Bankruptcy Questionnaire

CONFIDENTIAL BANKRUPTCY INFORMATION SHEET By filling out the information in the form below we can help you decide whether filing under U.S.Bankruptcy Law is the right course for you. Our Law Firm can also let you know approximately how much a bankruptcy will cost. This is not a complete interview by one of our Attorneys, and any recommendation is preliminary. We cannot make a recommendation for any Legal Services prior to meeting with you and discussing your matter in detail. All services are only provided in the areas we are licensed to Practice. Presently those areas cover Maryland, Virginia and The District of Columbia (Washington D.C.). We have Maryland offices in Frederick, Howard, Montgomery or Prince George’s Counties.

If you prefer, you may print this form as a PDF (here) and fax it to us at 301-942-8296

Your Name (required)
Your Email (required)
Phone Number (required)
Subject
Your Message
Best Time to Contact
Tell us about your debt

HOW MUCH TOTAL DEBT DO YOU HAVE IN THE FOLLOWING AREAS:

Credit Cards
Lawsuits
Foreclosure
Repossesion
Taxes
Student Loans
Medical Bills
Other Debt – Explain
Have you incurred any new
debt in the last 90 days?If so, what kind and how much?
What is your annual income?
What is your spouses annual income?

HOW MUCH TOTAL DEBT DO YOU HAVE IN THE FOLLOWING AREAS:

Mortgages on real estate
Are you behind on mortgage payments? If so, how many months and dollar amount?
Value of autos in your possession
Outstanding debt on autos above
Describe any valuable personal property, including jewelry, collectibles and antiques
House or other real estate current market value
Retirement accounts or Cash Value Insurance
Total cash in bank accounts
Total cash in stocks, bonds, etc.

Any special considerations or issues you are aware of to help us help you?

Bankruptcy Law