Bankruptcy Questionnaire

This submission will be kept strictly confidential.

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