• HOUSEHOLD INFORMATION SECTION

  • Have you lived in CA for the last 2 years?*
  • Have you ever filed Bankruptcy?*
  • Are you currently married? (Choose "YES" even if you are separated but still legally married)*
  • Are you currently legally separated?*
  • Is your Spouse planning on filing Bankruptcy/Debt Relief with you?*
  • Is your Spouse's Address the same as your address listed Above?*
  • Does your Spouse have any Dependents IN ADDITION to the ones you listed above?*
  • Has your Spouse lived in CA for the last two years*
  • Has your Spouse ever filed Bankruptcy?*
  • DEBT ANALYSIS SECTION
  • Your Debt(s) 
  • Please Check ALL the types of Debt you currently owe:*
  • Did you file your tax returns ON TIME for the years you owe?*
  • Did you file an Offer In Compromise for any of your TAX DEBT?*
  • Please select the type of debt(s) you Owe or Pay:*
  • Do you have any Co-Signers on any of your debt accounts?*
  • If "YES" who are your Co-Signers?*
  • If "YES" who are your Co-Signers?*
  • Your Spouse's Debt(s)
  • Does your Spouse owe any Debt you have NOT already listed above?*
  • Please Check ALL the types of Debt your Spouse currently owes (not included in your debts above):*
  • Did your Spouse file their tax returns ON TIME for the years they OWE Tax Debt?*
  • Did your Spouse file an Offer In Compromise for any of their TAX DEBT?*
  • Please select the type of debt(s) your Spouse owes or Pays:*
  • Does your Spouse have any other Co-Signers on any of his/her own debts?*
  • If "YES" who are your Spouse's Co-Signers?*
  • INCOME ANALYSIS SECTION
  •  Given the many variables surrounding debt resolution and bankruptcy, it's important you do your best to think about any and ALL sources of income received, even if you received income only once or occasionally.  ** NOTE - Move your mouse cursor over a question for definitions and/or explanations.
  • Your Income
  • Are you currently employed?*
  • Were you employed and/or did you EARN any income in the last SIX months?*
  • Do you currently have, or did you have, a SECOND JOB in the last SIX months ?*
  • In the LAST SIX MONTHS , did you receive ANY of the following? (please check ALL that apply!)*
  • Your Spouse's Income
  • Is your Spouse currently employed?*
  • Was your Spouse employed and/or did they EARN any income in the last SIX months?*
  • Does your Spouse currently have, or did your Spouse have, a SECOND JOB in the Last 6 Months?*
  • In the LAST SIX MONTHS , did your Spouse receive ANY of the following: (please check ALL that apply!)*
  • MONTHLY EXPENSE SECTION
  • Given many expenses are not necessarily paid on a monthly basis, please be sure to think of all potential expenses (such as annual renewals like insurance renewals, car registration, etc.)  
     
    NOTE:
     
    * Please enter "0" if you don't pay a listed expense
     
    * You CAN include future expenses IF you will be paying these expenses in the
       following 6-12 months. * Move your mouse cursor over a question for definitions and/or explanations.  
  • MONTHLY Housing and Personal Expenses
  • MONTHLY EXPENSE SECTION (Continued)
  • Given many expenses are not necessarily paid on a monthly basis, please be sure to think of all potential expenses (such as annual renewals like insurance renewals, car registration, etc.)  
     
    NOTE: 
    * Please enter "0" if you don"t pay a listed expense.

    * You CAN include future expenses IF you will be paying these expenses in the
       following 6-12 months.

    * Move your mouse cursor over a question for definitions and/or explanations.
  • MONTHLY Vehicle and Debt Payment(s)
  • MONTHLY EXPENSE SECTION (Continued)
  • Given many expenses are not necessarily paid on a monthly basis, please be sure to think of all potential expenses (such as annual renewals like insurance renewals, car registration, etc.)
     
    NOTE: 
     
    * Please enter "0" if you don"t pay a listed expense.

    * You CAN include future expenses IF you will be paying these expenses in the
       following 6-12 months.
     
    * Move your mouse cursor over a question for definitions and/or explanations.
  • MONTHLY Insurance Expense(s)
  • MONTHLY EXPENSE SECTION (Continued)
  • Given many expenses are not necessarily paid on a monthly basis, please be sure to think of all potential expenses (such as annual renewals like insurance renewals, car registration, etc.)  
     
    NOTE: 
     
    * Please enter "0" if you don"t pay a listed expense.
     
    * You CAN include future expenses IF you will be paying these expenses in the
       following 6-12 months.
     
    * Move your mouse cursor over a question for definitions and/or explanations.
  • Other MONTHLY Expenses
  • ASSET/PROPERTY SECTION
  • To help ensure you get accurate debt resolution and bankruptcy advice, please be sure to list any and ALL assets which you currently own, are on title to, or have the possible right to own... even if such assets are intangible/non-physical assets (such as music royalties or patents).

    This INCLUDES Houses, Condos, or other real estate which you have a mortgage to!
  • ** NOTE - The following questions refer to BOTH you AND your Spouse, and includes ALL assets you both may own, whether otherwise considered Community or Separate Property. Please be sure list any and all property or assets which EITHER you or your Spouse may own. Failing to do so will prevent us from adequately advising you about your legal rights and MAY lead to the loss of your asset(s)!
  • Real Property
  • Do you own any Real Property (ie. Houses, Condos, Timeshares, Burial Plots, Mineral Rights in Land). Please list ANY & ALL property you are ON TITLE TO !*
  • Property #1 - Do you intend to KEEP or GIVE UP this property?*
  • Property #1 - Do you owe anything on this Property?*
  • Property #1 - Are you behind on your 1st Mortgage payments?*
  • Property #1 - Do you owe anything IN ADDITION to the 1st Mortgage? (ie. 2nd mortgage, Line of Credit, HELOC, etc...)*
  • Property #1 - Are you behind on your 2nd Mortgage / Line of Credit payments?*
  • Property #1 - Are you behind on any OTHER payments? (ie. HOA dues, Property Taxes, etc...)*
  • Do you own Additional Real Property? (ie. Houses, Condos, Timeshares, Burial Plots, Mineral Rights in Land). Please list ANY & ALL property you are ON TITLE TO !*
  • Property #2 - Do you intend to KEEP or GIVE UP this property?*
  • Property #2 - Do you owe anything on this Property?*
  • Property #2 - Are you behind on your 1st Mortgage payments?*
  • Property #2 - Do you owe anything IN ADDITION to the 1st Mortgage? (ie. 2nd mortgage, Line of Credit, HELOC, etc...)*
  • Property #2 - Are you behind on your 2nd Mortgage / Line of Credit payments?*
  • Property #2 - Are you behind on any OTHER payments? (ie. HOA dues, Property Taxes, etc...)*
  • Do you own Any More Real Property? (ie. Houses, Condos, Timeshares, Burial Plots, Mineral Rights in Land). Please list ANY & ALL property you are ON TITLE TO !*
  • Property #3 - Do you intend to KEEP or GIVE UP this property?*
  • Property #3 - Do you owe anything on this Property?*
  • Property #3 - Are you behind on your 1st Mortgage payments?*
  • Property #3 - Do you owe anything IN ADDITION to the 1st Mortgage? (ie. 2nd mortgage, Line of Credit, HELOC, etc...)*
  • Property #3 - Are you behind on your 2nd Mortgage / Line of Credit payments?*
  • Property #3 - Are you behind on any OTHER payments? (ie. HOA dues, Property Taxes, etc...)*
  • Do you own any OTHER Real Property? Please list any & ALL OTHER property you are ON TITLE TO!*
  • Personal Property
  • ** NOTE - The following questions refer to BOTH you AND your Spouse, and includes ALL assets you both may own, whether otherwise considered Community or Separate Property. Please be sure list any and all property or assets which EITHER you or your Spouse may own. Failing to do so will prevent us from adequately advising you about your legal rights and MAY lead to the loss of your asset(s)!
  • Do you currently, or will you shortly, hold a combined total of more than $10,000 in a NON-Retirement bank or investment account(s)?*
  • Do you own a Motor Vehicle? (ex. car, truck, motorcycle, etc...) . Please answer "YES" for any vehicle you are on the registration/title to (Answer "Yes" EVEN IF you are still making payments)*
  • Do you owe any money on this Motor Vehicle?*
  • Do you want to keep this vehicle or surrender to the lender?*
  • Do you own ANOTHER Motor Vehicle? (ex. car, truck, motorcycle, etc...). Please answer "YES" for any vehicle you are on the registration/title to (even if you are still making payments)*
  • Do you owe any money on Vehicle #2?*
  • Do you want to keep Vehicle #2 or surrender to the lender?*
  • Do you own an ADDITIONAL Vehicle? (ex. car, truck, motorcycle, ATV, Boat, Jet Ski, etc.). Please answer "YES" for any vehicle you are on the registration/title to (even if you are still making payments).*
  • Do you owe any money on Vehicle #3?*
  • Do you want to keep Vehicle #3 or surrender to the lender?*
  • Do you own ANY ANOTHER Vehicles? (ex. dirt bikes, ATVs, Boats, Jet Skis, etc...)*
  • Select any of the following which you currently own or have ownerships rights to (ie. future awards). ** Failure to list an asset, even one with no apparently value, may lead to loss of the forgotten asset.*
  • OTHER QUESTIONS
  • Are you currently making Unsecured Debt payments? (ie. Credit Card, Medical Bills, Collections, Student Loans, etc...)*
  • Have you made ANY Unsecured Debt payments in the last 90 days?*
  • Are you OR your Spouse currently making Unsecured Debt payments? (ie. Credit Card, Medical Bills, Collections, Student Loans, etc...)*
  • Have you, OR your Spouse, made ANY Unsecured Debt payments in the last 90 days?*
  • Have you made any Credit Card balance transfers or borrowed any Payday Loans in the last 6 months?*
  • Have you OR your Spouse made any Credit Card balance transfers or borrowed any Payday Loans in the last 6 months?*
  • Should be Empty: