Questionnaire #8 - Vehicles

Please enter all vehicles that you own or titled in your name.

Questionnaire 8 - Vehicles

Name

Phone

Email Address

This questionnaire is for:

	No vehicle. Check and submit
	No vehicle I own has a lien. Check and submit.
	My vehicle(s) with a lien/loan.

Vehicle Make

Vehicle Model

Vehicle Year

Color

Estimated Mileage

List Any Repairs Needed

Who has interest in the property?

	Debtor 1 only
	Debtor 2 only
	Debtor 1 or 2 only
	At least one of the debtors and others

Current Value of the Entire Property ---- Do not deduct secured claims or exemptions.

Current Value of the portion YOU own? If you are joint owner, do not include their share.

Is this community property

	Yes.
	No.

Agreement

	Lease
	Purchase

Date Debt Incurred

Lienholder Name

Lienholder Address

Lien Holder Zip Code

Balance owed the lein holder.

Will you claim this property as exempt on Schedule C?

	NO
	YES.

Amount of exemption you claim (100% or amount) & Specific laws that allow exemption

My intentions for a vehicle I am purchasing

	I am leasing - this is not a purchase.
	I will surrender the property.
	Retain the property and redeem it.
	Retain the property and enter into a reaffirmation agreement.
	Retain the property and reaffirm the debt for fair market value.

Please enter the word that you see below.

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Rica Gilmore, 757-932-RICA, VA #0225235314 GA #401322

Lance Mason, 478-744-1257 GA Real Estate Agent #428771

Sean Gilmore, VA Real Estate Agent #0225246258

Laurinda Mason, Project Manager and Transaction Coordinator

FIRM - Rica Realty VA #0226034555

FIRM - Rica Gilmore Realty GA #81053

144 Shoe Lane, Newport News, VA 23606 - 1 (757) 932-RICA

Current Affiliates Business Arrangements and Family Businesses

Rica Gilmore is a Morty Loan Originator

NMLS ID# 2549170 Morty's NMLS ID# 1429243

Rica Realty is a family business and agents are related.

This website contains information related to law and is NOT LEGAL advice. It contents is for information only. If you need legal advice, please consult an attorney or act as your own.