Chapter 13 Business Questionnaire

The chapter 13 business questionnaire contains specific questions related to bankruptcy of a business in the United States and should be in accordance with 11 U.S.C. Section 1302 C. The chapter 13 business questionnaire should be filled only by owners of a business and contains both personal and financial information.

Sample Chapter 13 Business Questionnaire:

Name of the Business: _____________________________

Address or Location: _____________________________


Name of the owner(s): ____________________________________________

Primary Product or Service: ____________________________

Federal ID: _______________________

  • Which of the following type of business classifies your business the best?

a)      Sole proprietor

b)      Partnership

c)      Limited liability company

d)     Corporation

e)      Sub S

f)       Others: ________________________ (Please Specify)

  • Do you operate your business from home? If answer is “no” then please mention if your business is operating from rented, leased, or own location

a)      Yes

b)      No

c)      Business operation location:________________________

  • How many employees are there in the organization?

a)      1-10

b)      11-30

c)      31-50

d)     More than 50

  • Do employees receive IR form 1099 and W-2?

a)      Yes

b)      No

  • Are you current on paying salaries to your employees? If answer is “no” then please state the amount of delinquency in $.

a)      Yes

b)      No

c)      Amount of Delinquency ($):_______________________

  • What is the nature of your business?

a)      Providing services: ___________________________ (Mention Services)

b)      Manufacturing Products: _______________________(Mention Products)

c)      Independent Contractor For: ________________________

d)     Real Estate or Insurance

e)      Others: ________________________________ (Please Specify)

  • Do you have any of the following insurance? Check against the insurance you possess and provide copies of the same.

a)      Worker’s compensation insurance

b)      Business operation liability insurance

c)      Vehicle insurance

d)     Real or personal property insurance

e)      Others: __________________________ (Please Specify)

Category: Business Questionnaire

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