Full Name*
Email*
Phone*
Best time to call*
Phone anytime Phone before 10 am Phone after 10 am Phone after 2 pm Phone after 5 pm Phone Saturday
How long have you lived in Nevada?*
Less than 3 months Less than 2 years Less than 3 1/2 years More than 3 1/2 years
If in Nevada less than 2 years, what state did you live in before?
What is the main reason you are considering Bankruptcy?*
Foreclosure is Pending Wages are being Garnished Lawsuit is Pending Back Income Taxes Owed Creditor Harassment Large Amount of Debt Other – Please Explain
If other please explain
How many people are in your household (include yourself)?*
What is your gross (before taxes are taken out) yearly income?*
Under $45,000 Under $55,000 Under $60,000 Under $65,000 Under $70,000 Over $70,000
If married, what is your spouse's gross yearly income?*
Separated or not married Under $45,000 Over $45,000
If married, what is your combined gross yearly income?*
Separated or not married Under $55,000 Under $60,000 Under $65,000 Under $70,000 Over $70,000
How much do you owe for credit cards medical bills and other debt not tied to property being financed?*
Under $15,000 Under $25,000 Under $50,000 Under $100,000 Over $100,000
How much of the above debt is for student loans income taxes or child support?*
If you are behind on your home mortgage can you afford to (or do you want to) resume the monthly payments and try to make up the back payments?
How much is your first mortgage payment?*
(If you are not a homeowner, answer $0)
How much is your second mortgage payment?*
(If you are not a homeowner, answer $0)
What is the total pay off amount for all your vehicle*
(If you do not owe any money for a vehicle loan, answer $0)
Are you self employed?*
Questions and Comments
