Free Bankruptcy Consultation Information

First Name
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Last Name
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Spouse First Name
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Spouse Last Name
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Name of other party:
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Email address
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Name of county:
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Have you ever been sued?
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What is the full name or company name of the plaintiff?
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Please enter amount of damages from first lawsuit:
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Case number
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Have you been served in the first lawsuit?
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Have you lived in another state in the last 5 years?
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Any past bankruptcies?
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Date when last bankruptcy was filed:
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Are you married?
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How many people are in your household (including yourself)?
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Do you pay child support or alimony?
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Who earns this income?
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Where is this income from?
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Total annual income from this income:
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What is your approximate monthly gross income (before taxes)?
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What is your approximate bi-weekly gross income (before taxes)?
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How much do you make per hour (before taxes)?
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How many hours do you work per week?
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What is your current living situation?
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Other information you wish to add about this item, such as local property identification number
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Who has an interest in the property?
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Current value of the entire property
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The rental or home ownership expenses for your residence. Include the first mortgage payments and any rent for the ground or lot.
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Amount of claim (Do not deduct the value of collateral)
This refers to what you owe on the loan.
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Total amount past due on 1st mortgage
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Who has interest in this vehicle?
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Please enter the current value of the additional vehicle:
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Please enter the monthly payment amount on the additional vehicle
If not applicable, enter 0.
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Amount of claim (Do not deduct the value of collateral)
This refers to what you owe on the loan.
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If you claim this additional vehicle as exempt, what is the amount of the exemption you claim?
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Please describe the additional vehicle:
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Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property transferred in the ordinary course of your business or financial affairs?
Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property). Do not include gifts and transfers that you have already listed on this statement
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Are you going to receive any tax refunds?
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Approximately how much student loan debt do you have?
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Approximately how much unsecured debt such as medical, credit card and personal loans do you have? Please do not include auto or student loans.
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