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Law Office of John M. Given - BK INTAKE
Bankruptcy Intake Form
Email address *
Today's Date
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Full Name *
Your answer
Spouses Name (if applicable)
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Address (Residence)
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How long have you lived in CA?
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Phone Number(s) *
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Is it okay to send text message to this number?
Marital Status
Do you have any Dependents? How many?
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Have you Filed Bankruptcy Before?
Your answer
What Type of Bankruptcy Do You think you want?
Are you Being Sued/Harassed
What Kind of Debt Do You Have? *
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John M. Given
How much Debt do you have?
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Do you Own Real Estate?
If you own Real Estate, what type(s)
Tell me about your car(s). (Year/Make/Model/Balance/Payment)
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What are your sources of income?
What is your Typical Gross monthly income?
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What are biggest monthly Expenses, and how much? (e.g., Rent, Car Payment, Food, Gas & Transportation, etc.)
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How did you hear about us?
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