BUSINESS QUESTIONNAIRE

Name: The Pope Firm
Address: 404 East Watauga Avenue, Johnson City, Tennessee, 37601, United States
Telephone: 14239297673
Price range: 0-5000

INSTRUCTIONS: Complete the entire form using additional pages if necessary. All financial information, unless otherwise stated, is to be as of the bankruptcy filing date.

IMPORTANT

This form, along with COPIES of all documents requested, must be provided to the trustee in a timely manner. Submit all documents to your attorney. Your attorney must submit the material to the Trustee’s office one week prior to the section 341 meeting of creditors. Failure to supply information will result in the Trustee objecting to the confirmation of the case. INFORMATION SUPPLIED TO THE TRUSTEE WILL BE RETAINED AS PART OF THE CASE FILE. DO NOT SEND ORIGINAL INFORMATION.

BUSINESS QUESTIONNAIRE

INSTRUCTIONS: Complete the entire form using additional pages if necessary. All financial information, unless otherwise stated, is to be as of the bankruptcy filing date.
IMPORTANT

This form, along with COPIES of all documents requested, must be provided to the trustee in a timely manner. Submit all documents to your attorney. Your attorney must submit the material to the Trustee’s office one week prior to the section 341 meeting of creditors. Failure to supply information will result in the Trustee objecting to the confirmation of the case. INFORMATION SUPPLIED TO THE TRUSTEE WILL BE RETAINED AS PART OF THE CASE FILE. DO NOT SEND ORIGINAL INFORMATION.
Name of Business :
Address of Business:
Description of Business Activities:
1) If the business conducts construction related work and/or activities, does the business contract jobs in excess of $25,000?
2) Does the business engage in the wholesale and/or retail sale of goods?
If yes, attach copies of prior year sales tax returns.
Drop files here or

Max. file size: 32 MB.
Type of Business Organization:
Sole Proprietor
Partnership (list all partners and percent of ownership)
Corporation
Date incorporated
MM slash DD slash YYYY
% of Stock owned
(attach list of all shareholders and stock ownership %’s) Date corporation dissolved
Max. file size: 32 MB.
Reason for dissolution
LLC
Other
Date business began
MM slash DD slash YYYY
Federal ID number (if applicable)
Business Tax Number
List business bank accounts (including account numbers):
QUESTIONNAIRE
1. Employees and/or sub-contractors:
A) Does the business have employees?
If yes, complete attached Schedule of Full and Part-time Employees.
Max. file size: 32 MB.
Does business withhold on these employees?
If so, attach copies of the two prior quarterly federal payroll tax returns (form 941). Also attach proof of payroll tax deposits for the same tax periods.
MM slash DD slash YYYY
B) Does the business hire sub-contractors?
If so, does the business issue 1099’s for its’ sub-contractors?
If yes, attach copies of prior year’s 1099’s. If no, explain why
Max. file size: 32 MB.
If yes, attach copies of prior year’s 1099’s. If no, explain why
2. What is the balance of the business accounts receivable (A/R)?
A) How many items make up the A/R? (approximate)
B) Does the business factor the A/R?
If yes, attach factoring agreement.
Max. file size: 32 MB.
C) How old are the receivables? (Supply aged list if numerous.)
D) What amount is reasonably collectible?
3. Is the business cyclical?
If so, list the busy season.
list the slow season
4. Does the business keep inventory on hand?
A) Sales tax ID#
B) What is average monthly value of inventory?
C) Do any vendors allow purchase of inventory on credit?
If yes, list all supplier and vendors who allow a revolving credit account.
D) Does business have a Line of Credit or Bank Loan?
If yes, name institution.
5. Does the company own or lease office space or other real property?
Address of property:
Monthly payment:
Term of payments or lease:
Date
MM slash DD slash YYYY
Date purchased or leased
Date purchase or lease due to expire
MM slash DD slash YYYY
If more than one property is owned and/or leased, attach additional schedule detailing the above information for all properties.
6. Does the company lease business equipment or autos?
Description of leased/rented items
Monthly payment
Term of Lease
If more than one item, attach separate information for each lease.
Max. file size: 32 MB.
7. Does the business carry the following insurance policies? Attach copies of insurance binders for all policies.
Max. file size: 32 MB.
A) Commercial or General Liability?
Policy #
Current? Agent Name/Phone
B) Workman Compensation?
Policy #
Current? Agent Name/Phone
C) Automobile Coverage?
Policy #
Current? Agent Name/Phone
D) Other (list)
Policy #
Current? Agent Name/Phone
8. Is the business required to have any business licenses?
If yes, please list:
Are licenses current?
Attach copies of all current licenses. If no, attach list of delinquent licenses.
Max. file size: 32 MB.
Your Responsibility as a Business Debtor
If you have borrowed money from any creditor and as security or collateral for the loan you have pledged accounts receivables, rents, or other cash, you may not use the accounts receivables, rents or cash without express written consent from the creditor, or an order from the court allowing the use. Failure to obtain creditor consent or an order from the court before using these assets may result in severe penalties. During the course of your Bankruptcy it is your responsibility to pay any state and federal taxes on time. Failure to do so may result in severe penalties. In order to continue the operation of your business, it is your responsibility to obtain and maintain comprehensive liability insurance for the operation of your business.
DECLARATION UNDER PENALTY OF PERJURY BY DEBTOR
I (we) declare under penalty of Perjury that I(we) have answered all questions and provided all applicable documents pertaining to this business questionnaire in good faith and that said answers and documents are true and correct.
Name
Signature
Date
MM slash DD slash YYYY
Name
Signature
Date
MM slash DD slash YYYY
Upon review of submitted documentation, we may request additional financial information.
BUSINESS CASE CHECKLIST
Name
Case Number
Business Number
Schedule of Full and Part Time Employees
Schedule of Full and Part Time Employees
Employee Name Position/Function Salary or Hourly Rate P = Part time / F = Full time
Schedule of Sub-Contractors
Schedule of Sub-Contractors
Sub-Contractor Name Position/Function Pay Rate P = Part time / F = Full time
BUSINESS CASE CHECKLIST

Schedule of Business Assets
Name
Case #
Business Name
Schedule of Business Assets
Asset Description Date Aquired Original Cost Estimated Current Market Value Comments
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

BUSINESS QUESTIONNAIRE

BUSINESS QUESTIONNAIRE

IMPORTANT

BUSINESS QUESTIONNAIRE

IMPORTANT

Your Responsibility as a Business Debtor

DECLARATION UNDER PENALTY OF PERJURY BY DEBTOR

BUSINESS CASE CHECKLIST

Schedule of Full and Part Time Employees

Schedule of Sub-Contractors

BUSINESS CASE CHECKLIST

Our Offices

KINGSPORT

Phone: 423-426-9064

KNOXVILLE

Phone: 865-213-3617

JOHNSON CITY

Phone: 423-929-7673

Employee Name	Position/Function	Salary or Hourly Rate	P = Part time / F = Full time

Sub-Contractor Name	Position/Function	Pay Rate	P = Part time / F = Full time

Asset Description	Date Aquired	Original Cost	Estimated Current Market Value	Comments