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Chapter 13 Bankruptcy New York
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Intake Form
New York City Bankruptcy Attorney | NYC Law Office of William Waldner
Intake Form
Click here to download the form
Or fill it below
Step
1
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3
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Name
*
First
Last
Email
*
Phone
*
Have you ever filed for bankruptcy before?
*
Yes
No
When?
Where do you live?
For how long?
What borough of NYC?
Are you single, married or divorced?
Single
Married
Divorced
Do you have any children?
*
Yes
No
Ages?
Are you suing anyone or thinking of suing anyone or suing anyone?
*
Yes
No
Do you have any life insurance policies?:
*
Yes
No
When is the last time you used a credit card?
Have you purchased any luxury goods or services in the last 90 days on a credit card? (this does not include goods or services necessary for the support or maintenance of yourself or your dependent(s))
*
Yes
No
When is the last time you took a cash advance out on a credit card or received a cash/payday loan?
Is anyone holding any valuables, cash or assets for you?
*
Yes
No
What is the most money you have had in any bank account in the last 2 years?
Do you have any retirement accounts?
*
Yes
No
If so, are they funded through your paycheck at work?
*
Yes
No
Have you ever owned any Real Property?(co-op, timeshare, house)
*
Yes
No
How Much is your rent/mortgage payment?
Do you live in a rent stabilized/controlled apartment?
*
Yes
No
Do you own, lease or finance a car?
*
Yes
No
Monthly Payment
Are you expecting a tax refund?
*
Yes
No
How much?
Have you received or expecting an inheritance?
*
Yes
No
When?
What other assets do you own?( boat, jewelry, stocks, guitar….):
Does anyone owe you money?
*
Yes
No
Have you given anything away of value in the last 6 years?(including gifts or sales/transfers of property to friends or family)? (car, cash, stock, house):
*
Yes
No
Where do you work?
For how long?
List your GROSS income per MONTH?
Per paycheck?
List your YEARLY GROSS income
How much are your yearly bonuses?
Does anyone else support you?
If you are married, where does your spouse work?
What is his/her GROSS income per month?
Have you ever owned a business (even part ownership)?
Do you owe any student loans?:
*
Yes
No
How much credit card debt do you have?:
What other debts do you have?
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