Free Bankruptcy Evaluation. Bankruptcy Attorney Arlington, Tx.

Questionnaire for Free Online Bankruptcy Evaluation

Often when considering bankruptcy protection as an option, questions arise as to whether such an option is the best option. To determine whether bankruptcy protection is the right choice, you need reliable information. With the information you provide in the following questionnaire, we will provide you with a preliminary evaluation of your unique situation so that you can make an informed and intelligent choice.

The evaluation is CONFIDENTIAL and FREE, and you are under no obligation. And although we can provide you with a generally reliable evaluation of your bankruptcy options, you should be aware that there may be circumstances unique to your situation that may alter our recommendation.

By submitting the information requested in the following questionnaire, you and we understand and agree that the information shall be used solely for the purpose of conducting a preliminary evaluation of your legal options, that no attorney-client relationship is created until such time as you and we have agreed in writing to establish such a relationship, that the evaluation is made solely on the basis of the information submitted, and that we cannot guarantee that you will qualify for protection under any provision of the United States Bankruptcy Code.

Please submit the following information:

Name:
Address:
E-mail Address:
Phone:
Approximately what is the amount of your total debt, including your home mortgage and car payments?:
How much of your debt is secured by real estate or personal property?:
Are you in arrears on your mortgage payment or car payment?
If so, how many months?
How many persons are living in your household?
Of that number, how many are over the age of 65?
What are your average monthly GROSS earnings from your employment?
What deductions are withheld from your paycheck?
Federal Income Tax per month:	$
FICA per month:	$
Medicare per month:	$
Insurance per month:	$
Mandatory Retirement Contributions per month:	$
Union Dues per month:	$
Child/Domestic/Other Court-Ordered Support Payments per month:	$
Other (please specify) per month:	$
If you are married, what is your spouse’s monthly GROSS earnings from her employment?	$
What deductions are withheld from your spouse’s paycheck?
Federal Income Tax	$
FICA	$
Medicare	$
Insurance	$
Mandatory Retirement Contributions	$
Union Dues	$
Child/Domestic/Other Court-Ordered Support Payments	$
Other (please specify)	$
If you have any other source of income, please specify the source and the average monthly amount received. [Examples: child support received, retirement income, social security disability income, unemployment benefits, etc.]
What is your monthly mortgage payment?	$
Are taxes and insurance included in your mortgage payment? If no, please state the annual amount of taxes and insurance that you are required to pay.
If you have a car payment, please state the amount of each payment and the total balance that you owe on the debt.
Do you owe any debt for student loans? If so, please state the total amount you owe and the current monthly payment obligation.
Do owe any tax, penalty or interest to the Internal Revenue Service for current or previous year(s) taxes. If so, please state separately the amount of tax owed, the amount of penalty owed, and the amount of interest owed.

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