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E9. During the last 3 years, how many traffic accidents have you been involved in where you . <br /> were the driver? (INCLUDE ALL ACCIDENTS OCCURRING DURING THE LAST 3 YEARS, REGARDLESS <br /> OF WHO WAS AT FAULT,AND WHETHER OR NOT THE ACCIDENT WAS REPORTED TO A LAW <br /> ENFORCEMENT AGENCY.INCLUDE ACCIDENTS OCCURRING IN THE COURSE OF EMPLOYMENT.) <br /> a. None <br /> b. 1 <br /> c. 2 <br /> d. 3 <br /> e. 4 <br /> f. 5ormore <br /> E10. Have you ever been the driver in a traffic accident in which there was a serious injury or <br /> fatality(regardless of who was a fault)? <br /> a. No <br /> b. Yes, 1 time <br /> c. Yes, 2 times <br /> d. Yes, 3 or more times <br /> El 1. Have you ever left the scene of an accident in which you were involved (hit and run)? <br /> a. No <br /> b. Yes <br /> E12. Do you have any outstanding traffic warrants today(including warrants for outstanding <br /> parking tickets)? <br /> a. No <br /> b. Yes <br /> El 3. Do you carry auto insurance, or have a deposit on file with the Department of Motor <br /> Vehicles in lieu of auto insurance, on all of the vehicles that you own and operate? <br /> a. No <br /> b. Yes <br /> FINANCIAL HISTORY <br /> Note: Your answers to the following questions about your financial history may be verified by <br /> checks of records kept by police agencies, courts, financial institutions, credit reporting agencies, <br /> and collection agencies, by checks of your income tax returns and other legal documents, and <br /> through interviews with persons acquainted with you. If you deliberately give false or misleading <br /> answers, you may be disqualified. <br /> Fl. Are you able to pay all of your monthly bills, on time? <br /> a. Almost always <br /> b. Most of the time <br /> c. Some of the time <br /> d. Almost never <br /> Have you ever had any of the following financial problems: <br /> F2. ...chapter 7 bankruptcy(where all your debts were excused)? <br /> a. No <br /> b. Yes <br /> • <br /> PSS/LEPS PLLC 71 <br />