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Bankruptcy Intake Form

Have either you or your spouse ever filed bankruptcy? If so, please tell us the year(s) and type(s) of bankruptcy that was filed.
Here are some common reasons why people consider filing bankruptcy: repossession of personal property, foreclosures of real property, lawsuits, behind on credit card bills, store card bills, personal loans, student loans, child support obligations, auto loans, income taxes or medical bills. Let us know if any of these apply to you. Please tell us why you are considering bankruptcy.
If you are behind on your bills, please tell us what those bills are and how much you owe.
Please estimate the amount of your total bills or debts.
Please list your family’s source(s) of income and the amount(s) you receive per month.
Please describe any real estate property you own, including its location, present day value and whether there is a mortgage on the property.
If you have a mortgage on your real estate property, please tell us the year the mortgage was incurred, the original amount of the loan, the amount of your monthly mortgage payment and whether you are behind with your mortgage.
When is the last time you made a payment on this mortgage?
Is This property currently in foreclosure?
If you are behind with your mortgage, please tell us the month and year of when you made the last mortgage payment and if the property is in foreclosure.
Please tell us the make, model, year and mileage of your vehicle(s).
If you have an auto loan on your vehicle(s), please tell us the amount of your monthly obligation and whether you are current with the loan.