If you have a legal need, call me at (773) 429-0400 for a FREE initial consultation. If you are struggling to make ends meet and you're up to your ears in debt, I may be able to help. I'm a consumer bankruptcy lawyer. I offer free initial consultations to discuss your situation and assess whether or not bankruptcy could be a viable option. Here are 3 easy steps to get started:
STEP 1: Copy the f
ollowing intake form into an email message and complete it (it's pretty short). Use your best efforts to estimate the answers to the questions. STEP 2: Send me the completed form at [email protected]. STEP 3: Let me know the days of the week and times when you are available to meet for your free consultation. If you need to meet in the evening or during the weekend, just let me know. My schedule is pretty flexible with enough advance notice. You can also call me at (773) 429-0400. PROSPECTIVE CLIENT BANKRUPTCY INTAKE FORM
Name:__________________________________________
Address:_____________________________
City, State, ZIP Code:_____________________________
(H) Phone:_______________ (W) Phone:_______________ (Cell ph.)_______________
Email:______________________________
DEBTS (note that you must list all your debts on your bankruptcy schedules: it's a crime to intentionally fail to do so! However, what you are filling out here are not your schedules, and are only to give me an idea of whether I can help you):
1. Secured:$ ____________(secured debts are like mortgages and car loans)
2. Unsecured:$__________ (these are like credit card debt, medical bills, and personal loans from family)
3. Tax Debt:$___________(these probably will not be discharged, but you have to list them anyway!)
4. Student Loans:$_______(you won't get these debts discharged, but you must list them anyway)
5. Child support or alimony: $_______(you won't get these debts discharged, but you must list them anyway)
6. Other Debts:$ _________
REAL ESTATE (real estate is “dirt” and what sits on it; like a house, or a building, or a vacant lot):
First Property
1. Home value:$_____________________(use Zillow.com to estimate value)
2. First mortgage: $_________ Monthly payment:$_______
3. Second mortgage: $_______ Monthly payment: $ ______
4. Foreclosure sale date (if any) :_______
Additional Properties (same questions apply)
MOTOR VEHICLES:
1. Monthly payment: $____________
2. Delinquency total: $___________
3. Current Value: $____________(use private party value on kbb.com)
4. Loan Payoff: $_____________
5. Equity (subtract the loan payoff from the current value): _________
Additional Vehicles (same questions apply; I'm particularly interested in how many cars you have, and how much equity you have in each car! If the title for a car driven by someone else is still in your name, list that car here, also.) INCOME:
1. Your monthly gross income from all sources: $___________(gross, that's before deductions)
2. Spouse’s monthly gross income from all sources: $_________(gross, that's before deductions)
3. Any Income from operation of a business?: $_______ (monthly after business expenses)
4. Number of People Living in Your Home: ____Are They Dependents on Your Taxes?______
EXPENSES:
1. Your monthly expenses: $___________
2. Spouse’s monthly expenses (if paid separately): $_________
BUSINESS OWNERSHIP ISSUES:
1. Do you own a business?
2. Have you just closed down your business? LITIGATION:
1. Are you currently involved in a lawsuit? ________
2. Has a judgment been entered against you? _________
3. Are you being garnished? __________
GENERAL CONSIDERATIONS:
1. Have you used any of your credit cards within the last 90 days? ____
2. Have made any payments to friends or relatives within the last year? _____________ Amount of payment: $_________ Date of payment: _______________
3. Have you ever filed bankruptcy before? ___________ If so, when? __________ What chapter? ___________
4. Have you lived in Illinois for a FULL two years? ____________
5. What made you decide to explore bankruptcy? __________________________
