Interactive Form

1

Which One of These Best Describe Your Issue?* This field is required.

Credit Card Debt

Mortgage Loans / Foreclosure

Personal Loans

Medical Bills

Wage Garnishments

Collection Calls

Car Repossession

Other/Judgments

2

Judgments* This field is required.Please Explain.

3

Are There Any Significant Assets You Would Like to Retain? * This field is required.Ex: House, Car, Boat, etc.

YESNO

4

Do you wish to retain your car or any other significant assets such as a house? * This field is required.Ex: House, boat, etc. *Bankruptcy may help get your repossessed car back.*

YESNO

5

*Secured/Unsecured Pass1/Fail0

6

Do you wish to retain your home? * This field is required.

YESNO

7

Are you behind on your Mortgage Payments?

YESNO

8

Please Enter your Amount in Assets* This field is required.

House Value (Enter "0" if none)

Estimated car value (Enter "0" if none)

Please Enter the total value of any Other Significant Assets (Enter "0" if none)

9

Secured / Unsecured Debt * This field is required.Secured Debt: Mortgage Loans, Car Loans, and any other loans secured by collateral such as Personal Property Unsecured Debt: Student Loans, Credit Card Debt, Tax Debt, Any Loans not Secured by Collateral, exclude the portion of debt that has already been paid. (If you don't know the exact numbers, please enter a best estimate)

Please Enter Total Secured Debt (Enter "0" if none)

Please Enter Total Unsecured Debt (Enter "0" if none)

10

Household Size & Household Income* This field is required.

How many people currently reside in your house? (Including yourself.)

What is the total yearly household income?

11

* Secured / Unsecured Debt* This field is required.Secured Debt: Mortgage Loans, Car Loans, and any other loans secured by collateral such as Personal Property Unsecured Debt: Student Loans, Credit Card Debt, Any Loans not Secured by Collateral, exclude the portion of debt that has already been paid. (If you don't know the exact numbers, please enter a best estimate) *

Please enter total Secured Debt (Enter "0" if none)

Please enter total Unsecured Debt (Enter "0" if none)

12

Are you behind on your Car Payments?

YESNO

13

14

Asset to Debt Ratio

15

Full Name* This field is required.Almost there. Tell us a little bit about yourself!

First Name

Last Name

16

First NameHidden First Name Field

17

Last NameHidden Last Name Field

18

Phone Number* This field is required.One of our helpful attorneys can reach out to you for a free consultation. Please provide the best phone number to reach you.

Your information will be kept confidential.

19

(Secured Debt)

20

(Unsecured Debt)

21

(House Value)

22

(Car Value)

23

(Value/Other Assets)

24

All set. Enter your email to access the result of your evaluation!* This field is required.By submitting this form, you agree to receive emails from our firm. The results of this form are for informational purposes only. It does not constitute legal advice, and should not be construed as such. Contact an attorney in our offices to explore what the best options for your unique case are.

25

Email

example@example.com