Client Intake Form




Debtor's Basic Information

If yes what chapter and date filed?

Co-Debtor's/Non-Filings Spouse's Information

Current Monthly Income

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Mortgages:

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You can find out the value of your home here zillow.com and/or redfin.com
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If your current on this mortgage type in $0.00
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If your current on this mortgage type in $0.00
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If your current on this mortgage type in $0.00

Vehicles/ Motorcycles/ Boats etc.:

1 Click to get value here kbb.com and/or nada.com
(Examples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle accessories)
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Other Secured Loans:

Example: A Secured Debt, is when you take out a loan on a specific item that can be taken back if you default on payments like a car, boat, or house. List all items that you have as secure debt(s).
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Back taxes owed

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Other Debts

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Submit