Thinking About Bankruptcy?

Why are you considering bankruptcy? (select all that apply)
   
Garnishment Illness/Disability
Creditor Harassment License Suspension
Repossession Divorce
Foreclosure Loss of Income
Lawsuits Other
 
Estimate Your Total Debt:$
 
What bills do you have? (select all that apply)
   
Credit Cards/Store Cards Income Taxes
Personal Loans PayDay Loans
Child Support Medical Bills
Student Loans Other
Auto Loans    
 
Estimate Total Monthly Expenses:$
 
Do you own real estate? Yes No
If yes, are you behind in these payments? Yes No
 
Do you own an automobile? Yes No
If yes, are you behind in these payments? Yes No
 
Do you have any additional assets worth more than $1,000.00? Yes No
 
What types of income do you have? (select all that apply)
 
Employed (full-time) Child Support/Maintenance
Employed (part-time) Other
Social Security Benefits No Income
Pension/Retirement    
 
First Name* Last Name*
Home Phone* Work Phone
-       -       - -
Cell Phone Email*
- -
Address Zip Code*
Type the answer: What is this?