Bankruptcy Initial Consultation Form

This is the form we like filled out before your first appointment to discuss debt and bankruptcy options. It takes about 15 minutes to complete and doesn’t need to be exact – while it’s helpful if you can verify balances and values, it’s OK to just fill it out with information to the best of your knowledge, off the top of your head. If you have not scheduled an appointment, you may fill this out, and either schedule an appointment online or call us to schedule, or we can call you. Even if you don’t want to file bankruptcy, this information is helpful in analyzing your options.

Please fill in the information regarding your spouse if you live together, even if your spouse will not be filing. If both spouses will be filing, then both spouses will be our client.

(New)Bankruptcy Initial Consultation Form

Basic Information

Contact Information

Employment Information

Other Sources of Income

In the last six months, including part-time job, 401(k) withdrawals, Child support, unemployment, worker’s comp, maintenance

Household Members

Do you have minor children that live primarily outside the home?


What is the approximate total amount of your unsecured debts and what kind of debts do you have. (Secured debts are listed below)

Real Estate Property / Timeshares

If you have additional parcels, please email us similar information for other properties.


Other Titled Assets

Do you have any other liquid assets, retirement accounts, stocks, bonds, money in the bank
(including joint accounts with other people), 401(k)/IRA, cryptocurrency, etc.

if you have more than 3 401k accounts, you can just put in totals, or email us separately
if you have more than 2 IRA accounts, you can just put in totals, or email us separately
Investment accounts/stocks not held in a retirement account, cryptocurrency, etc.

Bank Accounts

Other debit accounts, such as loaded payroll cards, Venmo, Square, etc.,


(Note – if your tax refunds get direct deposited into a bank account where you owe $$ to the bank and are not current, they can take it)