Bankruptcy Intake Form
Badillo Law Group, P.C.
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Email *
How did you hear about us?                                     ¿Cómo se enteró de nuestra oficina? *
First Name/Nombre *
Middle name/initial
Last name/Apellido *
Phone number/telefono *
Full address with city/direccion completa con ciudad                 ex: 1234 S. Main Street, Chicago, IL 60609 *
Previous address (including city) /Direccion anterior (incluyendo ciudad)
Marital Status/estado civil
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If married, will your spouse will bankruptcy too?/Su esposo/esposa tambien va a declarar bancarrota?
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Date of birth/fecha de nacimiento *
Social Security Number/Seguro Social ,                format: 311-22-3344
Driver's License Number/Numero de licensia de manejar,                                                                                     example: B321-1234-5678
Are you working now? Esta trabajando ahora? *
Employer name/Nombre de empleador
Pay frequency/frequencia de pago
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Apx. gross pay per pay frequency/ingresos brutos cada cheque
Net or take home pay per pay frequency/ingresos netos cada cheque
Number of years at job/Numero de años en su trabajo
Other income and amount such as part time income/otro ingresos por mes?
Does your spouse work? Trabaja su pareja?
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Total monthly income for spouse/Ingreso mensual para esposo/esposa
Name of previous employer(s)/Nombre de empleador anterior
Have you filed bankruptcy before?/Se ha declarado en quiebra antes? *
Chapter of Bankruptcy you need to file/Tipo de bancarrato que necesita
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Do you have children under age 21?/Hijos menores de 21 años?
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Number of children under 21/Cuantos niños tiene menores de 21 años?
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How many of your children live at home with you?Cuantos niños viven en su casa?
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Do you pay child support?/Paga manutencia de hijos?
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If you pay child support how much do you pay per month/Cuanto paga por mes de manutencia?
Do you own real estate?/Es dueño de propiedades? *
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