Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
What County do you live in?
*
Marital Status
*
Single
Married
If married how will you be filing?
*
Jointly
Single w/o spouse
Do you have any children?
*
If you do have children how much do you pay in child support per month?
What is your estimated amount of debt?
*
Below $10,000
$10,000 - $30,000
$30,000 - $50,000
$50,000 - $70,000
$70,000 +
Do you owe debt to the IRS ?
*
What type of bankruptcy are you interested in filing?
*
Chapter 7 (credit card/medical debt)
Chapter 13 (foreclosure)
Have you filed bankruptcy in the past eight years?
*
If you have a roommate or live in partner please only include the expenses that you pay for per month.
If you are married and filing single, please note the non-filing's spouse income and expenses must be included in your monthly income and expenses breakdown below.
Please list all of your monthly expense i.e. rent, utilities, vehicle payment/insur., vehicle maintenance/registration, gasoline, phone/internet, food, chartiable contributions, all related living expenses (per month).
To qualify for a Chapter 7 filing your gross monthly income must be lower than your monthly expenses. After adding up all of your monthly expenses does the amount exceed your income?
*
Yes
No
If you have a mortgage, are you and your spouse’s name on the mortgage and deed? If not whose name is on the deed and mortgage note?
*
Mortgage
Have you gifted any money to anyone within the past two years?
*
If so who and was it over $600? Please describe below
Have you received a personal loan from a family member or friend in the past six months?
*
Please state below if you paid the loan back and if so when was it paid back?
Are you facing an eviction or expect to be evicted from your rental unit soon?
*
Do you have Paypal, Venmo, Zelle or any other similar money account?
*
If so state "Yes or No" please note this must state listed on your bankruptcy petition. These accounts are considered bank accounts.
Date
*
MM
DD
YYYY
