Means Test Inputs Worksheet

# Means Test Inputs Worksheet

Organizes a debtor's information into the inputs the attorney needs to run the means test, with every gap and judgment call flagged. It collects inputs only; it does not compute or conclude eligibility.

## What to ask for
- Client intake notes or questionnaire, pay stubs, bank statements, tax returns, benefit statements, business profit and loss, and debt statements.
- The planned filing month (it sets the lookback window) and the state and county of residence.
- Who lives in the household and how expenses are shared.
- If something isn't in the material, build the worksheet and mark each gap as [MISSING: ...].

## How to work
1. **Filing date and lookback.** Record the planned filing month and list the months in the lookback period as a draft (commonly the six full calendar months before filing; to verify). If the filing month may move, note that the window and the figures move with it.
2. **Household.** List everyone in the household with relationship and age, and whether each is financially part of the household. Flag judgment calls for the attorney: part-time custody, adult children, roommates, a non-filing spouse, dependents living elsewhere.
3. **Debt type.** Note whether debts appear primarily consumer or business, with the facts behind it. Flag if it's close or unclear; the attorney decides whether the test applies.
4. **Income by source and month.** One row per source, one column per lookback month: wages (gross), overtime and bonuses, self-employment or business income (gross receipts and ordinary expenses separately), rental income, interest and dividends, pensions and retirement, unemployment, alimony or support received, regular contributions from others toward household expenses, and other. Copy from documents; note which document supports each figure. List separately anything the client describes that may be excluded (certain government benefits) for the attorney to classify; don't decide exclusions.
5. **Non-filing spouse.** If married and the spouse isn't filing, list the spouse's income separately and any amounts the client says the spouse spends only on their own obligations (marital adjustment candidates), with proof.
6. **Expense categories.** Gather actual figures and facts for categories that use standards or actual amounts: housing and utilities (rent or mortgage), vehicle ownership and operation (number of vehicles, loan payments, public transit), health insurance and out-of-pocket health costs, taxes withheld, mandatory payroll deductions (required retirement, union dues), term life insurance, court-ordered payments, child care, education for a child, special needs dependents, charitable contributions, and continuing care for a family member. Don't apply standard amounts; mark that the attorney will apply the current figures.
7. **Secured debts.** For each: creditor, collateral, monthly contractual payment, months remaining, arrears, and whether the client intends to keep the collateral.
8. **Priority debts.** Recent income taxes, domestic support obligations, and other claims the attorney may treat as priority, with amounts as stated.
9. **Gaps and irregularities.** Flag missing months, cash income without records, one-time spikes (bonus, tax refund, sale of property) that fall in the window, changes in job or income since the window, and anything that may support or undercut special circumstances.

## Output

**Means Test Inputs: [Debtor(s)]**  State/County: [ ]  Planned filing month: [ ]

1. **Snapshot** (3-4 lines): household size as reported, income sources, consumer/business debt note, biggest gaps.
2. **Lookback months** (list, marked to verify)
3. **Household** table: Name | Relationship | Age | In household? | Notes for attorney
4. **Income by month** table: Source | Earner | Month 1 ... Month 6 | Supporting document | Notes
5. **Possible exclusions or questions** (bullets, for attorney classification)
6. **Expense inputs** table: Category | Actual amount or fact | Proof on file | Notes
7. **Secured debts** table: Creditor | Collateral | Monthly payment | Months left | Arrears | Keep?
8. **Priority debts** table: Creditor | Type | Amount | Period | Proof
9. **Missing items** (numbered, as requests to the client)
10. **To verify** (lookback window, current median income and standard expense figures, household size treatment, exclusions, special circumstances)

## Rules
- Draft for attorney review; not legal advice and not an eligibility determination.
- Don't compute current monthly income totals against median figures, apply standard expenses, or state whether the client passes. List the inputs; the attorney runs the test.
- Median income figures, standard expense amounts and lookback rules change: list them under "To verify", never state them as current.
- Never invent income figures, months or debts. Copy from documents and note the source; unknown = [MISSING].
- Never include full SSNs or account numbers; use last four digits only if the attorney needs to match an account.