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Intake Form
New York City Bankruptcy Attorney | NYC Law Office of William Waldner
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Intake Form
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Full Name
First
Last
Email
*
Phone
*
Have you ever filed for bankruptcy before?
*
Yes
N0
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?
