Free Bankruptcy Case Evaluation

Please answer as many questions as you can

Full name:
Address:
City:
State:
Zipcode:
Telephone:
E-mail:
Best time to contact you
What type of bills do you have? (Check all that apply)	Medical Bills Judgments Student Loans Tax Debts Government Fines Personal Loans
Number of bills
Amount Owed:	Under $5,000 $5,000 - $10,000 $10,000 - $15,000 $15,000 - $20,000 $20,000 - $30,000 $30,000 - $40,000 $40,000 - $50,000 Over $50,000
Approximate value of home:	$
Approximate balance on mortgage:	$
Monthly mortgage payment:	$
Are you up to date on your mortage payments?	Yes No
Are there any other mortgages on this property?	Yes No
Vehicle 1 Year/Make/Model:
Approximate Value:	$
Approximate Balance:	$
Monthly Payment:	$
Are your payments up to date?	Yes No
Vehicle 2 Year/Make/Model:
Approximate Value:	$
Approximate Balance:	$
Monthly Payment:	$
Are your payments up to date?	Yes No
Enter any other property of significant value. (For example, if you own a boat, list it here.)
You Are you employed?	Yes No
How often do you get paid?	every week every 2 weeks twice a month monthly
Net Pay: (after taxes, medical adn other deductions)	$
What other types of income do you have? (Check all that apply)	Disability Social Security Pension Rental Property Part-time Job Child Support Unemployment Worker's Compensation
Spouse (optional) Are you employed?	Yes No
How often do you get paid?	every week every 2 weeks twice a month monthly
Net Pay: (after taxes, medical adn other deductions)	$
What other types of income do you have? (Check all that apply)	Disability Social Security Pension Rental Property Part-time Job Child Support Unemployment Worker's Compensation

We Are a Debt Relief Agency, We Help People File For Much Needed Relief Under The Bankruptcy Code.
One of St. Clair County, Macomb County, Wayne County and Oakland County, Michigan's Bankruptcy Attorneys
serving all Michigan counties ©
The Law Offices of Bowser and Associates The information on this website is for general information purposes only. Nothing on this or its associated pages, documents, comments, answers, emails, or other communications should be taken as legal advice for any individual case or situation. This information on this website is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship.