What has caused you to think of bankruptcy? (check all that apply)
Accident or illness
Income is reduced
Garnishee of pay
Repossession
Mortgage foreclosed
Collection agencies harassing
Driving license suspended
Divorce or separation
Legal trouble
Other:
What debts do you have? (check all that apply)
Credit cards
Personal loans
Child or spousal support
Student loans
Car loan
Taxes
Payday loans
Mortgage
Other:
Approximate Total Debts:
Do you own any real estate?
Do you own any real estate? Yes No
If so, are your mortgage payments in arrears? Yes No
Do you own a car or truck? Yes No
If so, are your loan payments in arrears? Yes No
Do you have any other assets valued at over $1000? Yes No
If so, please describe them:
What kinds of income do you have? (check all that apply)
Full-time job
Part-time job
Retirement pension
Child or spousal support
Social Assistance or Welfare
None
Other:
Estimate Total Monthly Income: $
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