Free Bankruptcy Evaluation

Free Bankruptcy Evaluation Form

If you are in need of serious financial help then submit the requested information below.  We will review it and get back to you quickly with your personal evaluation.  You can always call for a complimentary in-house evaluation as well 440-964-3311.  We are a debt relief agency. We help people obtain debt relief using the Bankruptcy Code.

(*) are required

    * Your Name:

    * Address:

    * City, State, Zip:

    * Telephone:

    * Your Email:

    Debt Information...
    Credit Cards, Medical Bills, Personal Loans, etc.
    Just list totals per category. No need to list individual creditor names.

    Automobile #1...
    Year, Make, Model, Balanced Owed, Value, Monthly Payment.
    Are Payments Current?

    Automobile #2...
    Year, Make, Model, Balanced Owed, Value, Monthly Payment.
    Are Payments Current?

    Automobile #3...
    Year, Make, Model, Balanced Owed, Value, Monthly Payment.
    Are Payments Current?

    Real Estate...
    For each parcel owned please list the following:
    Value of Real Estate, Mortgage Balances(s), Monthly Payment Amount(s).
    Are you behind on payments? If so, how many?

    Other Assets...
    Please provide a description of each asset and its approximate value.

    Net Income #1...
    Your net income after tax and pay frequency. i.e. weekly, bi-monthly

    Net Income #2...
    Your net income after tax and pay frequency. i.e. weekly, bi-monthly

    Additional Information...
    Please provide any comments or information you feel is important.



    I know this matter is important to you. Once I review your information
    I will get back to you quickly with your complimentary evaluation.

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    NOTE: The use of this website does not establish a attorney-client relationship.
    Do not send messages containing confidential information such as
    creditor account numbers or your social security number.

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