Wittstruck Legal - Biographical Intake

Please complete the short biographical questionnaire below and forward it to us. We will use this data to create a temporary file to store future communications and notes. It helps to provide us with as much information as you can about why you are seeking a lawyer, what your situation is and how quickly you need action. And if you have a dispute with an individual or company, please provide us with the name of this person or entity. Upon receipt we will contact you to set up a time for a phone consultation which, depending on the legal action needed, may require payment of a consultation fee.

Personal Data

Gender * Salutation * Jr.

First Name * Middle Name Last Name *

Phone (day) * Phone (night) *

Street Address

Street Address 2

City * State * Zip *

Email * Email (again) *

How did you find us?

Spouse Data

(If not married leave this section blank)

Salutation

First Name Middle Name Last Name

Jr.

Employer Data

Employer Type of Work

Street Address

City * State * Zip *

Your Legal Issue

What is your legal issue? *

State the name of the person(s) or company with whom you have a legal dispute

Describe the facts of your legal issue and what you want to happen

Bankruptcy Questions

Do you own a house? Do you wish to keep your house?

How much equity do you have in your house?

Are you current with the mortgage payment on your house?

Do you own a car? Do you wish to keep your car?

How much equity do you have in your car?

Are you current with your car loan payment?

Have you ever filed for Chapter 7 bankruptcy relief before?

Have you ever filed for Chapter 13 bankruptcy relief before?

How much is your credit card/dept. store debt?

How much is your medical bill debt?

Have you obtained a copy of your credit history?

Which do you prefer for your first consultation?

Have you already been served with legal papers to collect a debt?

Do you understand that our base legal fee for either type of Bankruptcy relief is $850?

Do you understand that you are also responsible for the court filing fee of $300?

CREDIT HISTORY: Prior to your appointment please obtain your credit history. You can get a free copy of your credit history here. And be certain to retain the ability to access your credit history again for at least 30 days. Please save a copy of your credit history to your computer in PDF format and email this to us at 2772233@gmail.com. Other than your credit history, we will not need any additional paperwork at your appointment. We provide a worksheet for the listing of your debts and assets after your first appointment.

Biographical Bankruptcy Questionnaire

Personal Data

Spouse Data

Employer Data

Your Legal Issue

Bankruptcy Questions