Dempsey Foster Online Bankruptcy Intake
At Dempsey Foster, every potential case or attorney-client relationship starts with a consultation. This one-hour initial consultation can be conducted in person, over the phone, or via video call. We do charge a $200 fee for this consultation. Completing this form does not form an attorney-client relationship.
Your Full Legal Name
*
First and Middle Name
Last Name
Preferred name, if different
Different names you have used in the last eight years, if any:
Your Phone Number
*
-
Area Code
Phone Number
Phone is a:
Cell phone
Landline
Business phone
These are my cell phone texting preferences:
I DO consent to receiving text messages from Dempsey Foster
I DO NOT consent to receiving text messages from Dempsey Foster
Your Email Address
example@example.com
Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your age?
In order to know what state's law protects your property, we must know if you have lived in Idaho (or Malheur County, Oregon) for the last two, full, consecutive years. (With no breaks, even short ones, living in other states in that time.) In the last two full years, how long have you lived in Idaho (or Malheur County Oregon)?
Two full years or more
Less than two full years but more than 90 days
I have been back and forth between Idaho and another state in the last two years
I have lived in Idaho less than 90 days
It is complicated and I need to discuss with you
Different addresses you have lived at in the last four years and the approximate dates you lived there, if any. (If you can't recall the exact address, please list the city and state):
Back
Next
Your Spouse's Full Legal Name, if married
First and Middle Name
Last Name
Will your spouse be filling bankruptcy with you? (Whether or not your spouse is filing with you, please answer all the questions in the remainder of this questionnaire to include any money or property your spouse owns.)
Yes
No
Not sure
I’m not married
Spouse preferred name, if different
Different names your spouse has used in the last eight years, if any:
Your Spouse's Phone number
-
Area Code
Phone Number
Phone is a:
Landline
Cell phone
Business phone
Your Spouse's Email
example@example.com
Spouse's age
If different from you, how long has your spouse lived in Idaho (or Malhuer County Oregon)?
If different from you, different addresses your spouse has lived at in the last four years and the approximate dates they lived there, if any. (If they can't recall the exact address, please list the city and state):
Back
Next
How soon would you like to file your bankruptcy?
As soon as possible
I feel like it might be several months until I'm ready
I'm not sure
If you have filed bankruptcy before, what month and year?
Back
Next
How many people in your family do you support (including yourself, spouse, children, stepchildren, dependent adults)
If you work, what is your job and approximate GROSS monthly income (before taxes, social security, etc.)
If you work, what is your approximate NET monthly income (after taxes, social security, etc.)
If your spouse works, what is their job and approximate GROSS monthly income (before taxes, social security, etc.)
If your spouse works, what is their approximate NET monthly income (after taxes, social security, etc.
If you or your spouse do not currently work, but have worked within the last six months, what was your/their approximate GROSS monthly income (before taxes, social security, etc.) and what months did you/they work?
Have you or your spouse been unemployed 5 or more years of the last 10
I have been unemployed at least 5 years in the last 10
My spouse has been unemployed at least 5 years in the last 10
I/neither of us have been unemployed at least 5 years in the last 10
Do you or your spouse have a disability or chronic injury which limits the ability to work?
I do
Spouse does
Neither
Both
Is the gross amount of any paycheck from wages/salary that you or your spouse receive more than $2500 per paycheck?
Yes
No
Sometimes
Not applicable
Is any part of your wages (or your spouse's wages) related to a commission or regular bonus?
Yes
No
Not sure
If you (or your spouse) get money from something other than wages (such as child support, alimony, unemployment, social security, disability, etc.), what is that from and how much do you receive a month?
In the last three years, my family's income has come from the following (check all that apply):
Job
Business income
Bonuses/Commissions related to jobs
Retirement/pension
Child support
Worker's Comp
Disability/Social Security
Unemployment
Insurance or lawsuit settlements
Gifts (other than small holiday/birthday type amounts)
Gambling/lottery winnings
Inheritance or life insurance money
Other
Do you own your own business or have an ownership interest in someone else's business?
Yes
No
Not anymore but I have in the past
Not sure
Back
Next
Have you (or your current spouse) been divorced within the last 10 years?
Yes
No
Not sure
List the property that you (or your current spouse) were awarded in the divorce, if applicable
List property that the ex-spouse was awarded in the divorce, if applicable
If you signed over any property to your ex in the divorce (for example, signed a quitclaim deed for a house or changed the title of a vehicle, etc.), what property was that?
Were you assigned debts to pay in the divorce?
Yes, but they have been paid
Yes, and they have not been paid
No
Not applicable
Not sure
What was your ex-spouse's name?
Are you contemplating or currently involved with a divorce?
Yes
No
Back
Next
Have you been sued by any of your creditors?
Yes
No
Not yet sued but threatened with lawsuit
Other
If you have been sued, has it been more than 21 days since you were served those papers?
Yes
No
I'm not sure
Are you being garnished or levied? (check all that apply)
Currently garnished
Employer has been served papers for garnishment
Garnishment has occurred in the last year but is currently stopped
Creditors have threatened garnishment
Tax refund was taken
Money was taken (also called "levied) from my bank account
Paycheck was garnished by Child Support
Bank offset account to pay a debt you owed the bank
Have not been garnished or levied in the last year
Other
If you have been garnished or money taken in the last three months, who was/is garnishing you, how much did they take, and when did they take it?
Are you involved with, contemplating, or have any right to bring a lawsuit against anyone yourself?
Yes
No
Not sure
In the last four years, have you been in an auto accident, been injured in any sort of other accident, been injured at work, etc.? If so briefly describe those circumstances and any compensation you have received. If you have spoken to an attorney about any matter other than divorce or bankruptcy, who did you speak to and what did you speak to them about?
Back
Next
Do you have any of the following retirement accounts (check all that apply)
401k or similar retirement account
IRA
Pension
PERSI
Other
Have you contributed money to any retirement accounts within the last 10 years, OTHER than amounts withheld from your wages?
Yes
No
Not sure
Back
Next
What is your living situation?
Mortgage
Rent
Mobile Home/RV (own the land)
Mobile Home/RV (rent the land)
Other
If you rent, what is the amount of your security deposit, if any?
What is your monthly payment on your mortgage/rent?
Are you behind at all on your mortgage/rent?
Yes
No
Other
Have foreclosure or eviction proceedings been started against you?
Yes
No
n/a
Other
If you have a mortgage or own your home, what is the current market value of your property according to Zillow.com?
If you have a mortgage, what is the current balance on your mortgage (total, both first and second/equity line)
Other than a mortgage, are you aware of any liens against you personally or your property? (This might include judgment liens, mechanic's liens, medical indigent fund liens, HOA liens, tax liens, etc.)
Yes
No
I don't know
Other
Other than your home, do you own any other real estate? (Rentals, cabins, bare ground, timeshares, you have been added to the deed of someone else's property, etc.)
Yes
No
Other
In the last four years, have you done any of the following with respect to your real estate (check all that apply):
Purchased real estate
Sold real estate
Added someone else's name to the title/deed of your real estate
Modified a mortgage or requested a modification
Had a mortgage forebearance
Refinanced property
Taken out an equity line of credit or HELOC
Used real estate as collateral in any other way
Given any bank, person, or business a security interest in any of your property
Had real property foreclosed
Signed a quitclaim deed on property, whether or not you ever lived there
Received or had real property awarded to an ex spouse in a divorce
Had someone take over or pay a real estate loan for you
Other
Back
Next
How many vehicles do you own or are titled in your name? (Whether owned outright, making payments, or it is someone else's vehicle that you are on.) (Cars, trucks, boats, motorcycles, ATVs, UTVs, motorhomes, snowmobiles, trailers, utility trailers, travel trailers, etc.)
For each vehicle, please list the type, year, Kelley Bluebook (private sale) value from kbb.com, and current loan balance (if any):
If you owe money on a vehicle, what is your monthly payment?
Are you behind on any payments on any vehicle you own?
Yes
No
Not applicable
Not sure
Approximately how much do you spend per month in transportation? (Gasoline, oil changes, Uber, etc.)
In order to protect an on-street vehicle (such as a car, truck, street motorcycle, or motorhome) in bankruptcy it must be registered, insured, street legal, current on any required emissions testing, and currently operational. Do all of your on-street vehicles qualify?
Yes
No
Not sure
Not applicable
Would you like to get rid of any of the vehicles you currently own in your bankruptcy? If so, list the vehicles that you want to surrender.
Have you ever been on the title of ANYONE ELSE'S property (added to the title of someone else's car, home, trailer, etc.), whether or not you think you are currently on the title. If so, please describe.
In the last four years, have you done any of the following with respect to your vehicle(s)? (check all that apply)
Purchased a vehicle on credit
Purchased a vehicle outright
Refinanced a vehicle
Put a title loan on a vehicle
Used a vehicle as collateral in any other way
Added someone's else's name to the title of a vehicle you own
Had your name added to someone else's vehicle
Totaled a vehicle
Scraped a vehicle or signed it over to an insurance company
Given a vehicle away or donated a vehicle
Purchased or co-signed a vehicle for someone else
Had someone take over or pay off a vehicle loan for you
Sold a vehicle
Had a vehicle repossessed
Made payments on a vehicle that you don't own
Other
Back
Next
Other than real estate or vehicles, do you have any other secured property (that is, property that could be repossessed if you stopped making payments)? Examples often include furniture, heat pumps, Kirby vacuums, etc.
Yes
No
Not sure
If yes, please list what that property is, how much is owed, and its approximate value
Would you like to keep this additional security property (other than houses/cars)?
Yes
No
Not sure
Not applicable
Do you owe secured debts to the same financial institution where you owe unsecured debts? (For example, have a car loan and a credit card with the same bank or similar circumstance.)
Yes
No
Not sure
Do you currently have any items in pawn?
Yes
No
Not sure
Back
Next
If you have a Health Savings Account or similar account, what is its current balance?
Are you the beneficiary of any trust?
Yes
No
Not sure
Do you think you might receive an inheritance or life insurance payment within the next year?
There is one in progress now
I think it is likely
Unlikely
Back
Next
Do you have any property (other than vehicles and real estate) worth more than $500? Examples might include jewelry, paintings, antiques, guns, collectibles, electronics, tools, animals, season tickets, patents, copyrights, trademarks, memberships, water rights, crops, business interests, etc. If yes, please describe and provide the approximate value
Do you own firearms? What type and what is its value?
Do you own jewelry? What type and what is its value?
Have you done any of the following with respect to any of your property within the last four years? (check all that apply)
Sold any of your property (garage sales, ebay, Craigslist, etc.)
Given away or gifted your property
Donated property to a charity or thrift store
Lost property to fire, flood, theft, etc.
Had someone pay off or take over a loan on any of your property
Signed over the title of property to anyone
Had property foreclosed or repossessed
Other
Do you own stocks, bonds, bitcoin or similar accounts, or other investments outside of a retirement account?
Yes
No
Not sure
Back
Next
Are you current on filing all your tax returns?
Yes
No
I don't have a tax filing requirement
Not sure
Have you filed your 2025 taxes?
Yes
No
Other
If applicable, what was your 2025 tax refund(s) amount?
Are expecting a refund when you file your 2026 taxes next year?
Yes
No
I don't have a tax filing requirement
Not sure
How did you spend your 2025 tax refund? If you paid any creditors or anyone you owed with that money, how much and when?
Back
Next
Do you think you will receive any payments of more than $500 in the next six months, outside your usual income (back pay, bonuses, inheritance, insurance payments, lawsuit money, debts owed to you, etc.)? If so, list the type of payment and approximate amount.
Are you expecting a commission or bonus? If so, how much and what from?
Are you expecting student loan disbursements made to you in the next six months?
Yes
No
Not sure
Have you done any of the following with your money within the last two years (check all that apply)
Given gifts of money (beyond small birthday/holiday-type amounts)
Donated money to charitable or religious organizations
Had money stolen from you
Loaned money to a business you are involved with, family, or friends
Other
Does any person or business owe you any money?
Yes
No
Not sure
Back
Next
Approximately how much cash do you have on hand?
List all the places where you bank and the approximate current balance (include online or app accounts, prepaid cards, credit unions, banks, etc.) This is not how much money you may owe to these banks, but how much money you have in these accounts.
Do you owe any money to your bank (personal lines of credit, overdrafts, credit cards, car loans, etc.)?
Yes
No
Not sure
If you owe money to a place where you also do your banking, what banks, and how much do you owe them?
What are the sources of deposits into your bank account (job, social security, retirement, etc.)?
Are any of the following additional people are on your bank account? (check all that apply)
Spouse
Unmarried partner
Children
Parents
None
Other
Are you on anyone else's bank account (on parent's account, child's, unmarried partner, etc.)
Yes
No
Not sure
Back
Next
In the last four years, have you lived with an unmarried partner who is not your current spouse?
Yes
No
Other
In the last four years, have you paid to have property that you do not own repaired, replaced, or improved?
Yes
No
Not sure
In the last four years, have you made payments on any debts that you do not owe?
Yes
No
Not sure
In the last four years have you paid educational expenses (such as college tuition) for an adult other than your spouse or yourself? This including payments related to your child's education if that child is over 18.
Yes
No
Not sure
In the last four years, have you made payments on property not titled in your name (for example, payments on houses, cars, or other property owned by your unmarried partner, child, family member, friend, etc.)
Yes
No
Not sure
In the last four years, have you paid anyone else's debt, bills, or expenses for them (other than those of spouse/minor children). This includes paying the debts, bills or regular expenses of unmarried partners, adult children, family, friends, or others
Yes
No
Not sure
In the last four years, have you given money to a family member or a friend, whether a gift, loan, or paying them back money you owed them? If so please describe.
Have you borrowed money from family or friends in the last four years?
Yes, within the last two years
Yes, between four and two years ago
No
Not sure
In the last four years, have you given property or signed over title of anything over to a family member or a friend, whether a gift, loan, or paying them back for something you owed them? If so please describe
If you have borrowed money from family or friends, how much have you borrowed?
If you have borrowed money from family or friends, how much have you repaid and when did you make those payments?
Other than payments on your house and car, have you paid any ONE creditor a total of more than $600 in the last 90 days (i.e., payments of $200 a month or more for the last three months or a large payment)? List the creditor(s) and how much paid.
In the last year, have you worked with any debt relief/debt consolidation service?
Yes
No
Not sure
Back
Next
What types of debt do you have? (check all that apply)
Secured debt (houses, cars, etc.)
Unsecured consumer debt (credit cards, personal loans, payday loans, medical bills, etc.)
Child support or alimony (monthly payments but not behind)
Child support or alimony (behind)
Tax debt
Criminal fines, fees, or restitution
Debts where someone might say that you were engaged in fraud (embezzlement, unemployment fraud, etc.), whether you think it is true or not
Debts where someone might say that you intentionally injured a person or damaged property, whether you think it is true or not
Debts you were ordered to pay in a divorce
Student loans
Debts related to a DUI or injuring someone while driving under the influence of alcohol or drugs
Debts to a utility company
Business debt
Other
Please check any of the following that apply regarding cosigned debts (not including debts you have with a spouse):
I am a cosigner on someone else's debt
Someone else is a cosigner on my debt
I have been making payments on a debt that someone else cosigned on for me
I have been making payments on a debt that I cosigned for someone else
Other
What is your approximate amount of secured debt (houses, cars, etc.)
What is your approximate amount of unsecured debt (medical bills, credit cards, student loans, etc.)
Do you have federal student loans or are a cosigner on federal student loans (if unsure, check your account at studentaid.gov)
If you have student loans, what is your approximate outstanding balance?
If you have student loans, did you graduate?
Yes
No
Still attending
If you have student loans, is your school now closed?
Yes
No
Not sure
If you have student loans, in what year did you last attend?
Year
If your spouse has student loans, what is their approximate outstanding balance?
If your spouse has student loans, did they graduate?
Yes
No
Still attending
If your spouse has student loans, is their school now closed?
Yes
No
Not sure
If your spouse has student loans, in what year did they last attend?
Year
Have you used any credit in the last six months? (credit cards, personal loans, payday loans, title loans, refinances, purchases on credit, purchase of a car or home, etc.)
Yes
No
Not sure
Have you made any credit card balance transfers in the last six months?
Yes
No
Not sure
How many creditors do you estimate that you owe money to?
1-49
50-99
100-199
More than 200
Back
Next
What is happening in your life that has you thinking about filing bankruptcy?
What debts are giving you the most trouble right now?
Were you confused about any of the questions asked of you, or need to provide any additional information you think we should know?
How did you hear about Dempsey Foster?
Internet search
Family member/friend
Other attorney
Other
Have you already called us to schedule your free consultation?
Yes
No, please contact me by phone call (with voicemail and text if I can't answer)
No, please contact me by text
No, please contact me by email
Submit
Should be Empty: