HOME PAGE

 BANKRUPTCY CONSULT FORM FOR INDIVIDUALS

Please complete the form below and schedule your appointment:

**If you prefer not to submit your information online, you may  print out the forms to complete and return.  (The print-out forms are a bit more detailed, which can be beneficial if you have variable incomes).    You do not need to complete the form below online if you choose to print out and return the forms in this paragraph.

Be sure to complete all fields that have asterisks (*) or else the form will not submit.  If you are not taken to the appointments page after you press “submit”, then your information was not sent.


(you may save and continue later at any time!   Just scroll to the bottom to save)

*=required field

  • Be sure to enter your e-mail accurately as you will receive important instructions and notifications.
    This is really important to me, so if you can also let me know below what search terms you used to find me and any other related information it will be appreciated!
  • (Please be specific. This information is extremely important for the marketing and survival of my business.)
    Check as many as apply
  • (Include Spouse Debt if Married)
  • ("secured" means things like mortgages and car loans)
  • Total average amount you receive before taxes and other deductions.
  • (Include income for spouse if married. Gross means BEFORE taxes and expenses are deducted.)
  • (This should NOT include credit card payments, but should include all living expenses such as mortgage/rent, food, insurance, support, vehicle payments, gas, maintenance, medical, business expenses, etc.)
  • Please list any other information you wish me to have, or additional explanations for answers you gave above.
  • Max. file size: 50 MB.
    If you want to attach any files (such as spreadsheets, profit and loss statements), you may do so here.

Important:  If you do not receive an e-mail confirmation after you submit this form, it means I did not receive it.  In that case, you should resubmit and be sure you have filled in all the required fields and clicked the “SUBMIT” button at the bottom.