Online Data Entry

For your convenience, we offer secure online data entry for bankruptcy information, from the privacy of your own home. This is a free service, which greatly facilitates gathering the information we need to help you with bankruptcy. In fact, we offer a $100 discount for entering your information online. You may enter this before or after retaining us.

We’re confident you will find this method convenient and secure. Alternatively, if you would prefer, we can provide the printed form via Email or Postal mail. Just let us know!

Here’s how to get started:
1. Complete the form below by typing your full name, phone and email address.
2. Optionally, you may type additional comments.
3. Verify you have entered your information accurately.
4. Click the, “I’m not a robot” box to generate the CAPTCHA and type that code exactly as it appears. If you cannot read the CAPTCHA, simply click the refresh button to receive a new CAPTCHA.
5. Review the disclaimer and then click, “Submit”.


Please be advised this Web site has been prepared for general information purposes only. The information on this Web site is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Also, the law may vary from state to state, so that some information in this Web site may not be correct for your jurisdiction. Finally, the information contained in this Web site is not guaranteed to be up to date. Links to third-party web sites are provided for convenience and for general information purposes only. We do not have control over the content or privacy settings of sites linked to this site. Please refer to the owners privacy policies for more information on their specific policies. E-mails or online submissions to Timothy Casey Theisen, P.A. do not constitute a client-attorney relationship. Your information is nevertheless considered confidential and will not be shared with third parties. Timothy Casey Theisen, P.A. is not responsible for information provided by linked sites.