Please complete in full. We will call back at the time you tell us is best for you and give you a free phone consult along with setting up an office appointment at that time.
You will still have to fill out a packet of bankruptcy forms in our office. Including time to complete our forms, our consultations generally last one hour.
Background
Your Full Name
Your Spouse’s Full Name
City Of Residence
Primary Phone Number
Secondary Phone Number
Your Email
Gender Male Female
Marital Status ---SingleMarriedDivorcedWidowedSeparatedEngaged
If Married, Provide How You Will File Bankruptcy ---Jointly With SpouseAlone, Without SpouseUncertain If Jointly With Spouse
Number Of Dependents (Not You Or Your Spouse)
Provide Dates And Chapters Filed Under For Prior Bankruptcy Filings If No Priors, Enter "None"
Income
Provide Your Yearly Gross Income Before Deductions And Job Title
Provide Your Spouse's Yearly Gross Income Before Deductions And Job Title
Provide Monthly Amount And Description For Any Income Outside Employment
Property And Debts
Provide Number Of Real Estate Properties You Own (Houses, Land, Etc.)
Provide The Amount of Equity You Have In All Real Estate Combined
Lawsuits ---I Have NO Lawsuits Against MeI Have Lawsuits Against MeI Have Lawsuits And Garnishments Against Me
Provide The Number Of Financed Or Leased Vehicles You Have
Provide The Number Of Paid In Full Vehicles You Have
Provide Description And Value For Any Large Assets You Own (Over $3,000 Value) Other Than Real Estate And Vehicles Already Disclosed
Provide Description And Estimated Total For Your Debts Other Than Mortgages And Vehicle Loans For Property Already Disclosed
Contact
Provide The Best Time And Day For Us To Contact You
Provide How You Heard About Us If Online, Please Provide The Website
Your Name (required)
Your City
Your Phone (required)
Best Time To Reach You
How Did You Hear About Us?
