Texas Bankruptcy Form, Dallas & Ft Worth Bankruptcy Lawyers, Texas Bankruptcy Laws

Why Choose The Leinart Law Firm?

Marcus Leinart

Chapter 7 and 13 Debt Solutions

Business Bankruptcy

Foreclosure

Repossession

Wage Garnishments

Back Taxes

Stop Creditor Calls

Credit Counseling Not Working

Stop Credit Card Payments

Divorce and Bankruptcy

Frequently Asked Questions

Get A Copy Of Your Credit Report

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Bankruptcy Articles

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Appointment Request

Case Evaluator

Fill-out the following for your free and confidential online case evaluation.

How did you learn about the Leinart Law Firm:

Your Name:

E-mail:

Name of Spouse:

Address:

City:

State:

Zip Code:

County:

PHONE NUMBERS:

Home Phone: preferred number to reach you

Work Phone: preferred number to reach you

Cell Phone: preferred number to reach you

Spouse Cell Phone:

Other Phone Number:

Fax:

Have you ever filed a bankruptcy (Chapter 7 or Chapter 13)?
Yes No If YES, Date:

I. INCOME:

A. Occupation:

Employment:

What is your monthly income after taxes (take-home)?

What is your take-home pay each paycheck?

How often are you paid?

B. Spouse's Occupation:

Employment:

What is your monthly income after taxes (take-home)?

What is your take-home pay each paycheck?

How often are you paid?

C. Other Income (social security, child support, rent house, 2nd job, unemployment, etc.):

$per month Source

II. DEBT:

Please provide estimates of your debts for each of the categories listed below. You will be asked to provide more specific information after your initial consultation; therefore it is understood that the figures you provide today may change prior to completing your legal documents.

Credit Card Debt (total):		$
Date you last used any of your credit cards:
Medical Bills:		$
Repossession Debt:		$
Wage Garnishments:		$
Personal Loans:		$
Tax Debt:		$
Child Support Arrears:		$
Student Loans:		$
Judgments:		$
Returned Checks:		$
Cash Advances:		$
Other:		$
Other:		$

III. ASSETS:

A. Residence.

I Own I Rent Monthly rent payment $

If you own your home and it is encumbered by a mortgage(s),
please provide the following information:

$ 1^st Mortgage Balance

$ 1^st Mortgage Payment

Are you behind on payments? Yes No

$ Arrearage (Amount you owe for back payments)

Creditor

$ 2^nd Mortgage Balance

$ 2^nd Mortgage Payment

$ Arrearage (Amount you owe for back payments)

Creditor

Estimated Value of Your Home: $

Please list if you have any other properties such as
land, timeshares, rent houses, 2nd home, etc.

B. Vehicle.

Do you have a vehicle(s)? Yes No


1^ST VEHICLE		2^ND VEHICLE

Type:		Type:
Year:		Year:
Make:		Make:
Model:		Model:
Mileage:		Mileage:
Purchase Date:		Purchase Date:
Vehicle is paid in full and I own it		Vehicle is paid in full and I own it
I am financing my vehicle		I am financing my vehicle
Monthly Payments $		Monthly Payments $
Past Due Amount $		Past Due Amount $
Balance (Pay Off) $		Balance (Pay Off) $
Name of Creditor:		Name of Creditor:
I am leasing my vehicle		I am leasing my vehicle
Monthly Payments $		Monthly Payments $
Past Due Amount $		Past Due Amount $
Name of Creditor:		Name of Creditor:

Do you have any additional vehicles that you own free and clear or are financing? Yes No

If yes, please list:

Please list any other important information about your situation (houses, cars, boats, rent houses, timeshares, or other info):