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Bankruptcy Information Form

In order to assist us in arriving at a solution to your debt problems, please complete the following new client information form. Our bankruptcy practice is made up of experienced team members who look forward to helping you solve your financial situation. Approximate numbers are fine – Just give your best estimates on all information.

Step 1 of 8

12%
  • DEBTOR (Husband, if married)

    • MM slash DD slash YYYY
  • CO-DEBTOR (Wife, if married)

    • MM slash DD slash YYYY
  • CONTACT INFORMATION

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  • RESIDENCE / REAL ESTATE

  • HOMESTEAD

    If you own your home, and it has debt such as mortgage loans, home equity loan, home equity line of credit, homeowner’s association dues or assessments, property taxes or IRS liens please provide the following information:
    Save and Continue Later
    • VEHICLES

      • MM slash DD slash YYYY
      • MM slash DD slash YYYY
      • MM slash DD slash YYYY
    • RECREATIONAL VEHICLES

    Save and Continue Later
    • RETIREMENT ACCOUNTS

    • OTHER ASSETS

      • MM slash DD slash YYYY
      • MM slash DD slash YYYY
    Save and Continue Later
    • DEBT

      Please provide estimates of your debt for each of the below categories. You will be asked to provide more information after your initial consultation; therefore, it is understood that the figures you provide today may change prior to completing your legal documents.
      • MM slash DD slash YYYY
      • MM slash DD slash YYYY
    Save and Continue Later
    • INCOME

      • Debtor - Current Employment

      • Debtor - Additional Employment

      • Co-Debtor - Current Employment

      • Co-Debtor - Additional Employment

    • BANKING INFORMATION

      • Debtor Only Accounts

        Accounts ONLY in Debtor's Name
      • Co-Debtor Only Accounts

        Accounts ONLY in Co-Debtor's Name
      • Joint Accounts

        Accounts owned jointly by Debtor and Co-Debtor
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    • EXPENSES

    • Dependent Children

      Name and ages of dependent child(ren) and other dependents you can claim on tax returns
    • Monthly Expenses

    • (Gas, public transit)
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    • DOCUMENTS

      Please upload any documents you wish to share with us for your appointment. This can include paystubs (helpful), foreclosure notices, lawsuits, judgments etc)
      • Max. file size: 50 MB.
      • Max. file size: 50 MB.
      • Max. file size: 50 MB.
      • Max. file size: 50 MB.
    • THANK YOU!

      Thank you for taking the time to complete this questionnaire. This will allow us to give you more accurate and helpful guidance and analysis of your options.
    • This field is for validation purposes and should be left unchanged.
    Save and Continue Later
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    Dallas & Plano Office

    10670 N Central Expwy
    Suite 320
    Dallas, TX 75231

    +1 469 232 3328

    Fort Worth Office

    5601 Bridge St
    Suite 400
    Fort Worth, TX 76112

    +1 817 426 3328

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    • Call the Dallas Office: (469) 214-6276
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    Free Case Evaluation

    • Call the Dallas Office: (469) 214-6276
      or Fort Worth Office: (817) 426-3328
    • This field is for validation purposes and should be left unchanged.

    Your privacy is important to us. We’ll never share your information.