PROVIDE CONFIDENTIAL INFORMATION
 
    Please Find Information Here Regarding My Bankruptcy                
Bankruptcy Information

The information required below is necessary for filing a Bankruptcy. Please be as concise as possible and try to have it submitted prior to your first regular scheduled appointment. Should you wish not to send this information via the internet, print this form, complete it and ensure that all of the information is available and present it to your attorney at the time of your first appointment. If you are unsure about an answer, leave it blank.

Your Full Legal Name:

How do you sign your name:

Home Phone:

Work Phone:

Have you lived in Nebraska for 180 days?
Yes      No
Are you Currently a Client?
Yes      No
Do you have an attorney?
Yes      No
How did you happen to call us?
Type of Bankruptcy (Debtor)::
Individual: Single Married
Joint
Corporate: Private Public
Partnership, Stockbroker
Other
Nature of Debts:
Consumer Business
Chapter/Section: :

7 11 12 13

Funds will be available for unsecured creditors?
State:
 ZIP Code:
Email Address:
List all other names you may have used in the past six months:

Your Social Security Number:

Taxpayer Identification Number:

Your Street Address:

Your Mailing Address:

Your County Of Residence:

Your City Of Residence:

Prior Bankruptcies
Location of filing:

Case Number:

Date Filed:

Pending Bankruptcy (filed by any spouse, partner, or affiliate)
Debtor Name:

Case Number:

Date Filed:

District:

Relationship:

Judge:

Notes
Spouse (If a joint Filing Is Involved)
Your Full Legal Name:

How do you sign your name:

Home Phone:

Work Phone:

Have you lived in Nebraska for 180 days?
Yes      No
Are you Currently a Client?
Yes      No
Nature of Debts:
Consumer Business
Chapter/Section: :

7 11 12 13

Funds will be available for unsecured creditors?
State:
 ZIP Code:
Email Address:
List all other names you may have used in the past six months:

Your Social Security Number:

Taxpayer Identification Number:

Your Street Address:

Your Mailing Address:

Your County Of Residence:

Below is a list of information which you will need to bring with you for your first appointment:
Assets (Property You own. Include the type of property, real estate (real property) and other personal property
Description and location of Property (if real estate, provide the legal description
Indicate the type of ownership of property: Single Individual, Husband, Wife, Joint and Community
Indicate the market value of your property
If real estate, state your interest. If you still owe money on property, list to whom:
Executory Contracts - list names and addresses of those you have such contract with.
Your Contact, their phone number and the description of the contract.
For each contract, indicate what your intent is - to assume it or to reject in in the bankruptcy.
Family Information: (For both debtor and spouse if joint filing)
Current marital status; Dependents and their names, ages and relationship to you
Employment - occupation, employer, length of employment and address of the employer
How you are paid - weekly, bi-weekly, semi-monthly or monthly. Provide your gross earnings, and overtime
Bring copies of your pay stubs, pay checks and last years income tax records
All other income including income from a business, from real property, interest and dividends, alimony, maintenance or support payments. Include Social Security or other government assistance, pension or retirement income and all other monthly income you receive.
Expenditures, including rent, taxes, insurance, utilities, home maintenance, food, clothing, laundry and cleaning, medical and dental expense, transportation (not including care payments), recreation - entertainment, charitable contributions, insurance, taxes (those not deducted from wages or included in home mortgage payments), installment payments, alimony, maintenance, support paid to others, payments for support of dependents not living at home and regular expenses from operating a business, profession or farm.
Do you wish to have an attorney call?
Yes      No
Please indicate any other information you wish the attorney to be aware of:
 

Simply by providing formation or scheduling an appointment does not imply an attorney-client relationship between you and/or the Law firm. If you do not live in, have interests in or have an issue involving a matter located within the State of Nebraska, the firm may not be able to assist you and you are encouraged to contact your local Bar Association. Click HERE to review the firm's Disclaimer and Liability Information. Please NOTE: We will not provide legal information or advice over the phone!

 
 
   © Copyright 2003 Patricia Geringer. All Rights Reserved.