Bankruptcy Questionnaire

This submission will be kept strictly confidential.

I charge a $100 fee for consumer bankruptcy consultations.  During a consultation I will listen to your story, analyze lawsuit or foreclosure documents, and lay out all your options--both in and out of the bankruptcy system.  You will not get a sales pitch, but honest, straightforward advice, even if bankruptcy is not the choice right for you.  After the consultation, you will have received the advice you need to move forward confidently and resolve your debt problems.  Clients who retain me within seven days of the initial consultation also receive a credit towards their legal fees for the amount of the consultation fee.
 

Your Contact Information:
Your First Name:
Your Last Name:
City or Town in Massachusetts where you live:
Phone Number (Best one to reach you at):
Email:
Your Debts:
How much do you estimate owe on credit cards and store cards? $
Do you owe any personal loans? If so, please estimate the total. $
Do you owe any tax debts? If so, please estimate how much. $
Do you owe any back medical bills? If so, please estimate the total. $
Do you owe any student loans? If so, please estimate the total. $
Do you owe any other debts (besides current car loans)? If so, please describe and estimate the total.    
$
Have you ever been sued for a debt? Yes No
Are you being harassed by creditors or collection agencies? Yes No
Your Property: (Note: If properly represented by an attorney, most people keep all their property in a bankruptcy.)
Do you own a house or condo? Yes No
Do you own a car or other motor vehicle? Yes No
Are you behind on any house, car, or other secured debt payments? Yes No
Your Income and Family:
What is your annual income? $
Are you married? Yes No
If you have children, how many are under 18?
Options:
Do you know what type of bankruptcy you would prefer to file? Chapter 7 Chapter 13 I don't know