Name: Utah Bankruptcy Professionals
Address: 9227 1300 E, Sandy, UT, 84094
Telephone: (801) 501-0100

This is the first form required by the Bankruptcy Court to initiate your bankruptcy case. Complete all boxes with the information requested, then use the submit button once to send the information to us. Alternatively, you can hit the browser print button to print a hard copy for your records before you submit it, or to bring with you to our offices.
IMPORTANT: if filing a Joint application, please enter husband's information first.
PART A. NAME AND ADDRESS
Last Name*
First Name*
Middle Name
Home Phone*
Work Phone
Your Email*
Have you used any other names in the past six years?*
Other Names*
Address*
Street Address Address Line 2 City State ZIP Code
Have you lived at this address for at least 180 days?*
If you have a different Mailing address please list
Street Address Address Line 2 City State ZIP Code

PART B. NAME AND ADDRESS OF SPOUSE
Spouses Name
First Middle Last
Has your spouse used any other names in the past six years?*
Other Names*
Does your spouse have a different address?*
Address (if different from your address)
Street Address Address Line 2 City State ZIP Code
Does your spouse have a different mailing address?*
If your spouse has a different mailing address, please list
Street Address Address Line 2 City State ZIP Code

PART C. PRIOR/PENDING BANKRUPTCY CASES
Has a bankruptcy case been filed by you or against you in the last 6 years?*
If yes, in which district of which state was the case filed?*
State
Case Number*
Date Filed*
MM slash DD slash YYYY
Are there currently any bankruptcy cases pending against you, your business, your spouse, or your spouse's business?*
If yes, name of debtor*
First Last
Relationship to you*
Case Number*
Date Filed*
MM slash DD slash YYYY
Name
First Last
Judge*

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