposit boxes? If so, for each depository please state—
a.the full name and complete address of each person or entity to whom the depository is rented or leased;
b.the full name and complete address of the bank or other institution where the depository is located;
c.the full name and complete address of each person having access to the depository;
d.a complete description of the property contained in the depository on the date you are answering these questions;
e.the date of each inventory of the depository; and
f.the complete contents of each inventory, copying the inventories verbatim or, if you will do so without a court order, attaching copies of them to your answers.
37.Has anything been removed from any above-mentioned depository during the last twelve months? If it has, for each thing removed please state—
a.a complete description of the property removed;
b.the date it was removed;
c.why it was removed;
d.the full name and complete address of each person who removed it;
e.the full name of the present custodian of the property and either the complete address of the property’s present location or a detailed description of its disposition, whichever applies; and
f.whether the property is worth more than $500. If it is, also please state the date of acquisition and the cost of acquisition of the property.
38.Is there any real estate or personal property that any person or entity holds title to or possesses in the name or for the benefit of you, your spouse, or any member of your family now residing with you? If there is, for each property please state—
a.the full name of the person in whose name the property is held and, if it is not in your name, your relationship with the person in whose name it is held;
b.the full name of the person for whose benefit the property is held and, if it is not for your benefit, your relationship with the person for whose benefit it is held;
c.a detailed description of the property;
d.the value of the property;
e.the full name, complete address, and telephone number of the person or entity holding the property;
f.the relationship between the person or entity holding the property and the person for whose benefit it is held; and
g.a detailed description of the arrangements under which the property is being held, including a description of the interest you, your spouse, or your family member has in the property.
* 39.Have you or your spouse furnished a financial statement to any person or entity in the last five years? If you have, for each financial statement please state—
a.the full name and complete address of each person or entity to whom it was furnished;
b.the date it was furnished;
c.the contents of the statement, copying it verbatim or, if you will do so without a court order, attaching a copy of the statement to your answers; and
d.the name(s) of the person(s) (you, your spouse, or both) who furnished the statement.
* 40.If you will do so without a court order, please attach to your answers a copy of each federal income tax return for the last five years for you, your spouse, or both of you. Please state—
a.the source and amount of each item of income listed;
b.the total income received for each year, whether reported or not;
c.the date each return was filed and the address of the Internal Revenue Service office where it was filed;
d.the amount and source of each amount of income received but not shown on any of the returns that you are attaching to your answers; and
e.the full name and complete address of each person who worked on or helped prepare each return.
* 41.Do you or your spouse have any life insurance? If so, for each policy please state—
a.the full name, complete address, and telephone number of the issuing company;
b.the policy number;
c.the date of issuance, amount, and type of the policy;
d.the cash value of it or that it has no cash value;
e.the full name and complete address of each beneficiary of the policy; and
f.whether the policy is encumbered in any way and, if it is, in what way and for what amount.
42.At any time in the last five years, have you or your spouse paid or had paid a premium on any life insurance policy payable to your estate or your spouse’s estate? If so, for each policy please state—
a.the full name, complete address, and telephone number of the issuing company;
b.the number of the policy;
c.the face value of it on the death of the insured;
d.each date on which a payment was made; and
e.the amount of each payment.
43.Has any beneficiary designation of an insurance policy on you or your spouse been changed in the last five years? If so, for each change please state—
a.the date the change took place;
b.the name of the new beneficiary;
c.the name of the old beneficiary; and
d.why the change was made.
44.If you will do so without a court order, please attach to your answers a copy of each insurance policy, contract, or document to which the preceding answers pertain.
* 45.Do you or your spouse now own, claim any interest in, or have title to any vehicle (including but not limited to automobiles, trucks, boats, aircraft, trailers, and motorcycles)? If so, for each vehicle please state—
a.a complete description of the vehicle, including, as applicable, its year, make, model, vehicle identification number, serial number, and other permanent identification numbers;
b.the general condition of the vehicle;
c.the complete address of its current location;
d.the full name and complete address of each person or entity having control over the vehicle;
e.the present estimated market value of the vehicle; and
f.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the vehicle and the nature of the interest.
* 46.Do you or your spouse now own, claim any interest in, or have title to any firearm? If so, for each firearm please state—
a.a complete description of the firearm, including as applicable its year, make, model, serial number, and other permanent identification numbers;
b.the general condition of the firearm;
c.the complete address of its current location;
d.the full name and complete address of each person or entity having control over the firearm;
e.its present estimated market value; and
f.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the firearm and the nature of the interest.
* 47.Do you or your spouse now own, claim any interest in, or have title to any art object? If so, for each object please state—
a.a complete description of the object;
b.the complete address of its current location;
c.the full name and complete address of each person or entity having control over the object;
d.the present estimated market value of the object; and
e.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the object and the nature of the interest.
* 48.Do you or your spouse now own, claim any interest in, or have title to any collection, including but not limited to stamp collections and coin collections, that has not been described in a previous answer? If so, for each collection please state—
a.a complete description of the collection, including as applicable the year, make, model, serial number, and other permanent identification numbers of each thing in the collection;
b.the complete address of its current location;
c.the full name and complete address of each person or entity having possession or control of the collection;
d.the present estimated market value of the collection, or of each thing in it if appropriate; and
e.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the collection and the nature of the interest.
* 49.Do you or your spouse now own, claim any interest in, or have title to any manufactured home, mobile home, trailer house, recreational vehicle, camper trailer, trailer, or other item of a similar nature that has not been described in a previous answer? If so, for each item please state—
a.a complete description of the item, including as applicable the year, make, model, vehicle identification number, serial number, and other permanent identification numbers;
b.the general condition of the item;
c.the complete address of its current location;
d.the full name and complete address of each person or entity having possession or control of the item;
e.the present estimated market value of the item;
f.the full name and complete address of the person or entity having possession of the certificate of title or other document evidencing title to the item;
g.the amount of any lien against the item and the full name and complete address of the holder or owner of the lien; and
h.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the item and the nature of the interest.
* 50.Do you or your spouse now own, claim any interest in, or have title to any animal of a value of $100 or more? If so, for each animal please state—
a.a complete description of the animal, including registration information as applicable;
b.the complete address of its present location;
c.the present estimated market value of the animal;
d.the full name and complete address of the person or entity having possession of the animal;
e.the date and cost of acquisition of the animal;
f.the amount of any lien against the animal and the full name and complete address of the holder or owner of the lien; and
g.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the animal and the nature of the interest.
* 51.Do you or your spouse now own, claim any interest in, or have title to any farm machinery of any kind that has not been described in a previous answer? If so, for each item please state—
a.a complete description of the item, including as applicable its year, make, model, motor number, serial number, and other permanent identification numbers;
b.the complete address of its present location;
c.the full name and complete address of the person or entity having possession of the certificate of title or other document evidencing title to the item;
d.whether the item is subject to a lien and, if so, the amount of the indebtedness and the full name and complete address of the holder or owner of the lien;
e.the present estimated market value of the item;
f.the date and cost of acquisition of the item; and
g.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the item and the nature of the interest.
52.Do you or your spouse now own, claim any interest in, or have title to any kind of aircraft that has not been described in a previous answer? If so, for each aircraft please state—
a.a complete description of the aircraft, including the FAA identification number, motor number, and other permanent identification numbers;
b.the complete address of its present location;
c.the full name and complete address of the person or entity having possession of the certificate of title and, if different, the present location of the certificate;
d.whether the aircraft is subject to a lien and, if it is, the amount of the indebtedness and the full name and address of the holder or owner of the lien;
e.the present estimated market value of the aircraft;
f.the date and cost of its acquisition;
g.the full name and complete address of the person or entity having possession of the aircraft; and
h.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the aircraft and the nature of the interest.
* 53.Do you or your spouse now own, claim any interest in, or have title to any of the following kinds of property?
a.stocks, bonds, or other securities;
b.mortgages or liens on real or personal property;
c.promissory notes, drafts, bills of exchange, or other commercial paper;
d.judgments;
e.savings bonds or other government-issued bonds;
f.any interests in oil, gas, or mineral leases;
g.certificates of deposit, letters of credit, money orders, cashier’s checks, traveler’s checks, bank deposits, or escrow funds;
h.Keogh plans, individual retirement accounts, profit-sharing plans, deferred compensation plans, pension plans, prepaid funeral plans, retirement benefits, or other retirement plans;
i.leases, life estates, remainder interests, or other interests in real property; and
j.patents, copyrights, trademarks, service marks, franchises, or other such licenses.
If you do and if the information sought in this question has not been provided in another answer, for each item of property please state—
a.a complete description of the item, including account number, registration number, other permanent identification numbers, and other specified identification;
b.the full name and complete address of the person in whose name the item is held;
c.the present value of the item;
d.the amount of the indebtedness outstanding against the item; and
e.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the item and the nature of the interest.
* 54.Do you or your spouse now own, claim any interest in, or have title to any personal property including but not limited to household effects, furniture, tools, appliances, clothing, and jewelry that is worth more than $500 and that has not been described in a previous answer? If so, for each item please state—
a.a complete description of the item, including as applicable the year, make, model, serial number, and other permanent identification numbers;
b.the complete address of its present location;
c.the full name and complete address of the person or entity having possession or control of the item;
d.the present estimated market value of the item; and
e.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the item and the nature of the interest.
* 55.Do you or your spouse now own, claim any interest in, or have title to any personal property now pledged as security for a debt? If so, for each item please state—
a.a complete description of the item, including as applicable the year, make, model, serial number, and other permanent identification numbers;
b.the amount of the debt the property was pledged to secure and the current amount of the debt;
c.the full name and complete address of the person or entity to whom the property is pledged;
d.the date the debt is to be paid;
e.the date the debt was incurred; and
f.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the property and the nature of the interest.
56.Have you, your spouse, or an agent for either of you moved any property that you or your spouse owns or claims any interest in from the county of residence of the owner (you or your spouse) at any time within the last twelve months? If so, for each item that was not located in the county of the owner’s residence on the date you received these questions, please state—
a.a complete description of the property, including as applicable the year, make, model, serial number, and other permanent identification numbers;
b.the complete address of its present location;
c.the reason for removing the item from the county of the owner’s residence; and
d.the name(s) of the person(s) (you, your spouse, or both) having title to or an interest in the item and the nature of the interest.
* 57.Do you or any member of your family now residing with you have an ownership interest in any business, partnership, joint venture, or other noncorporate legal entity? If so, for each interest please state—
a.the full name, complete address, and telephone number of the business or entity;
b.a detailed description of the type of business or other endeavor in which it is engaged;
c.the full name of the person (you or a family member) having the interest and, if applicable, your relationship to that person;
d.the date, manner, and cost of acquisition of the interest;
e.a detailed description of the interest;
f.a description of the legal nature of the entity;
g.the full name and complete address of each officer, director, or partner in the business;
h.the full name and complete address of each bank in which the business maintains any type of checking or deposit account or from which the business has borrowed money;
i.the present estimated market value of the interest and its percentage of the total value of the business; and
j.the amount of any interest you or a family member has transferred within the last year and the full name and complete address of the person or entity receiving the interest.
58.Have you or any member of your family now residing with you been at any time an employee, officer, director, or stockholder or owner of any other kind of interest, including debentures, purchase options, or beneficial interests, of a corporation? If so, for each relationship or interest please state—
a.a description of the relationship or interest;
b.the full name of the person (you or a family member) having the relationship or interest;
c.the full name, complete address, and telephone number of the corporation;
d.the nature, amount, method, and date of payment of compensation received from the corporation by you or a family member at any time; and
e.the nature and extent of your or your family member’s duties or responsibilities in the relationship.
* 59.Are you or your spouse a beneficiary of any trust? If so, for each trust please state—
a.the full name of the trust;
b.the full name, complete address, and telephone number of the trustee;
c.the full name, complete address, and telephone number of each beneficiary of the trust;
d.a detailed description of the terms of the trust as they relate to you or your spouse as beneficiary;
e.a detailed description of how the trust is funded;
f.the total amount presently held in trust;
g.the portion of the current balance held in trust for you or your spouse;
h.the date on which rights in the trust will vest in you or your spouse;
i.a description of the assets owned by the trust and their present estimated market value;
j.the account number and location of each checking, savings, or other depository account of the trust;
k.the date and period when trust disbursements are regularly made; and
l.the contents of every one of the trust’s tax returns for the last five years, copying the returns verbatim or, if you will do so without a court order, attaching copies of the returns to your answers.
* 60.Do you or your spouse maintain any business or personal account with any bank, savings and loan association, credit union, or postal savings department? If so, for each account please state—
a.the full name and complete address of the institution holding the account;
b.the full name and number under which the account is maintained;
c.the balance of the account five calendar days before the day you received these interrogatories; and
d.the balance of the account on the day you answered these interrogatories.
61.Do you or your spouse own an interest in a patent or copyright? If you do, for each interest please state—
a.a full description of the thing patented or copyrighted;
b.a description of the interest owned;
c.the registration number of the patent or copyright; and
d.the amount of income received from the patent or copyright during the last twelve months.
62.Do you or your spouse hold any property as trustee of any type of trust? If so, for each trust please state—
a.a detailed description of all the property held in trust;
b.the full name and complete address of each beneficiary of the trust;
c.whether the trustee (you or your spouse) has a general power of appointment over any property in the trust;
d.the date the trust was created; and
e.the full name of the trust.
63.During the last five years, have you or your spouse created or contributed to any trust? If so, for each trust please state—
a.the date the trust was created;
b.a description of the property contributed;
c.the full name and complete address of each trustee; and
d.the full name and complete address of each beneficiary.
* 64.Does any person or entity owe you or your spouse money, including but not limited to promissory notes and accounts receivable? If so, for each debt please state—
a.the full name and complete address of the debtor; and
b.the amount and due date of the debt and to whom owed.
65.Has any account receivable of yours or your spouse’s been assigned or disposed of, other than by collection in full, in the last twelve months? If so, for each account please state—
a.the full name of the account;
b.the kind of disposition;
c.the date of the disposition;
d.the full name and complete address of the person or entity taking the account;
e.the amount of reserve due you or your spouse;
f.the extent to which future accounts receivable were covered;
g.the amount of payment received in exchange; and
h.the name(s) of the person(s) (you, your spouse, or both) who owned the account.
* 66.At any time in the last five years, have you or your spouse disposed of any personal property of a value of $100 or more by sale, gift, or other action? If so, for each disposition please state—
a.a full description of the property disposed of;
b.the date of the disposition;
c.the full name and complete address of each person or entity to whom disposition was made;
d.the payment or other consideration received in exchange;
e.the manner of disposition (gift, sale, etc.);
f.the date you or your spouse acquired the property;
g.the name of the person(s) (you, your spouse, or both) who owned the property;
h.the estimated market value of the property when you or your spouse acquired it; and
i.the contents of any gift tax return filed in connection with the disposition, copying the return verbatim or, if you will do so without a court order, attaching a copy of the return to your answers.
67.Have you or your spouse ever made any conveyance, transfer, gift, or other disposition of property with any reservation of rights, benefits, or options for the reacquisition of the property at some future date? If so, for each disposition please state—
a.a full description of the property involved;
b.the date of the disposition;
c.the full name and complete address of the transferee;
d.the nature of the reservation, benefit, or option;
e.the cost of the property when you or your spouse acquired it;
f.the market value of the property at the time of disposition or the payment or other consideration received in exchange; and
g.the name(s) of the person(s) (you, your spouse, or both) making the transfer.
* 68.At any time in the last five years, have you or your spouse disposed of any real estate by sale, gift, or other action? If so, for each disposition please state—
a.a full description of the property disposed of;
b.the date of the disposition;
c.the full name and complete address of each person or entity involved in the transaction;
d.the payment or other consideration received in exchange;
e.the manner of disposition (gift, sale, etc.);
f.the contents of any gift tax return filed in connection with the disposition, copying the return verbatim or, if you will do so without a court order, attaching a copy of the return to your answers; and
g.the name(s) of the person(s) (you, your spouse, or both) making the disposition.
69.At any time in the last five years, have you or your spouse transferred any real estate or personal property to any other person or entity in exchange for a promise of future support? If so, for each transfer please state—
a.a full description of the property transferred;
b.the date the transfer occurred;
c.the full name and complete address of each person or entity to whom the transfer was made;
d.a detailed description of the transaction; and
e.the name(s) of the person(s) (you, your spouse, or both) making the transfer.
70.At any time in the last five years, have you or your spouse suffered any casualty loss from fire, wind, theft, or any other cause? If so, for each loss please state—
a.a complete description of the property lost or damaged;
b.the date of the loss;
c.the cause, nature, and amount of the loss;
d.whether the loss was covered by insurance and, if it was, the name of the insurance carrier, the policy limits, and whether any claim was filed;
e.if a claim was filed, the amount of the claim, the full name and address of the agent who processed it, and how much of the claim was paid; and
f.in whose name(s) (you, your spouse, or both) the lost or damaged property was held.
71.At any time in the last five years, have you or your spouse made any agreement by which some entity or other person was granted an option to buy any assets of yours or your spouse’s? If so, for each agreement please state—
a.the date of the agreement;
b.the full name and complete address of each party to the agreement;
c.the payment or other consideration you or your spouse received in exchange for the agreement;
d.a complete description of the property covered by the agreement and the name(s) of the person(s) (you, your spouse, or both) in whose name the property was held; and
e.the terms of the agreement, copying it verbatim or, if you will do so without a court order, attaching a copy of the agreement to your answers.
72.Have you or your spouse ever been a plaintiff or defendant in a lawsuit? If so, for each suit please state—
a.the party designation (plaintiff, defendant, etc.) of you or your spouse;
b.the names of the parties under which the suit was filed and indexed and the number of the suit;
c.the name, number, and location of the court;
d.the date the suit was filed;
e.the damages and other relief sought by each party;
f.the amount of any settlement offer in the case;
g.the present status of the suit; and
h.the amount of any judgment entered against you or your spouse, the date it was entered, and the name(s) of the person(s) (you, your spouse, or both) against whom it was entered.
* 73.Is there any judgment against you or your spouse that is unpaid? If there is, for each unpaid judgment please state—
a.the date of the judgment;
b.the amount of the judgment and how much remains unpaid;
c.the name of the plaintiff having the judgment against either or both of you;
d.the name of the present holder of the judgment if different from the plaintiff;
e.the name, number, and location of the court in which the judgment was obtained;
f.the cause number of the judgment;
g.the name of each county and the volume and page numbers of each record book where it is recorded; and
h.the name(s) of the person(s) (you, your spouse, or both) against whom it was entered.
74.Have you or your spouse ever filed a petition in a bankruptcy proceeding, entered into an assignment for the benefit of creditors, or been a party to a composition agreement? If so, for each such occurrence please state—
a.the nature of the proceeding or agreement;
b.the date the proceeding began or the agreement was made;
c.the name, number, and location of any court that was involved;
d.the disposition or present status of the proceeding or agreement; and
e.the name(s) of the person(s) (you, your spouse, or both) involved.
75.Has any person or entity ever filed an insolvency proceeding against you or your spouse (including a state receivership action or federal bankruptcy proceeding)? If so, for each proceeding please state—
a.the full name and complete address of the person or entity that filed it;
b.the date it was filed;
c.the name, number, and location of the court in which it was filed;
d.the grounds alleged;
e.the disposition of the proceeding or its present status; and
f.the name(s) of the person(s) (you, your spouse, or both) against whom it was filed.
* 76.Do you or your spouse now keep, or have you kept at any time in the last five years, any records (including but not limited to checkbooks, books, ledgers, memoranda, other written documents, tape recordings, and computer records) of receipts, disbursements, and other business or personal transactions, including those of any business you or your spouse now operates or has operated? If so, for each set of records pertaining to any part of the last five years please state—
a.the name(s) of the person(s) (you, your spouse, or both) or business whose records are or were kept;
b.the form in which they are or were kept;
c.when they were first maintained;
d.the accounting basis (cash or accrual) used;
e.whether a bookkeeper or accountant is now being used and, if so, his or her full name and complete address;
f.the full name and complete address of each person or entity that prepared them;
g.the full name and complete address of each person now having custody of them;
h.the complete address of each location of any such records;
i.whether the records accurately reflect the income reported in federal income tax returns for you, your spouse, and any business either of you now operates or has operated, for each year during which the records were kept; and
j.the contents of these records, copying them verbatim or, if you will do so without a court order, attaching copies of them to your answers. If the records amount to more than one hundred pages for all sets, you may comply by stating that you will permit inspection or make them available without a court order.
77.Has any record relating to your or your spouse’s income, disbursements, or business been stolen or disposed of in the last five years? If so, for each disposition please state—
a.the nature of the disposition, such as theft or intentional destruction;
b.the date of the disposition;
c.the reason for the disposition;
d.the full name and complete address of the person making the disposition; and
e.if theft occurred, whether it was reported to the police.
78.Are you or your spouse presently entitled to receive any money from a governmental office, such as a utility deposit or income tax refund? If so, for each payment please state—
a.the full name and complete address of the office owing the money;
b.the reason you are owed the money;
c.the amount owed;
d.the date it will be paid; and
e.the name(s) of the person(s) (you, your spouse, or both) to whom it is owed.
* 79.At any time in the last five years, has anyone taken an inventory of your or your spouse’s property, either personal or business? If so, for each inventory please state—
a.the date of the inventory;
b.the name and complete address of each person who made the inventory or supervised it;
c.the name and complete address of each person or entity having a copy of the inventory;
d.the contents of the inventory, copying it verbatim or, if you will do so without a court order, attaching a copy of the inventory to your answers; and
e.the name(s) of the person(s) (you, your spouse, or both) whose property was inventoried.
80.Has any written inventory relating to your or your spouse’s business been stolen or disposed of in the last five years? If so, for each disposition please state—
a.the nature of the disposition, such as theft or intentional destruction;
b.the date of the disposition;
c.the reason for the disposition;
d.the full name and complete address of the person making the disposition;
e.if theft occurred, whether it was reported to the police; and
f.the name(s) of the person(s) (you, your spouse, or both) whose inventory was disposed of.
* 81.Do you claim that any real estate or personal property of yours or your spouse’s is exempt from the claims of creditors? If so, for each piece of property claimed to be exempt please state—
a.the legal and common descriptions of the property;
b.the present estimated value of the property;
c.your reason for claiming the property is exempt;
d.the nature of the property, describing it as either “rural” or “urban” if it is real estate;
e.the complete address of its location;
f.the amount paid for the property when acquired by you or your spouse; and
g.the name(s) of the person(s) (you, your spouse, or both) owning or having an interest in the property.
* 82.Do you or your spouse have an interest in a pension plan, retirement fund, annuity fund, or profit-sharing plan? If so, for each interest please state—
a.the full name and complete address of the administrator of the plan or, if you cannot provide that information, the full name and address of the employer through which the plan is provided;
b.the present value of the interest that you or your spouse has in the plan;
c.a detailed description of the terms under which you or your spouse may receive money or property under the plan; and
d.the name(s) of the person(s) (you or your spouse) having the interest.
83.At any time in the last five years, have you or your spouse used the services of an accountant, bookkeeper, or certified public accountant or had these services employed in behalf of you or your spouse? If so, for each such person please state—
a.the full name and complete address of the person;
b.the dates during which the services were employed;
c.a description of the services the person performed;
d.the contents of resulting reports, copying them verbatim or, if you will do so without a court order, attaching a copy of each report to your answers; and
e.the name(s) of the person(s) (you, your spouse, or both) for whom the services were performed.
84.Do you or your spouse have any charge accounts or credit cards? If so, for each please state—
a.the full name and complete address of the establishment carrying the account or issuing the card;
b.the account number or credit card number;
c.the name in which the account or card is listed; and
d.the balance now owed on the account or card.
85.Is any state or federal tax lien filed or outstanding against you or your spouse? If so, for each lien please state—
a.the name(s) of the person(s) (you, your spouse, or both) against whom the lien applies;
b.the date the lien was filed or became effective;
c.the kind of tax from which the lien arose; and
d.the date and amount of each payment made to reduce the lien.
86.Please state all reasons why you have not paid your debt to [name of judgment creditor].
87.If [name of judgment creditor] is willing to accept less than the full amount of the claim against you, how much money would you be able and willing to pay to [name of judgment creditor] within the next thirty days to settle this matter?
88.If arrangements for a lump-sum settlement cannot be made, please state when you could start making monthly or other periodic payments and how much you are able and willing to pay each month toward satisfying your debt to [name of judgment creditor].
89.Why are you unable or unwilling to pay more than the amount you listed in the answers to questions 87. and 88.?
[Name of debtor]
SIGNED under oath before me on ___________________________________.
Notary Public, State of Texas