How did you hear about us? Online advertisement. Google/online search A friend or family member referred me to you. Another attorney referred me to you. Lawyer Referral Service
Please Tell Us a Little About Yourself: Name*
First
Last
Are you married?* No Yes Divorced Separated
Do you have any dependents that live with you?* Include elderly family members.
Do you have anything you would like to tell me regarding your personal information that you have not already shared?
Please tell us about situations that might require our immediate attention. Please check all that apply.
Please tell us about this situation
Now let’s talk about your debts. Approximate total amount you owe on credit cards? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate total of all signature loans, lines of credit, and payday loans? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe on vehicle loans. $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe on real estate loans (mortgages, home equity loans)? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe on secured loans other than real estate or vehicle loans (for example, jewelry or furniture loans)? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in medical debt? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in student loans? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in fees, fines or restitution? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount of back child support or alimony? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in debt to family members? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in tax debt? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Approximate amount you owe in any other debts? $0 $1-$5,000 $5,000-$10,000 $11,000-$20,000 $21,000-$30,000 $31,000-$40,000 $41,000-$50,000 $51,000-$75,000 $76,000-$100,000 Greater than $100,000
Please list the type of debts (for example: rent, repossessions, business debt) and the approximate amount you owe. Do you have anything you would like to tell me regarding your debts that you have not already shared?
Now let’s talk about things you own: Do you or your spouse own any real estate? No Yes
This includes your residence, rental properties, timeshares, burial plots.
Please list the type of real estate, how much you owe on it (if anything), and its approximate value (best guess). If you own more than one property, please list each one.
Please list each one of your vehicles, how much you owe on it (if anything) and its approximate value.
Have you or your spouse owned any part of any business in the last three years? No Yes
Please tell me a little bit about them, including the approximate opening date and closing date (in any).
Do you have anything you would like to tell me regarding items you own that you have not already shared?
Let’s Talk About Income: Please provide your most recent pay stub, if available. In order for me to be able to provide you with the most helpful consultation I can, it is important that I have an accurate figure for your income. You can attach the pay stub here, to an email at martin@null hawaiidebtsolutions.com, or to a text to 468.7000.
Do you or your spouse contribute to a 401K or other retirement plan? Are you or your spouse paying back a 401K or other retirement plan loan? Do you have anything you would like to tell me about your income that you have not already shared?
Now let's talk about some of your monthly household expenses. Estimates are fine. Please list any other monthly expenses not already listed, for example: storage fees, gym memberships, timeshare payments. If you have more than one extra expense, just press the + button at the end of the line.
Do you have anything you would like to tell me about your expenses that you have not already shared?
A Few Final Matters Are you concerned about your credit rating? If you have ever been sued, please check off the type of lawsuit it was. Pick as many as necessary. Do you have a right to sue anyone? Have you ever filed for bankruptcy before (required)?* Have you transferred anything worth over $5,000 in the last 2 years (for example: cars, real estate, one time cash transfers)? Please list the items and the approximate amount, if anything, you received for each one. Are you an owner, beneficiary, or trustee of a trust? Finally, please tell me anything you feel would help me understand your situation.
We are a debt relief agency. We help people file for bankruptcy.