Web Evaluation Please complete in full. We will call back at the time you tell us is bestfor you and give you a free phone consult along with setting up an officeappointment 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 lastone hour. Background Your Full Name Your Spouse’s Full Name City Of Residence Primary Phone Number Secondary Phone Number Your Email Gender MaleFemale Marital Status —Please choose an option—SingleMarriedDivorcedWidowedSeparatedEngaged If Married, Provide How You Will File Bankruptcy —Please choose an option—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 —Please choose an option—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 How Did You Hear About Us? —Please choose an option—GoogleYahooBingReferred by Client or Other AttorneyYellow PagesYP.comOther Δ
