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Online Intake Form

If you have not yet spoken with a lawyer from Vanden Bos & Chapman, please submit a Snapshot Analysis before using the OnLine intake form. A lawyer will call you at no cost to you to discuss the information in the Snapshot Analysis. After you have a conversation with the lawyer, the decision can be made whether you should proceed with submission of a full Online Intake form. If you are asked to submit a full Intake Form, and would like to fill out your Intake Form online, please fill in your name, email address, and phone number, below. Within two business days, we will send you a link to the OnLine Intake form. If you do not receive an email from our firm with the link and login instructions within this time frame, please call our office at (503) 241-4869.

Name: (*)
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Form Verification (*)

Please type the word you see above into the field below.

Which Intake Form Should I Use?

Intake Form #1 - For Consumer Chapter 7 or 13
Word Format | PDF Format (Not Fillable)

Use this form if you (and spouse) are individual consumers who HAVE NOT owned or operated a business in the last six years. If you own any rental properties, you must use Intake Form #2.

Intake Form #2 - Business or Sole Proprietor Chapter 7 or 13
Word Format | PDF Format (Not Fillable)

Use this form if you (and spouse) are individuals who currently operate or have operated a business in the last six years. A "business" includes the activity of owning and renting real estate.

Intake Form #3 - Corporate/Partnership/Limited Liability Company Chapter 7
Word Format | PDF Format (Not Fillable)

Use this form if the Debtor is a Corporation, Partnership, or Limited Liability Company.

Additional Intake Form Pages

1. Real Estate - Intake No. 1Word FormatPDF Format (Not Fillable)
2. Real Estate - Intake No. 2Word FormatPDF Format (Not Fillable)
3. Real Estate - Intake No. 3Word FormatPDF Format (Not Fillable)
4. Bank AccountsWord FormatPDF Format (Not Fillable)
Creditors & Debts
1. Creditors Secured by Real PropertyWord FormatPDF Format (Not Fillable)
2. Creditors Secured by Personal PropertyWord FormatPDF Format (Not Fillable)
3. Employee CreditorsWord FormatPDF Format (Not Fillable)
4. Unsecured CreditorsWord FormatPDF Format (Not Fillable)
Leases or Contracts
Leases or ContractsWord FormatPDF Format (Not Fillable)
Statement of Financial Affairs
Question 4a: Suits /GarnishmentsWord FormatPDF Format (Not Fillable)
Question 10: Sales/TransfersWord FormatPDF Format (Not Fillable)
Question 18: Business Names/LocationsWord FormatPDF Format (Not Fillable)

Instructions For Completing Consumer Bankruptcy Intake Form

Please read and follow the following instructions carefully when completing your bankruptcy intake form.

  1. To begin, click on the appropriate form above for your case type. The forms are available in two formats - a Word document or a PDF file. If you would like to type in your answers and then print the form, please choose the Word document option. If you would like to print out the form and fill in your answers by hand, please choose the PDF option. Please note, these PDF forms are not fillable - unless you have Adobe Acrobat, you will not be able to save your answers if you type them in to the PDF form.
  2. Please answer all questions. If the question does not apply to you, fill in the initials "N/A" ("not applicable") so that we know that you have read the question and decided it does not apply. The information requested by these questions is required information for the completion of your bankruptcy petition and schedules.
  3. You must list every creditor. You may not pick and choose. The law requires that you schedule every creditor, even if your intention is to pay that creditor later voluntarily. Failure to list a known creditor is grounds for disqualifying your bankruptcy and denying you a discharge. Please include the complete address for each creditor, including the zip code. The exact amount owing is not critical, just use your best estimate.
  4. If you accidentally leave out a creditor, in most cases we should be able to file an amendment to add the creditor later, but there are additional fees and court costs for filing amendments.
  5. All assets must be listed. You do not need to individually itemize small items of insignificant value (such as knives, forks, plates, dishes, etc.). It is acceptable to simply refer to broad categories of goods, such as "household goods, tools, clothing, etc."
  6. When determining the value of your property, you should be aware that the Bankruptcy Court uses liquidation value as the accepted measure of valuation. Indicate property values based on what the property would be sold for on a quick sale, "as, is – where, is." These are garage sale, flea market, or pawn shop type prices. Do not use replacement values. Do not use insurance coverage values. For real property values, you may indicate the real market value shown on your most recent county tax statement. If you have any recent appraisals, you should disclose those appraisals to your attorney and bring them with you to your initial appointment. If you have any comparative market evaluations provided by a real estate agent or have listed your house for sale in the last 24 months, you should bring those documents with you to your appointment.
  7. Because the year in which taxes became due is critical for us to determine whether the taxes might be dischargeable or not, it is essential that you segregate your tax debts by each year and the amount owed for each year. We may ask you to sign a tax power of attorney form so the tax agencies will confirm the dates of filing of your tax returns and the amounts of any unpaid assessments.
  8. Please write or print as neatly as possible. Our staff will be typing your information into our software. There is less chance for error in the transcription of your information if it is legibly written.
  9. If you have questions about how to complete the information requested on the intake forms, please contact one of our legal assistants: Amy Sinclair, Sara Parker, or Jennifer Houck at 503-241-4869. The legal assistants are not lawyers and cannot give you legal advice. If your questions go beyond how to complete the form, the legal assistant may need to refer you to an attorney. If your question is a legal issue, you should contact one of the attorneys directly.
  10. Bring the completed questionnaire with you to your initial appointment. If you are unable to complete the full intake form prior to your initial appointment, we may ask you to reschedule or you may be asked to complete our bankruptcy "Snapshot Analysis" before meeting with the attorney. We want the initial meeting to be a productive use of both your time and our time. Our experience tells us that completion of the intake form in advance of the meeting will help accomplish that goal.